As Albany lawmakers begin the 2024 legislative session, Mayor Eric Adams’ administration is again pitching changes to state law that would expand the definition of who could be involuntarily hospitalized for psychiatric illness.
Currently, only those who pose a threat of serious harm to themselves or others can be held without their consent. In pending legislation, involuntary hospitalization could apply to some people who can’t care for themselves.
Adams’ top advisor on mental health last week appeared before a committee of Manhattan Community Board 5, which covers an area of Manhattan that has long struggled with chronic street homelessness, asking members to write a letter in support of the bill, dubbed “The Supportive Interventions Act.”
The bill was introduced in the final days of the 2023 session by Assemblymember Edward Braunstein (D-Queens) with the support of City Hall. The bill still has no major advocacy groups behind it.
“We’re in the process now of building a coalition, an army of support of folks who care enough about the mentally ill that they want to see things change and get better and see this as a component of that,” Brian Stettin, senior advisor to Adams on matters of severe mental health, told CB 5 members virtually at hybrid meeting on Jan. 2.
The board represents much of central Midtown, including Times Square and Penn Station, where Adams has suggested removing people in emotional crisis as a solution to the area’s crime and homelessness issues.
At the meeting, Stettin hinted that state Sen. Jessica Scarcella-Spanton (D-Brooklyn/Staten Island) was potentially going to introduce the bill in the Senate, but they were dealing with a procedural snag. The senator’s office confirmed to THE CITY that she would, indeed, sponsor the bill.
Last year, Scarcella-Spanton and Braunstein sponsored a similar bill, aiming to broaden the scope of the mental hygiene law. But the bill failed to get out of committee.
Wrong Focus?
The board members weren’t immediately sold on the idea. Among the members present at the conference was Mary Brosnahan, who previously served as the longtime president of the Coalition for the Homeless. She asked Stettin why the city was looking to change the standards of the mental hygiene law, rather than focusing on the many people who would like to receive hospital treatment but can’t access it.
”What’s clear is that we have hundreds and hundreds of people who already meet the current standard and can’t get the help they need,” she said. “They’re begging to be admitted, but there’s no capacity. Why aren’t you focused on that?”
Stettin responded that not wanting help could be a function of mental illness itself: “I think what I take issue with is the notion that a person wanting the treatment in some way makes them more deserving of it.”
The Adams administration has called on state legislators for over a year to change the mental hygiene law so that involuntary hospitalization would be justified in circumstances that extend beyond the current standard of serious harm to oneself or others.
The Braunstein bill backed by City Hall would allow involuntary hospitalizations on the grounds of “substantial inability of the person to meet his or her basic need for food, clothing, shelter or medical care.”
The bill would also expand the pool of medical experts who can determine whether a person should be hospitalized, and it would expand the definition of serious harm to self or others to include psychiatric harm, as opposed to the current standard of physical harm.
Adams has argued that these changes are critical for his own policy to remove severely mentally ill people from the subway and streets, even if they’re not being violent.
Adams’ 2022 plan came in the heels of several high-profile deaths and attacks involving mentally ill individuals in subways. The mayor’s approach has been criticized by advocacy groups, including the NYCLU, for forcing people into treatment rather than providing more resources such as supportive housing.
The Adams administration’s efforts have yet to translate into strong political backing in Albany.
In November, Adams held a press conference to tout his plan on its anniversary, saying it had yielded results and called for state legislators to take up Braunstein’s bill this session.
“He will address this series of flaws and gaps in our New York State mental hygiene law that are making it more difficult to help those who don’t know they need help,” Adams said of the bill. “And it will further clarify the role city services in providing assistance with those who cannot take care of themselves.”
Stettin argued during the Jan. 2 Midtown board meeting in that, while the state mental hygiene law already allows for involuntary hospitalizations under circumstances that go beyond being suicidal or a medical emergency with a imminent threat of death, the statute must be made more explicit. He claimed nearly all other states in the country have language allowing involuntary hospitalization similar to what Adams is calling for.
“What it means to be a danger to oneself or others is really left under the eye of the beholder under New York law in a really unfortunate way and puts us in a very small minority of states,” Stettin said.
‘A Means to an End’
Braunstein told THE CITY in December that efforts to get buy-in from his office and the administration would pick up this month.
“The mayor’s office usually has a whole legislative agenda, and I’m hoping that they’ll include this as part of that agenda and push for the legislation,” he said.
While the mayor has emphasized the need for more flexibility for involuntary hospitalizations, others have pointed at the need for more support. A New York Times investigation of nearly a hundred attacks involving mentally ill people in the city found that most did not get adequate psychiatric services and that the relevant state and local agencies failed to properly communicate with each other.
At CB5 in Manhattan, members ultimately agreed that it would be best to decide whether to submit a letter of support or a resolution at a later time, with several members wanting to talk to other advocacy groups to hear the other perspectives before lending their support.
In a conversation with THE CITY after he appeared before the board, Stettin said he thinks people have the wrong idea about what the involuntary hospitalization changes are going to do.
“I think there is a notion out there really, unfortunately, that the idea of bringing people to the hospital is to simply get them off the street and warehouse them in a hospital — a return to the bad old days of the 1950s, where there were no investments in community care,” he said.
“That’s not what we want to go back to at all. Hospitalization is not the end in itself. It is a means to an end,” he added.