There has been a lot of debate recently about how to address the severe mental illness crisis playing out on our streets. I have always said New Yorkers need to be safe, but just as importantly, they need to feel safe.
And, while rare, we continue to experience unacceptable random attacks committed by people who desperately need help.
We have made real progress in not only getting more people the lasting help they need but also in changing the culture around the tools at our disposal, including involuntary commitments where appropriate. In my first year as mayor, I announced a major policy shift for the city that expanded our work to get people involuntary help.
At the time, it was portrayed as controversial, but I don’t believe that’s how common-sense New Yorkers ever felt. Indeed, 90% of those polled in a recent survey expressed support for expanding involuntary commitment.
Still, with an issue this emotional, there are bound to be misperceptions and disagreements. Here’s where I stand on the most frequent criticisms.
First, some people say the entire answer is to invest in a “continuum of care,” which supports patients at all levels along their journey to stability.
The needs are undeniable, but this is a false choice.
We can repair our broken system and bring people into it when they are unable to recognize their own illness. Our administration has been working diligently from day one to make these long-overdue investments. We have had back-to-back record-breaking years of producing affordable housing with 2,761 total units produced in 2024 alone.
We have expanded access to clubhouses, which offer a safe space to build community and stability. We have added intensive mobile treatment teams that deliver direct treatment and support to people wherever they are.
And, paired with a historic $650 million investment in tackling homelessness and severe mental illness, our “Bridge to Home” facilities will give patients a supportive, home-like environment after they discharge from the hospital so we can break the cycle of leaving a hospital to go right back on the street.
Second, some say that involuntary treatment is inhumane. On the contrary. I believe it is the compassionate and right thing to do when a clinical professional deems that a person’s mental illness is posing a threat to them or someone else.
There is nothing noble or respectful about allowing a person to live with the disastrous consequences of “choices” they did not make with a clear mind. Instead, we should help them regain control of their life. Transport to the hospital is only a first step on a long road of healing, but it’s one you simply cannot skip with someone in acute psychosis. Their most immediate need is medical care.
From there, amazing recoveries are possible, with hard work, resources and patience. This is our mission with each person we bring into care. The ultimate goal is community re-integration with permanent supportive housing. We don’t always succeed, but we continue to learn and identify ways to improve.
A third frequent misconception is that a person must be an “imminent” danger to justify action.
New York courts have long recognized that these laws can also be used in situations where untreated mental illness prevents a person from meeting their basic human needs, presenting a serious risk of harm over time.
Think of a person you have surely seen in a subway station or park, who wasn’t presenting an obvious emergency, but was clearly mentally unwell and in dire physical condition — swollen feet, clothing badly torn, smelling of urine.
In the past, if our outreach teams were unable to persuade that person to accept services, they would move on to someone else, believing they couldn’t help.
Today, our policy is to bring that person into care, even if necessary to do so involuntarily. The results we see every day confirm that this is the right path.
There is still more to be done. To end confusion, it should be made explicit that a person requires care when mental illness prevents them from meeting their basic needs of food, clothing, shelter, or medical attention.
We included this in a package of reforms we first proposed in 2022, and we are grateful that Governor Hochul is fighting for it in the current state budget negotiations.
This common-sense reform — already on the books in 48 other states — will affirm the importance of the work our administration has taken on.
To deny someone psychiatric care just because they can’t recognize their own need for it is unacceptable. It is punishing a person for a symptom of the illness itself.
And that is unacceptable in a city with a heart as big as New York’s.
Eric Adams is the mayor of New York City.
