Mayor Eric Adams is fighting for his political life: Should he fend off loud calls for his resignation or removal, a tough reelection battle still awaits.
If he loses his job, though, it won’t be on account of mental health.
Adams’ push to amend state law on involuntary treatment of the severely mentally ill has brought welcome discipline to one of the city’s most notorious problems.
Recent polling data shows that voters back his policy.
Gov. Kathy Hochul, sensing that it’s good politics to be on the mayor’s side on at least this issue, has proposed loosening state law’s involuntary commitment standard.
But state legislators are balking.
To be mayor of New York is to rank as one of the most famous politicians in America, commanding a budget of over $100 billion and a workforce in the hundreds of thousands.
Yet any mayor remains handcuffed by the whims of obscure state senators and assembly members — many under the sway of upstate interest groups indifferent to problems of pressing concern to city residents, such as mental illness-related subway chaos.
Here’s the latest on Mayor Eric Adams
Hochul has been helpful on mental health, adding psych beds and funding to treat the seriously mentally ill.
What she has not been is strong.
She has shown scant ability to budge legislators from their belief that more money for voluntary community mental-health programs can fix everything.
The Legislature has no answers for how to help the people who aren’t seeking help, and who even turn it down when offered.
An estimated 900 severely mentally ill New Yorkers are living on NYC’s streets. About 7,000 others are in shelters and other temporary housing programs, and 1,400 are in the city jails.
Adams’ plan, with its practical focus on involuntary treatment, is best suited to the crisis at hand.
The mayor’s critics have tried to dismiss his approach to mental health as a former cop’s knee-jerk reaction to visible poverty. They are vested instead in what they see as the long-term solution: more housing.
Last year, according to the Mayor’s Management Report, city government added 3,000 units of supportive housing for the homeless — on top of New York’s vast universe of mainstream affordable-housing programs.
The mayor’s mental-health policy attends instead to the medium-term, the appropriate horizon for policymaking.
It’s a package of reforms known as the Supportive Interventions Act that would strengthen the rules surrounding hospitalization for the severely mentally ill, requiring, before discharge, more careful evaluation and eligibility for Kendra’s Law, New York’s highly effective outpatient commitment program.
Albany’s response to the bill has been tepid.
Hochul wants to change state law to make it easier to hospitalize the severely mentally ill if they are failing to meet their basic living needs — even if they’re not (yet) dangerous.
A Manhattan Institute poll last month found 61% of New York City likely voters support that idea.
But during a state budget hearing this month, some legislators objected, questioning whether New York’s hospitals could absorb a surge in new commitments.
The state is not contemplating a mass round-up of patients, Office of Mental Health Commissioner Dr. Ann Marie Sullivan responded, and the current system has sufficient slack to manage new cases.
Again, Hochul has already invested in hospitals, adding a few hundred inpatient beds for the mentally ill in recent years.
Adams’ current focus, rightly, is on making legal reforms to match that past investment.
Whatever may occur in Albany, at the city level, Adams can count on extensive support for his mental-health policies.
Other local Democrats have recently voiced strong support for expanding involuntary care, including Reps. Dan Goldman and Ritchie Torres. Conservatives, like GOP Rep. Nicole Malliotakis and Democratic City Councilmember Robert Holden, are certainly aligned with the mayor’s general approach.
But only the state Legislature can make the necessary changes to the law.
Adams has largely driven the increased focus on the seriously mentally ill. Ever since the killing of Michelle Go two weeks after his inauguration, the mayor has used his office’s vast media reach to spotlight pervasive government neglect of the hardest cases.
New Yorkers have never been renowned for their patience. But they have reached their breaking point over mental-health experts’ refusal to intervene with the severely mentally ill until tragedy strikes.
Reform-minded policymakers must keep pressing their advantage. Adams will do so as long as he is in office — but if he’s not, others will need to step up and fulfill the voters’ demands.
Gov. Hochul plainly cannot do it alone. The window for reform could be closing.
Stephen Eide is a senior fellow at the Manhattan Institute, a City Journal contributing editor and a 2024–25 Public Scholar at The City College of New York’s Moynihan Center.
