Advocates Fear The Impact Of NYC’s Involuntary Hospitalization Plan

Disability and mental health experts told HuffPost that the plan echoes historical legislation that has left homeless and disabled communities isolated in the past.

New York City Mayor Eric Adams announced a plan last month to involuntarily hospitalize homeless people with mental illnesses, raising alarm for disability and mental health advocates.

Under the new policy, law enforcement, as well as medical workers, will be authorized to remove and involuntarily hospitalize any individual who “appears to be mentally ill” or “displays an inability to meet basic living needs,” even if they don’t appear to be a danger to themselves or others.

This would solve a “crisis we see all around,” Adams said at a press conference introducing the plan on Nov. 29, referring to homeless people with mental illnesses living on the streets.

But the new policy isn’t the safest solution for that population, according to disability activists and mental health experts who spoke to HuffPost. Many had major concerns surrounding the mayor’s plan and how it reflects historical legislation that has targeted and endangered homeless and disabled communities in the past.

The plan’s use of the word “involuntarily” raised immediate concern for activists.

While introducing the plan, Adams stated that the nature of people’s mental illnesses can prevent them from realizing they need intervention and support. But mental health activist Dior Vargas points out that this stance fails to value their autonomy.

“There may be circumstances where you may not necessarily know what’s best for you. But I think that having that person’s involvement [is important],” Vargas told HuffPost. “They know themselves better than anyone else … and having them involved in their treatment, I think it is more important because it’s something that’s empowering for people.”

Dr. Sharon McLennon-Wier, executive director of the Center for Independence of the Disabled, New York, said that people have the right to do what they want, which includes not seeking treatment if they don’t pose a threat to themselves or others.

“If they’re not necessarily causing any harm or harm to themselves, why should they be removed from a corner that they find to be their home?” McLennon-Wier asked.

Adams did not respond to HuffPost’s request for comment.

While Adams’ plan will have a direct and immediate negative impact on the homeless population, especially Black and Indigenous people of color, advocates also worry about how the language in the plan further perpetuates the stigma that all people experiencing homelessness have a mental illness.

According to McLennon-Wier, a person’s psychological diagnosis can’t be determined just by looking at them.

Statistics also disprove the assumption that all homeless people have a mental illness. The National Alliance of Mental Illness found that among the half a million unhoused people in the U.S., 20.8% of them have a serious mental illness.

Additionally, McLennon-Wier notes, in a society that has a substance abuse problem, intoxication could be mistaken for a psychotic episode.

“Because of that, we can’t say that everyone that’s living on the streets has mental [illnesses],” McLennon-Wier, who is a mental health provider, told HuffPost. “Substance abuse is more of a behavioral health disorder rather than a mental illness.”

Since the plan focuses on outside perceptions of someone’s mental state and their ability to take care of themselves, any unhoused person could be involuntarily hospitalized, even if they don’t actually have a mental illness.

The city announced the plan after numerous attacks on subways and streets, some involving homeless people, left residents scared. In October, Adams claimed that mental illnesses were the cause of these attacks. One incident in January involved a woman who died after a man with schizophrenia pushed her onto the subway tracks, The New York Times reported.

But people with psychiatric disabilities are more likely to be victims of a crime than perpetrators, said Vargas, drawing parallels to the way mental illness is often associated with violence in discussions about gun violence.

“I just feel like because of [this rhetoric and negative portrayals of mental illness], people don’t see them as human beings, and as people who deserve that understanding and support,” said Vargas.

“This isn’t a preventative measure; I think this is more reactionary, and one that is very politicized.”

- Mental health activist Dior Vargas

The Ugly Laws

Many disability advocates have drawn parallels between the New York plan and the historic “ugly laws” — a name disability advocates use to describe city ordinances introduced in the late 19th century that made it illegal for poor, disabled people to exist in public.

The laws came as a supplement to anti-begging and anti-vagrancy laws that were sweeping the nation at the time, said Susan Schweik, a retired professor and author of “The Ugly Laws: Disability in Public.”

The first “ugly law” was passed in San Francisco in 1867 and swept the nation throughout the rest of the century. The laws were based on appearance discrimination, saying that “no person who is diseased, maimed, or deformed, so as to be an unsightly or disgusting object shall expose himself to the public.”

The last known ugly-law-related arrest, in Omaha, Nebraska, in 1974, caught the attention of disability rights activists and organizations in the Midwest that spoke out against the discriminatory laws and organized to overturn them.

These laws are examples of “disability discrimination by the state,” combining “policing, surveillance, shutting in of disabled people, the systems of fear and disgust that could be mobilized against disabled people,” Schweik said.

The last ugly law wasn’t removed from the books until 1974 in Chicago.

Opponents of New York Mayor Eric Adam's plan to involuntarily send mentally ill homeless people to psychiatric hospitals rally at City Hall on Dec. 8, 2022, in New York City. The mayor's plan has been met with fierce opposition from civic groups, homeless advocates and some law enforcement.
Opponents of New York Mayor Eric Adam's plan to involuntarily send mentally ill homeless people to psychiatric hospitals rally at City Hall on Dec. 8, 2022, in New York City. The mayor's plan has been met with fierce opposition from civic groups, homeless advocates and some law enforcement.
Spencer Platt via Getty Images

While an ugly law couldn’t be passed in Congress today because of the Americans With Disabilities Act, Schweik says there are many current policies founded on the same anti-homelessness and ableism that underpinned those old laws.

Even without the laws, Schweik added, there are other dynamics at play that are designed to keep anyone deemed to have a “problem body or mind” out of public spaces.

Institutions for people with disabilities and mental illnesses, such as the Willowbrook State School in New York, also segregated these groups out of the larger community.

In the ’60s, disability activists fought for independent living freedoms, such as home- and community-based services, to ensure support for disabled people in their own communities. But barriers to public transportation, employment and other resources still exist, making it difficult for disabled people to fully integrate into society.

Fears Over Police Handling Social Work

Vargas said she worries about having the police carry out the mayor’s plan.

“Having police involved just makes me worried, given how they’re not properly trained to work with people from those communities,” she said. “The idea of [people with disabilities or mental illnesses] being taken and placed somewhere without their permission just was really upsetting.”

While city officials say that New York’s new policy seeks to connect people struggling with mental illnesses with the treatment and resources they need, activists are worried that, in practice, the plan will go the way of the previous ugly laws, which shut out and hid homeless people away from society.

“[The plan] just seems very related to other situations where people who were considered undesirable [would] be placed elsewhere away from the community, when really having those community resources are more helpful than anything,” Vargas said.

Advocates Want Community Investment

The city has a “moral obligation” to provide treatment and care to homeless people with mental illnesses, Adams said in the news conference. But advocates say his plan doesn’t work to address systemic issues like lack of affordable housing and employment for unhoused people.

“You want to be able to give them that support, but if you aren’t investing in other systems or programs that prevent them from getting to that spot, I think that’s where the money and the time should be invested in,” Vargas said. “This isn’t a preventative measure; I think this is more reactionary, and one that is very politicized.”

Vargas wants to see investments in communities and mental health care, as well as more empathy and compassion for the unhoused population.

Similarly, McLennon-Wier said she would like to see the mayor put his efforts toward addressing the housing, employment and health care inequities in New York.

In September 2022, 20,764 single adults were sleeping in New York shelters each night, according to the Coalition for the Homeless. Data shows that the number of vacant apartments in New York is notably higher than it was five years ago, with 4.54% of apartments vacant as of 2021, compared to 3.63% in 2017.

“Use the resources that you have to really address the homeless population, because people need housing, people need employment, people need comprehensive medical services or mental health services based on proper diagnosis,” she said.

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