NYC PUBLIC ADVOCATE QUESTIONS DETAILS OF CITY'S NEW MENTAL HEALTH POLICIES, PUSHES FOR SPECIFICS

 

Public Advocate Jumaane D. Williams continued to question the Adams administration’s new mental health initiative today, pushing for specifics after Tuesday’s announcement of a plan which includes involuntary hospitalization, among other strategies. In a letter to the administration, the Public Advocate questioned several elements of the proposal – including its intentions, implementation plan, and investment levels. 

“I know we agree on the need to address the mental health crisis in our city and related issues, I trust we also agree that we cannot treat mental health or homelessness as simply law enforcement issues…” wrote Public Advocate Williams. “There has been widespread and understandable confusion and alarm among New Yorkers in the wake of your announcement on November 29, including from people who may share a goal of treating the mental health crisis but believe that the proposed methods that had the most clarity do not meet the practical constraints or ethical guidelines for care and continuum of care we must set for the city.”

Earlier this month, the Public Advocate released a review of the city’s mental health response, updated from a previous report in 2019, and found that while the city had made some progress, in many areas it had remained stagnant or gone backward. He wrote yesterday of the mayor’s announcement that, “While some steps were alluded to in line with the report, much of your recent announcement seems to continue the City’s long standing pattern of police-first policies.”

The Public Advocate’s extensive questions include:

•   How will your administration allocate funding to these proposed initiatives and how much? What percentage of these funds would be allocated to the NYPD? What about EMS and mental health professionals?
•   Not all EMS are city employees. Is there an expectation that private hospitals will be incorporated in first-response?
•   There are currently no established guidelines regarding removals for mental health evaluations. How will police officers and EMS be trained on how to recognize people who would fall under involuntary removal given that it is deemed subjective?
•   Additionally, will this training have any overlap with already-existing crisis intervention training for the NYPD? 
•   How will the NYPD determine what protocols to change, including the training of officers?
•   What protections will individuals have against excessive force during involuntary removal?
•   Who will pay for the medical treatment of those placed on an involuntary hold? 
• Will the city cover all medical bills for those detained? 
• Will an individual’s health insurance (if they are insured) be billed for medical expenses?
• Is there an expectation that the individual detained will need to pay any related costs?
•   Are there protocols under DOHMH that would address a situation where the individual refuses treatment including medication whilst in the hospital?
•   Will the city expedite the scaling up of psychiatric beds when there is already a shortage of beds?
•    Where will the psychiatric beds be located? Are there priority locations throughout the city?
•   Is there an expectation that hospitals may need to make space for additional psychiatric beds and possibly modify space and beds for other medical services?
•   How will additional beds be funded? How many beds does the city project needing to add over the next fiscal year?
•   Regarding the continuum of care, will supportive housing become a priority in ensuring individuals do not end up on the street and without treatment? 
•   How will you ensure the housing system will have supportive infrastructure to keep individuals safe and sheltered?
•   What protections will EMS, NYPD, and health care providers have against lawsuits for false imprisonment?

He closed his questions reaffirming that “We both agree it is in our city’s best interest to address the ongoing mental health crisis and make it a major priority. In asking these questions I am hoping to continue collaboration and transparency so that all stakeholders understand what the steps and processes behind the city's mental health response look like.”

Download the Public Advocate's full letter to the administration here. Read his new review, Improving New York City’s Responses to Individuals in Mental Health Crisis: 2022, here.