Mental Health
“For years, the social safety net intended to help homeless, mentally ill people… and keep them from unraveling violently . . . has failed in glaring and preventable ways. [C]ity and state agencies have repeated the same errors again and again, insulated from scrutiny by state laws that protect patient privacy but hide failings from public view.” — Amy Julia Harris and Jan Ransom, “Behind 94 Acts of Shocking Violence, Years of Glaring Mistakes,” New York Times, November 20, 2023
As Mayor, I will remove mentally ill people from the streets, subways and jails, placing them in treatment centers, where they will be evaluated, treated, and securely housed.
Every day, people suffering from severe mental illness are left on the streets and in the subways without care. The consequences were always predictable. Ramon Rivera stabbed three innocent people to death. Jordan Neely died when a bystander tried to bring him under control. These tragedies have been the subject of numerous articles, white papers, speeches, and pronouncements. All the spilled ink has not corrected the problems. New Yorkers are rightly scared. No one—not the mentally ill, their victims, or the public —is served by the status quo.
Career politicians have largely ignored this problem, despite intermittent tough talk.
The NYS Office of Mental Health made clear in 2022 that officials have the power to remove the mentally ill from the streets and subways.1 Instead, then-Gov. Cuomo reduced bedspace in psychiatric wards, limiting options for moving them from the streets into care.2 Both Gov. Kathy Hochul and Mayor Eric Adams promised to act with verve, but it was all talk.3 An innovative plan from Manhattan Borough President Mark Levine offers a partial solution but—for two years—legislators have ignored him.4
This is a humanitarian issue and a public safety issue. New Yorkers no longer feel safe in their own city. We need change. As Mayor, I will lead this change.
The Solution:
• First, we need to establish an intake area capable of housing 200 people in safe and humane conditions. There, individuals will undergo evaluation before being transferred to appropriate mental health facilities for long-term care, with new arrivals processed on a rolling basis.
• Second, we need contracts with facilities outside of New York City to house and treat the mentally ill.
• Third, we need to stop the revolving door, where mentally ill people are stabilized and released, only to descend again into crisis when they stop taking their medication. For this, we need to change the law, so that mentally ill people are released only if a mental-health expert certifies the person’s ability to meet their basic needs under an individualized mental-wellness plan with accountability.
• Fourth, we need to vastly expand recruiting of trained mental health professionals to help us get the job done.
• AND Fifth, we need to significantly increase reimbursement rates for hospitals so they have the funds to treat the mentally ill and create incentives to increase bed space here in New York City.
There are roughly 2,000 people on the streets with serious mental illness. More are in jail. An operation of this magnitude takes time. When elected, I would start this process with discipline and urgency. I would begin moving mentally ill people from the streets and into treatment within six months of my inauguration. At an average of four months for each placement, that means that I can complete this job in my first term.
Money exists to get the job done. In the past three years, the city budgeted roughly $1b on outreach and other programs for the mentally ill. Trying to tackle the problem through “counseling,” “outreach,” and “housing first” is virtue-signaling that doesn’t solve the problem. We need to use these funds to get homeless people with serious mental illness into long-term treatment. Officials in Albany and Washington can ensure the success of the plan, including by funding large portions of this. The good news is that both Governor Hochul and President
Trump previously committed to getting the job done.5 I will work with them to make sure we succeed.
This is my plan:
1. I will transform the City’s Intensive Mobile Treatment into a Task Force of mental-health workers, medics, crisis workers and enforcement personnel across the City.
2. We will have dozens of teams working daily across the city, taking mentally ill people off the street, one-by-one, and placing them in the Manhattan Psychiatric Center (MPC), which will start the 4-month clock to place them in long-term facilities.
3. We will also work with the District Attorneys to suspend pending criminal cases against the mentally ill, where appropriate, while we move them from jail into treatment. To do this, we will work with Albany to expand existing mental-health courts.
4. To pay for this, I will suspend ineffectual programs and divert existing funds and resources, while also seeking state and federal resources and funds.
5. The City Charter gives the Mayor the powers of a Magistrate. That power has never been tested. But I will use it to mandate these and other steps.
6. I will also have a legislative package for City Council and the Legislature in Albany to provide additional emergency powers. In the longer term, the City needs Albany to provide full funding for the MPC, so that profoundly mentally ill New Yorkers can get the care they need and deserve.
Conclusion
Getting mentally ill people into treatment is personal to me. My sister Debbie struggled with mental illness most of her life. She didn’t get the care she needed. She ended up in jail. When she was released, she got into an altercation with the wrong person. It cost her life. Today marks the 13th anniversary of her death.
This is about public safety. Having mentally ill on the streets and subways is terrible for New Yorkers. And warehousing them in jails is terrible policy, strains our already stressed prison system, and does nothing to treat the underlying problems. It is a crime that our elected officials let the crisis go along for so long already. People are victimized—and sometimes killed or severely injured. People avoid subways. Businesses suffer. The entire city feels the impact. Fixing this problem isn’t just the right thing to do—it is essential to restoring order and making New Yorkers feel safe.
New Yorkers deserve real leadership, not more excuses. We can fix this. We will fix this. And we will do it by putting people ahead of politics.
Jim Walden, Candidate for Mayor