NYC Mayor Pushes to Hospitalize Those Experiencing Homelessness—Week of 12/5/22

Every week I will be reviewing a reputable news article and engaging with it from a mental health professional standpoint. These will be short posts following a three segment model: 1. The News=short synopsis of article 2. The View= My initial impression of the article, and the news impact in the mental health world 3. The Reflection= Useful ways to engage with this information/applications to caring for our mental health. These posts will be published 8am on Mondays!

The News: New York’s Mayor, Eric Adams, has decided to allocate resources towards assessing NY’s population experiencing homelessness for acute psychiatric care. 50 more psychiatric beds will be opened up, and he has stated that he is wanting these patients who get admitted to be held inpatient until ongoing care can be established. This move will include involuntarily hospitalizing people who are not posing a risk to others. This means police bringing in an individual for treatment against their will. In Virginia this is called an Emergency Custody Order (ECO). The individual is then evaluated in the Emergency Room and potentially placed on a Temporary Detention Order (TDO) where an individual is committed to the hospital for up to 1-5 days until a hearing can be held. He voiced that he wants compassionate care to be shown to the homeless who are admitted, but that they will bring in homeless against their will if assessed that their mental illness is of harm to themselves. Here is the article for reference.

The View: Addressing homelessness compassionately and competently is something many countries struggle to do. Data on homelessness has been impacted by the pandemic, but here is some data that has been consistent or most up to date in America. Over 500 thousand Americans are homeless. The state of NY accounts for almost ⅕ of this population. NYC alone accounts for approximately 50k of the homeless population. Native Americans and African Americans (demographic names used in the captured data) have higher rates of experiencing homelessness. Temporary Shelters only offer space to over 300K people on any given night in our country. The unsheltered homeless population had been trending down since 2007, but from the 2015-2020 there has been a surge that has almost eradicated progress since 2007.

The Reflection:

Addressing homelessness is a difficult task, but research has consistently shown that housing first with wraparound services is the most effective. Approximately 25% to ⅓ of the homeless population experiences severe mental illness. We know that the trauma of experiencing homelessness can exacerbate mental illness, but untangling correlation/causation is difficult. Involuntary commitment is inherently traumatic in that use of force is required, and autonomy (that was already in short supply given the experience of homelessness) is further stripped away.

So here are some things that should concern us as a community. If we just prioritize emergency mental health resources in opening up an insufficient number of psychiatry inpatient beds, we are not being good stewards of community resources. We are also not fully addressing the issue, and further traumatizing an already marginalized community. There is no mention of how resources might be allocated to outreach or comprehensive wrap around services (which would likely be significantly cheaper than inpatient hospital stays.) Lastly, it is completely unethical to hold an individual on TDO, who has regained capacity, against their will…even if it is in the name of finding a better discharge plan.

Dehumanizing people experiencing homelessness contributes to our society feeling more cruel and unjust. Witnessing others experiencing injustice and harm impacts our own mental health, as well, as we feel more helpless and hopeless in tending to others. Here is a great post capturing how we need to find movement as a community to address these injustices and find healing together.

Additional articles from which data was retrieved: 1. 2. 3. 4. 5.

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