Mayor Eric Adams' involuntary hospitalization policy criticized by City Council report

Few of those taken to a hospital involuntarily under New York City Mayor Eric Adams' policy aimed at helping people in the grips of a mental health crisis have access to long-term care, according to a City Council report.

The report, released Monday in response to a January report by the Adams administration on involuntary hospitalizations, questioned "the effectiveness of this practice in ensuring New Yorkers experiencing a mental health crisis are connected to treatment that provides them with stability."

Also in a statement, Councilmember Linda Lee, who chairs the Committee on Mental Health, Disabilities, and Addiction, said: "The Administration has continuously relied on involuntary removals as a catch-all solution without providing funding for the necessary treatment measures for people in need of long-term services."

Adams outlined in 2022 the process by which officials such as law enforcement and clinicians could involuntarily transfer people to hospitals as a way to confront the city’s mental health crisis, with particular emphasis on how it functioned in subways and other public spaces.   Although crime in almost all categories is trending downward, there have been high profile, outlier crimes, including slashings, subway pushings and other attacks, committed allegedly by people who were mentally disturbed.

On Monday, Adams defended his plan, saying homelessness and mental illness are intractable problems that long predate his mayoralty.

"So many who are critiquing what we're doing don't have the answers of how do you deal with a person who clearly is dealing with severe mental health illness and refuses care, refuses care," Adams said. "And so idealism collides with realism."

The council report notes that involuntary removals are more likely to happen in a private dwelling than in public transportation or any other public setting. For instance, from October to December, the number of involuntary transfers was 1,015 from a residence, 241 from a public space, 219 from public transportation and 369 from an unknown location, city data show. (Those numbers don’t include figures from involuntary transfers issued by a clinician.) 

Also, nearly 40% of people involuntarily taken at a physician’s request in 2024 to a facility within the city's public hospital system, NYC Health + Hospitals, did not receive in-person treatment. A person can be taken to an emergency room for up to 72 hours for psychiatric evaluation, according to Adams' report released Jan. 31. After that, a physician can find that the person meets the legal standard for voluntary or involuntary psychiatric treatment admission within a hospital.

Mental health advocates and the City Council have said they support several changes, including intensive mobile treatment to help those living on the streets.

"There’s no magic pill ... or magic button that can address issues of mental illness," said Matt Kudish, CEO of the National Alliance on Mental Illness of New York City.

He later added, "It really needs to be very individualized and person-centered. And what that requires is a continuum of care that includes housing and social work services and family support, and, you know, off ramps from the criminal legal system."

Sharon McLennon Wier, executive director at the Center for Independence of the Disabled, New York, said it’s important to remember that people who are experiencing mental illness are not monsters.

"We have to find a way to destigmatize mental health so that people will get the care that they need," she said.