Judy: The rise in homelessness
is a source of major tension
around the United States,
including in New York City,
which has a larger homeless
population than any other city
in the U.S.
This week, mayor Eric Adams
announced a new policy to try to
curb homelessness.
But as William brangham tells
us, it has also drawn criticism.
William: Judy, the new policy
gives police and other first
responders the authority to
forcibly hospitalize anyone
living on the streets who,
because of their mental illness,
are believed to be a danger to
themselves, not just a threat to
others.
Announcing the plan Tuesday,
mayor Adams said he wanted to
address what he called "A crisis
that we see all around us."
>> If severe mental illness is
causing someone to be
unsheltered and a danger to
themselves, we have a moral
obligation to help them get the
treatment and care they need.
William: The mayor said city
hospitals would also be required
to develop ongoing treatment
options for those admitted.
For more on the challenges and
questions surrounding this plan,
I'm joined by Sam tsemberis.
He's the founder of pathways to
housing, which is a national
homeless advocacy organization
that started in New York City.
You have helped struggling with
substance-abuse disorders to try
to help those people.
So from your perspective, what
do you make of the mayor's plan?
Sam: Thanks for having me on,
William.
It is good to be back with you.
The mayor's plan came as a bit
of a surprise to me.
A very disappointing surprise
because I have been working in
this field for a decade, as you
say, and another
well-intentioned mayor, almost
35 years ago in New York City,
had a similar -- had exactly the
same proposal to take people who
were apparently a danger to
themselves or gravely disabled
off the streets involuntarily.
Bring them to the hospital for
treatment.
And this was an idea of a
compassionate approach as mayor
Adams just said, a moral
obligation to do something about
homelessness.
Yes, we do have a moral
obligation to do something about
homelessness, but that something
has to be informed by evidence
and experience.
We already know that involuntary
treatment in a psychiatric
hospital is not a solution to
homelessness.
Housing is a solution to
homelessness and follow-up
mental health support services
are what helps people with
mental illness do better.
William: I want to ask you about
the coercive, involuntary nature
of this.
If you are asking police to take
people against their will, that
may be illegal and certainly
unethical.
Do you think it is humane and/or
effective depressed people who
might be resisting treatment
into treatment?
Sam: I don't think treatment
actually works in a coercive
manner.
It works much better when a
person is offered options.
When we started the housing
first program, it was exactly
after five years of this
coercive taking people to the
hospital, they stay a month and
discharged back to the street
with no housing, these repeated
failures led us to do something
different which is much more
effective.
We do need to intervene when
someone is actually a danger to
themselves, if they are coughing
up blood or wounds, there are
emergency situations, but we
already have mental health laws
that address these quite
adequately and they are often
enacted by a psychiatrist or
social worker or nurse.
Police officers are about
enforcement and public safety.
They are not clinicians.
It's really a questionable
practice to put that kind of
decision-making authority into
the hands of the police.
William: One of the problems, as
I think you know, is that new
York City has suffered several
terrible violent attacks by
people who are mentally ill and
living on the streets.
Again, we should caveat this by
saying mentally ill people are
much more likely to be the
victims of violence than the
perpetrators of it, but many
people argue that they feel
terrorized and the city has to
do something.
The remedies that you are
talking about have been
difficult to fund and implement.
If you were counseling the mayor
of New York City, any big city,
what would you be counseling
them to be doing?
Sam: I would be counseling them
to take an evidence-based
approach.
I think caution and public
safety are a huge issue.
They are random acts of violence
as you say so that's not really
a big problem or frequently
occurring problem.
We have people roaming the
streets that are clearly
disabled, clearly need
assistance, and clearly need
housing.
The focus has to be on
addressing the homelessness
first for all of our sakes, not
just for the folks who are
homeless, for all of our sakes.
We would have a safer,
healthier, better environment.
We did this during the height of
the pandemic before the vaccine.
We would put people into the
empty hotels.
We knew that a safe space is
exactly what people who are
homeless needed to stay safe,
keep the rest of us safe, and
people did much better.
Now that the emerging --
emergency funding is gone,
people are back on the street in
larger numbers than before.
We need to do an emergency
program but the emergency is
about homelessness, not about
mental illness.
Mental illness takes a wild
tequila.
Homelessness can be cured
immediately by the offer of an
affordable place to live and for
these people with severe mental
illness, robust follow-up
support services.
That is what the evidence shows
to be effective.
Judy: I guess we are going to
have to wait -- William: I guess
we are going to have to wait to
see.
There is reporting that that is
what is coming down the line in
New York City's plan which may
suffer quite a few legal