Forced Treatment for Mental Illness Is No Treatment at All
Reading Time: 4 minutesNew York City Mayor Eric Adams’ misguided forced-treatment plan for mental illness.
Welcome to State of Mind, a new section from MediaDownloader and Arizona State University dedicated to exploring mental health. Follow us on Twitter.
In November, New York City Mayor Eric Adams announced a new plan that gives non-medical professionals, including law enforcement, expanded authority to transport people presumed to live with mental illness to hospitals against their will, even if they’re not an immediate threat to themselves or others.
The mayor claims that people who can’t meet their own basic human needs are, at least by his definition, a danger to themselves and in need of intervention. But shouldn’t public health issues warrant a public health response?
Forced removals, particularly those that involve armed police officers, sound like an easy solution and sell an illusion of public safety. But make no mistake: These kinds of short-term, carceral, and expensive approaches to addressing mental illness do nothing for a person’s well-being or recovery.
For me, this issue is deeply personal: I live with schizoaffective disorder, a form of serious mental illness, and have been involuntarily hospitalized under a similar law in Florida known as the Baker Act. I wouldn’t wish the experience on my worst enemy. These hospitals are really just prisons by another name—constantly overcrowded and overstimulating, not exactly the most healing setting for anyone, let alone someone experiencing a mental health crisis. Even though there are no barred windows or doors, you can’t leave all the same, and people are left to languish sometimes for days on end while waiting for a psych bed. The protocols in these ‘health jails’ can feel demeaning and punitive by design, not only dismissing patients’ concerns but escalating our stress and frustration right when we need help the most. Sometimes, people are physically restrained and medicated against their will—a legitimately terrifying experience that breaks the trust that could have made voluntary treatment possible.
This directive is the latest attempt to crack down on the city’s homelessness crisis. But however well-intentioned the mayor’s policy may be, I worry about what it looks like in practice. I fear that having armed cops, who are untrained in the nuances of mental health treatment and who don’t even want to take on this challenge, will not only further criminalize mental illness but lead to deadly consequences. Nationally, people living with serious mental health conditions are 16 times more likely to be killed by police than the general public, with a disproportionate impact on communities of color. The thought that someone could be killed simply for having a stigmatized health condition is a disgrace. And the reality is many of my peers and other marginalized people will now be driven to isolate themselves further to avoid getting caught in the crosshairs.
No one wants people who are experiencing homelessness or living with mental illness to suffer or struggle to find care. But there are better ways of connecting the critical, life-changing services that we promise to those in need. The mayor’s plan, as of yet, is too vague and doesn’t seem to have buy-in and support from those on the frontlines. In the rush to make up for the city’s dire shortage of psych beds, we run the risk of making even worse health jails that funnel more people into a broken pipeline without a long-term, holistic plan for community-based care.
From my experience, the key to anyone’s recovery, regardless of their illness, is the acceptance and willingness to seek treatment. Instead of doubling down on over-hospitalization and incarceration as our default ‘solutions’ to the mental health crisis, we should be exploring and expanding the voluntary, community-based mental health programs, including clubhouses, respite centers, and peer advocacy programs that have been shown to help people recover and thrive.
You wouldn’t be able to tell by looking at me now, but there was a time in my life when I was hospitalized more than 20 times in just a few years for symptoms of my illness. Each psych ward felt like a prison, and all of the mental health clinicians I had faced, whether inpatient or outpatient, had started to feel to me as if they were a prosecutor. It was the nature of constantly being admitted to these health jails and having no advocate on my side that made any interaction about my care into a courtroom session.
It wasn’t until I joined Fountain House’s clubhouse in the Bronx that I was able to break this vicious cycle and stabilize, find community, find housing, and truly recover in a setting that supported my dignity and agency as much as my physical wellbeing. The key was finding a place where I was treated as a person, not a patient; a friend, not a burden or eyesore that should be shooed away. Today, I’m not just a member of Fountain House Bronx; I also serve on Fountain House’s Board of Directors, ensuring that members—what we call people with lived experience of mental illness—have a say in the organization’s decisions and can help shape the policies that will ultimately impact our lives.
The very rare times now when I need to get immediate mental health support, I have access to an entire community who understand where I’m coming from and will go with me to the hospital to advocate on my behalf—making sure that I’m safe and cared for, and will have someone to meet me when I get out. I worry for everyone who will be swept up by the mayor’s directive and won’t have that kind of accountability and support.
People living with serious mental health conditions are already some of the most stigmatized, marginalized, and isolated in our city. The mayor’s plan will only further criminalize mental illness and force people like me to live in fear that any manifestation of our health condition will lead to terrible, if not fatal, consequences.
We know the help we need is centered in social reintegration. Our officials choosing to disappear an entire subset of people not only sweeps the problem under the rug but fails to acknowledge the inefficiencies of our mental health care system, and the holistic solutions that can make a difference.
Ref: slate