The Status Quo on Homelessness and Mental Health Care is Untenable

Shortly after news broke that Ramon Rivera, an unhoused man with serious mental health issues, was accused of stabbing and killing three people, politicians and media outlets predictably called for locking more people up.

The killings in Manhattan in late November are incredibly heart-wrenching, and we must commit many more resources to avoid these kinds of tragedies. It is undeniably true that the status quo for how we address issues like homelessness and people with serious mental health issues is untenable. But the response must not be to simply lock more people away. That doesn’t make us safer, and it doesn’t solve the root problems that lead to these devastating events.

Everyone deserves to have safe and stable housing, and we should all be able to get the health care we need, when we need it. But for this to happen, we need meaningful, comprehensive, and paradigm-shifting new investments in affordable housing and our mental health care system.

If we don’t see these types of commitments from our state leaders soon, we are headed for incredibly dark days, especially with another Trump administration set to take power in January.

Bail Blame Game

In response to the three killings in Midtown Manhattan on November 18, Republican City Council Member Vickie Paladino expressed the political sentiment voiced by many when she reflexively blamed the state’s recent bail reform efforts.

“People need to understand something important. Nothing — NOTHING — will convince progressives to reconsider their criminal justice reforms which repeatedly enable horrors like this,” Paladino wrote on X.

Paladino’s comment ignores the fact that the man accused of the Midtown killings was not out of jail because of bail or other criminal system reforms. Her statement also entirely disregards  the reality that the bail legislation that passed in 2019 has already been significantly reversed by a Democrat-controlled legislature and Gov. Kathy Hochul several times.

Lies about bail reform never seem to matter to much of the media or to many of our state politicians. Nor does the fact that studies have repeatedly shown that bail reform has not contributed to increases in crime. Whenever a violent crime makes headlines, many politicians on both sides of the aisle inevitably blame bail and other criminal legal reforms, while ignoring the fundamental structural causes that can lead to violence.

One entity that has largely escaped blame in the Manhattan stabbings is the NYPD. Midtown is almost always blanketed by NYPD officers. Yet the man accused of committing the stabbings walked for hours throughout Midtown, allegedly covered in blood and wielding  large bloody kitchen knives until he was apprehended by federal security agents – not the NYPD.

Emphasize Care, Not Confinement

Besides doubling down on mass incarceration, the other primary solution politicians offer after tragedies like the one in Midtown is to involuntarily commit more people with mental health issues broadly.

We don’t know the details of why Rivera was not involuntarily committed before the killings. We also don’t know why he wasn’t put under a Kendra’s Law order which would have prioritized his access to the mental health services that are in such short supply. But what we do know is these stabbings are being used to suggest the further criminalization of people with mental illness — even if they aren’t an immediate danger to themselves or others, and to make it easier for bureaucrats to take away people’s most basic freedoms.

These new powers are not needed, and they serve to take our eye off the ball. What we need is transformation, not carceral solutions that serve to sweep people with mental health challenges out of sight without fixing the core problems.

The repeated calls to criminalize mental illness come even though – in New York City alone – police and other city officials claim they forcefully commit more than 100 people every week on average. What exactly happens to these New Yorkers after they are involuntarily committed – who if history is any guide, are overwhelmingly Black and Brown – is not clear and hasn’t been made publicly available.

Existing law already establishes that there are indeed times when involuntary commitment, and involuntary treatment, is appropriate. But studies have made clear that coercing people into getting mental health care is generally ineffective and does little to improve people’s mental health. Even though politicians are fully aware of this, they routinely default to this response rather than taking steps to fix the long-running mental health crisis in our state.

This misguided and counterproductive effort is embodied by the misleadingly-titled Supportive Intervention Act and HELP Act, and through the proposed expansion of a statute known as Kendra’s Law. These three legislative efforts would make it easier for police officers and other government bureaucrats to snatch people off the street, fine them, and take away their most basic freedoms. They then could be kept in this Kafkaesque situation for long periods of time, even if they pose no threat to themselves or anyone else and have very understandable reasons for wanting to avoid the dangerous homeless shelter systems.

This raises enormous legal and constitutional issues but it also falsely presumes that, once these New Yorkers are spirited away, they will get the care they need. The real problem is there are not nearly enough mental health care resources available, especially for those who need them the most. This won’t change by criminalizing people with mental health issues, who are 11 times more likely to be the victim of crimes.

Our health care system has already repeatedly failed many of the people the government sweeps up through involuntary removals. They are bounced from one under-staffed and under-resourced facility after another before they are deposited onto the street. They are left without supportive housing, access to services, or the assistance of a care manager who can help them figure out how to access scarce mental health and housing services. It should come as no surprise that this cycle often repeats itself again and again.

There have been recent laudable if belated efforts by Gov. Hochul and others to increase funding for mental health care. But they represent a few droplets of water in what must be a sea-change in how we support those with mental health challenges.

We need much more community-based care that is welcoming, not isolating, and that is available when people need it.

The Center Cannot Hold

The results of the 2024 elections and the re-election of Donald Trump make it clear that the current way New York handles the issues of homelessness and mental health care are unsustainable. Kamala Harris won New York, but it swung dramatically towards Trump. A large percentage of the electorate is not satisfied with the way things are, and another huge portion doesn’t believe change is possible.

The president-elect has laid out his version of what he thinks the future should hold. Under the headline “Ending the Nightmare of the Homeless, Drug Addicts, and Dangerously Deranged,” making it illegal for people to sleep on the streets, while also urging states and local governments to force unhoused people to live in federally created “tent cities.” Trump and his fellow Republicans are also poised to gut funding for supportive housing and health and mental health care. Add to that the conservative majority on the Supreme Court’s ruling that effectively criminalizes being homeless, and it’s clear what the right-wing’s plan is.

Trump and his allies are offering those who are better off a vision of a world in which they never have to see or think about unhoused people or people with mental health struggles. Rather than fixing the problems of homelessness or mental health care, right-wing politicians want to sweep these problems under the rug. They hope that enough people assume they will never end up in a tent city or care what happens to those who do.

This kind of society – where more and more people are considered “excess humanity” that can be essentially disposed of – is not the kind of country we should be building towards. But it could be where we’re headed if we don’t make the needed investments to change course.

When New Yorkers see a growing number of unhoused people on the street – many of them decompensating and some who need urgent psychiatric care – many feel less safe, and they take it as a sign that society is decaying. The right-wing has proposed a dramatic – if barbaric – way to deal with the situation.

New York’s leaders need to take bold steps to keep us from this dystopian future. State and local politicians pleading poverty will not get us where we need to go, especially since there always seem to be enough funds for police robot dogs, subway robots, excessive NYPD overtime, new sports stadiums and other frivolous expenditures. A few affordable housing units here or there and a handful of new psychiatric beds will not be enough to turn things around.

We need investments in affordable housing and mental health care that match the scale of the problem and prove that our state can fix the issues that have frayed our social fabric and galvanized millions of voters. If those commitments don’t materialize, we shouldn’t be surprised if things only get worse from here.