Last week, I was taking the train in Brooklyn when a seemingly unhoused man lost his shit in the neighboring car. Passengers migrated to the next car, as he thrashed and screamed. People shook their heads or smiled uncomfortably. I dipped in to ask if he needed to go to the hospital, and he screamed, “NO! FUCK YOU BITCH!” I was on the trains for like 40 minutes and this was the second person I saw exhibiting symptoms of severe mental distress.
While I think the “dangerousness” of the train is cynically overblown, it does seem that there are more mentally distressed people. That’s also what EMT Anthony Almojera observes in the New York Times’, “I’m an N.Y.C. Paramedic. I’ve Never Witnessed a Mental Health Crisis Like This One.
Almojera blames the pandemic and lack of mental health resources, not, like bail reform, as Adams tends to do. And he definitively explains why Adams’ plan to force people in treatment or shelters is dangerous and ineffective.
Now Mayor Eric Adams wants medical responders and police officers to force more mentally ill people in distress into care. I get it — they desperately need professional help, and somewhere safe to sleep and to get a meal. Forceful action makes for splashy headlines.
Forcible mental health treatment has emerged as a solution to visible homelessness all around the country, but particularly in wealthy blue cities. Dumb clown Michael Shellenberger ran for governor of California on that platform. When he only got like under 5% of the vote, he migrated to the New York Post to blame the ACLU for supporting the rights of mentally ill homeless people.
When the debate revolves around abstract principles, most people ask themselves, “Does the right of that guy to scream into the void override my right to get home in peace?” Well, most people would probably say not really?
Since these advocates mostly exist in blue cities, they have to couch the policies as being more “compassionate” than letting mentally ill and addicted people just shoot up in the Tenderloin in San Francisco or scream in the trains in New York.
Almojera explains why forcible treatment is the opposite of compassion.
For one thing, the mayor is shifting more responsibility for a systemic crisis to an overworked medical corps burned out from years of low pay and the strain of the pandemic. Many E.M.S. workers are suffering depression and lack adequate professional mental health support, much like the patients we treat. Several members of the Fire Department’s Emergency Medical Services have died by suicide since the pandemic began, and hundreds have quit or retired. Many of us who are still working are stretched to the breaking point.
I’ve gone down the road of despair myself. The spring and fall of 2020 left me so empty, exhausted and sleepless that I thought about suicide, too. Our ambulances are simply the entrance to a broken pipeline. We have burned down the house of mental health in this city, and the people you see on the street are the survivors who staggered from the ashes.
Those who are supposed to respond and help them are not doing well either. Since March 2020, the unions that represent the Fire Department’s medical responders have been so inundated with calls from members seeking help that we set up partnerships with three mental health organizations, all paid for by the E.M.S. F.D.N.Y. Help Fund, an independent charity group founded and funded by medical responders and the public through donations to help us out in times of crisis.
What New York, like so many cities around the United States, needs is sustained investment to fund mental health facilities and professionals offering long-term care. This effort would no doubt cost tens of millions of dollars.
I’m not opposed to taking mentally ill people in distress to the hospital — our ambulances do this all the time. But I know it’s unlikely to solve their problems. Hospitals are overwhelmed, so they sometimes try to shuffle patients to other facilities. Gov. Kathy Hochul has promised 50 extra beds for New York City’s psychiatric patients. We need far more to manage those patients who would qualify for involuntary hospitalization under Mr. Adams’s vague criteria.
Often, a patient is examined by hospital staff, given a sandwich and a place to rest for a few hours, and then discharged. If the person is intoxicated, a nurse might offer a “banana bag” — an intravenous solution of vitamins and electrolytes — and time to sober up. Chances are the already overworked staff can’t do much, if anything, about the depression that led the patient to drink or take drugs in the first place.
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