Mental healthcare for the homeless

MYRNA BROWN, HOST: It’s Thursday the 15th of December, 2022.

Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Myrna Brown.

MARY REICHARD, HOST: And I’m Mary Reichard. First up: mental health and the homeless in New York City.

Mayor Eric Adams launched a new initiative in which the city can provide involuntary mental healthcare to homeless people struggling to meet basic needs. Adams is empowering outreach workers, hospitals operated by the city, and first responders to get homeless people off the street and into treatment.

BROWN: Advocacy groups for the homeless immediately protested the directive. But some ministry leaders and experts on homelessness take a different perspective. WORLD’s Addie Offereins talked with workers on the front lines of the issue. She joins us now.

Addie, welcome!

ADDIE OFFEREINS, REPORTER: Thanks for having me, Myrna.

BROWN: So tell us a little bit more about the directive. What does the mayor hope to accomplish?

OFFEREINS: Yeah, so Mayor Adams’ directive builds on current New York mental hygiene law. Current law gives officials the authority to hospitalize mentally ill individuals who pose a danger to themselves or to others. And this has typically been interpreted as they have threatened violence or committed violence against themselves or others. But Adams’ directive takes a more proactive approach to the law. In his announcement, he gave city outreach workers, law enforcement, and other officials the authority to hospitalized homeless individuals struggling with mental illness if they are failing to provide for their basic needs, and so pose more of a long-term danger to themselves or to the public around them rather than only if they have committed or threatened violence.

Here’s what he had to say about the directive.

ADAMS: It is not acceptable for us to see someone who clearly needs help and walk past. For too long there’s been a gray area where policy, law, and accountability have not been clear. And this has allowed people in need to slip through the cracks.

BROWN: Why are advocates upset?

OFFEREINS: Yeah, Myrna, so almost immediately several homeless advocacy groups denounced the directive. For example, Donna Lieberman with the New York Civil Liberties Union said Adams is playing fast and loose with the legal rights of New Yorkers. And Jacqueline Simone, a policy director with the Coalition for the Homeless, said the measure scapegoats homeless individuals who are struggling with mental illness as being violent, but that isn't always the case. She accused Adams of not providing enough mental healthcare services and affordable housing for people to access voluntarily. And she said if there were more services available, people would access those services.

BROWN: How did proponents of the measure respond?

OFFEREINS: Yeah, so not all homeless experts or nonprofits working with the homeless take this perspective. I talked with Stephen Eide, an expert on homelessness with the Manhattan Institute, about some of the concerns of these advocates that I mentioned previously. I asked him how he would respond to groups that are concerned this program is bad for the freedom and dignity of homeless people. Here’s what he had to say.

EIDE: We have been trying their preferred solutions, building more housing, building more community programs that are offered to people on a voluntary basis. New York has been doing a lot of that. And New York will continue to be doing a lot of that. Just in the 2010s alone, New York cut a lot of psychiatric hospital beds, and invested a lot in housing, other community services. And yet, there are too many people living out of the subways and too many people stuck in jail. I mean, the jail system in New York City is a huge something about 1000 seriously mentally ill individuals. If we really want to get people out of jail to have serious mental illness, we probably need to be talking about something like hospitalization because I think stuff like housing is just not going to be enough.

BROWN: What do ministries to the homeless have to say?

OFFEREINS: So, James Winans is the CEO and President of the Bowery Mission in New York. His mission offers emergency shelter to homeless men and women who need a place to stay for the night, a shower, a fresh bed to sleep in. But he also has a life transformation program for homeless men and women where they get employment and training, transitional housing, help with budgeting and are able to turn their lives around. He works with the homeless day in and day out and he had a few things to say. Here’s a clip from our conversation.

WINANS: As usual, both sides of this argument have some validity. And so you know, as New Yorkers, we see daily people in very vulnerable circumstances and very disruptive conditions of mental well being, and I think intervention in those situations is compassionate. At the same time, I think, you know, history tells us that grave mistakes can be made if we take action without protecting the dignity of the individual. You know, without being ready to advocate for that individual and in a way that's good for that individual. All of that really goes back to seeing each and every individual as a person created in God's image, or deserves to be treated with all the dignity and frankly, individuality that God has created that person and  any plan here needs, actually needs to recognize that.

And Winans says the Adams plan is only a part of an approach that should keep God-given human dignity front and center. He's a little bit concerned about the execution of the initiative because New York struggles to recruit and retain a strong mental health workforce that has been weakened by COVID-19 when a lot of workers left during the pandemic. He also says it’s important to ask what happens when people leave the hospital.

WINANS: I think what the mayor has proposed in this case, is, is a short term fix. It's one part of a bigger puzzle. And, you know, I think, I think, maybe a bigger even bigger question is what happens to that individual after they've been discharged from the hospital because they won't stay in the hospital forever. And, and this is where you know, the Bowery mission wants to be one of those places of you know, life transforming community.

BROWN: To keep up with WORLD’s homelessness coverage and other compassion issues, head to wng.org and sign up for Addie's weekly newsletter called Compassion. Addie, thanks for joining us.

OFFEREINS: You’re welcome, Myrna.

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