New York Must Do More to Help the Mentally Ill Before Tragedy

Someone should not have to become homicidal or inflict serious and physical harm before they are committed.

Edward Cordero, a mentally-ill teenager off his medication, sucker-punched 65-year-old Jacinto Suarez on the subway on Wednesday afternoon in Brooklyn. Mr. Suarez fell on the tracks and shortly after died of a heart attack. On that same day 19 years ago, 32-year old Kendra Webdale was pushed to her death in front of a Manhattan subway by Andrew Goldstein, a 30-year-old man with schizophrenia who had been shunted in and out of mental hospitals.

In the nearly 20 years between these two tragic deaths, we’ve seen police shot by people with serious and untreated mental illness. We’ve also seen police shooting people with serious, untreated mental illness.

We’ve seen an explosion in the number of homeless mentally ill and the number of mentally ill incarcerated. Families are being torn apart. When will the mayhem end?

The day that Cordero punched Suarez and sent him to his death, Gov. Cuomo was in Albany delivering his State of the State address. Cuomo admitted there is a mental health problem and committed to fix it.

“It’s our obligation as a caring people and compassionate society to reach out and provide whatever social services or address whatever needs the individual presents,” he said. “Some jurisdictions say case law prevents them from helping mentally ill street homeless. If that is their excuse, they should tell us what law stops them from helping sick homeless people and we will change the law this session.”

Wonderful. We’ll tell you.

Gov. Cuomo: New York’s “dangerousness” statue prevents involuntary commitment unless the dangerous behavior is “manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm.”

That’s the law you should change. Someone should not have to become “homicidal” or inflict serious and physical harm before they are committed.

The words homicidal, serious and physical should all be removed from that statute. That will help New York move from a set of laws that require tragedy before treatment to one that allows treatment before tragedy.

And New York should add statutes that allow treatment over the objections of those who have become so gravely disabled they are unable to provide for their own health, safety and welfare or need treatment in order to prevent a deterioration to the point where they will become dangerous. Most states have those. New York does not.

Some seriously mentally ill people need psychiatric hospitals. But Gov. Cuomo, you have been closing those, causing a back-up in emergency rooms. Hospitals have no other way to deal with closures than by declaring sick people well and discharging them. That is causing much of the homelessness you mentioned. Could you stop closing psychiatric hospitals?

Mayor de Blasio: Fixing the problem in the city requires you to do what Gov. Cuomo did, and recognize there is a problem. So far, you haven’t. If the homeless mentally ill on the streets aren't enough to convince you there's a problem, look at the data. The city’s own figures show that in recent years 40% of the most seriously mentally ill people have received zero treatment. In 2016 there were over 150,000 calls to police for emotionally disturbed persons, and the mentally ill occupy 38% of all city cells.

Instead of addressing these problems head on, you launched ThriveNYC, an $800 million dollar mental health plan that virtually ignores seriously mentally ill and instead works to improve mental wellness in others.

As Gov. Cuomo said, "Leaving a sick person to fend for themselves is not progressive, charitable or ethical or legal." But your plan does that, Mayor de Blasio. You should immediately and robustly expand the use of Kendra's Law, which allows courts to order a subset of the most seriously mentally ill to stay in treatment as a condition of living in the community.

It's the most successful tool you have. None of the other programs you are funding are able to reduce homelessness, arrest and incarceration that’s in the 70% range. Move funds from those that don't improve those metrics to ones that do. And put your outreach teams at the exits of hospitals and jails. Mentally ill individuals who are being discharged from those institutions are the most likely to become homeless or fall into a cycle of incarceration, so catch them and provide services before that happens.

And when either of you, Mayor de Blasio and Gov. Cuomo, talk about increasing housing, please allocate it to the seriously mentally ill. A study by Stephen Eide at Manhattan Institute found that when housing is allocated to the seriously mentally ill, it saves taxpayers money by reducing incarceration and hospitalization. And Judge Matthew D'Emic of the Brooklyn Mental Health Court has repeatedly stated that the lack of housing options creates an often insurmountable difficulty in keeping the mentally ill who come before him off the streets and out of jail.

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DJ Jaffe is Executive Director of Mental Illness Policy Org., and author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill.

Carolyn Gorman is the project manager for education policy and mental-illness policy at the Manhattan Institute.

This piece originally appeared in New York Daily News