Not Quite Home Sweet Home: Mayor Adams’s Support Interventions Act is a Faulty Cure to the Mental Health Crisis Among Unsheltered New Yorkers

Photo courtesy of Ed Yourdon.

On May 1, 2023, Jordan Neely—a mentally ill homeless man—was strangled to death on the subway by a former U.S. Marine officer. Neely had been screaming in the subway car and threatening passengers but had not caused any harm when the officer put him in a chokehold and killed him. The tragedy shook the nation along several resonances, not least among them the harrowing repetition of violence perpetrated against African Americans by members of law enforcement. For anyone who has ridden the New York City subway consistently, though, the horror of May 1, 2023 embodies a mere microcosm of the wider depravity that the unsheltered population in the subway, and across the city, have been forced to suffer. 

Mayor Eric Adams responded to Neely’s death by claiming it exemplified the gravity of New York City’s mental health crisis and pushing his administration’s plan as a solution to the issue. Seven months earlier, in November of 2022, Adams had announced an initiative that has evolved into a bill he is currently lobbying to pass statewide, the Support Interventions Act, which would purportedly help alleviate this mental health crisis among the unsheltered on New York City subways and streets by targeting legal obstacles to emergency psychiatric care. 

It goes without saying that Adams’ bill has costly drawbacks to individual agency. The current state law regarding involuntary hospitalizations, the 1999 Kendra Law, states that involuntary removal of the mentally ill from the streets is justified when the individual’s deterioration of mental health is “likely to result in serious harm.” Asserting that this law has been interpreted too narrowly, the Support Interventions Act Bill instead proposes that cases of “egregious self-neglect” should also be grounds for involuntary hospitalization. In contrast to the Kendra Law, the Support Interventions Act Bill would allow involuntary hospitalizations by law enforcement officers if a person cannot meet their “basic need for food, clothing, shelter or medical care,” thus widening the remit of those who determine what situations qualify for this treatment—namely, law enforcement.

On November 29, 2023, a year after the initial announcement of the policy, Mayor Adams reported that 54 severely mentally ill unsheltered people had been involuntarily hospitalized, and hundreds more connected with hospitals for evaluations. Claiming that New Yorkers have a “moral obligation” to help its mentally ill citizens find the help they need,” Adams suggested that law enforcement, not trained medical professionals experienced with mental illness, should be allowed to forcibly remove unsheltered people displaying acute signs of mental illness to hospitals where they may be treated. In doing so, Mayor Adams’ Support Interventions Act effectively criminalizes our fellow New Yorkers’ mental health issues instead of helping cure them. This, as most failed treatment plans do, stems from a misdiagnosis of the source of the problem. 

The bill admittedly acknowledges “it is always preferable for an individual in psychiatric crisis or at risk thereof to accept mental health treatment voluntarily”—however, that admission does not mean “mandated treatment” is suddenly a “flexible approach.” If the “core function of our mental health system” indeed remains to help each person with severe mental illness maximize their chances of pursuing a “self-directed life,” how can it do so if the state removes the mentally ill’s autonomy?

The solution to the riddle of balancing public order with a care for the individual at-risk person lies in systemic change. The NYCLU’s Executive Director Dana Lieberman criticized Adams’ proposed policy as criminalizing mental illness instead of providing more tangible support for unsheltered people who struggle with untreated mental health problems. After all, although over 93,000 people were eligible for “enhanced mental health services in NYC under the State’s Medicaid managed care program for those with serious mental illnesses,” only 2,179 people in the year the bill was proposed received this care. Rather than involving law enforcement in people’s mental health, the Mayor must bring voluntary access to medical care and affordable, permanent housing for the New Yorkers who need it most.

In Adams’ defense, systemic solutions are always easier said than done. New York City is experiencing a housing crisis greater than it has at any point in the last half-century, with little more than 1% of rentals available. Combined with the influx of migrants from Central and South America, the problem is only growing more desperate. The number of unsheltered people who need to be housed is daunting—100,000 New Yorkers are unhoused, and the number of people sleeping in shelters is 76 percent higher than ten years ago. New York hasn’t had rates of homelessness this high since the Great Depression. While the vast majority admittedly spend each night in shelters, 4,000 live unsheltered in the subways and streets—though that number is considered to be significantly underestimated. 

To make matters worse, the New York Housing Authority (NYCHA) is incompetent, wasteful and under-staffed. While the number of vacant NYCHA units has increased from 460 to over 4,920 vacant units as of February 2024, the waiting list of a much less encouraging 240,000 people suggests that the changes which are needed are nothing short of monumental. To call this system broken and byzantine would be an understatement. 

Addressing the weakness of New York’s public housing system, not involuntarily removing unsheltered people from the streets once the damage to their mental health and livelihood has reached its nadir, is the only way to relieve the crisis exemplified by Jordan Neely. In fact, housing has been termed a form of “preventive neuroscience”—after all, without it, the unsheltered face a constant crisis of survival that exacerbates mental health issues by removing any sense of safety or security from their lives that would allow them to focus on getting better. 

While the Support Intervention Act acknowledges that voluntary admission to treatment is always superior to the alternative, it nonetheless shamelessly impinges on unsheltered New Yorkers’ right to make decisions about their health. Instead, Mayor Adams should fulfill his administration’s “moral obligation” to this city’s most vulnerable by seeking to create a more stable and robust mental health and housing system. Pursuing a proactive public housing policy and a commitment to ensuring high-quality, voluntary medical care would see people like Jordan Neely not wandering subway cars, putting themselves and others at risk, but instead find them housed, in recovery and maximizing their chances of a “self-directed” life. Attempting to eliminate New York City’s symbiotic plagues of homelessness and mental illness by effectively criminalizing their victims will never be the cure.

James Cordingley is a columnist at CPR majoring in English with a philosophy concentration. He can often be found running across campus to a class that’s already started.