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Political Solutions Have Failed NYC’s Mentally Ill: The City Needs A Marshall Plan for Mental Health Care Run By Doctors

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By Gary Tilzer

Adams’ new initiative, vigorously opposed by the city’s progressives, is to use mental health care treatment teams and police officers to force those they believe are unable to care for themselves or a danger to others, into hospitals to evaluate their emotional problems and needs.  The fight has put the spotlight on a problem that generations of elected officials ignored, reduced hospital funding for, and hid those in need of psychological help in inhuman mental institutions or jails out of public view. The mentally ill have no vote and are not a popular cause with public support.  The energy to treat them now is caused by the damage they are doing to NYC and as usual in NY the political fight over who will control the money and the treatment results in more dysfunctional government, while the mental health crisis grows worse. In NY, politicians gain more reelection power by citing their ideological narrative talking points in press releases and hiding from the damage the problem causes, than working together to find solutions to serious problems.

The mayor facing a crime wave destroying the city’s economy, partly caused by the mentally ill committing high-profile crimes, scaring riders from returning to the subway and office workers to midtown, is making desperate moves to patch up a broken and dysfunctional mental health care system, only to be trapped and attacked by the same progressive activists’ that prevented him from reforming the crime-causing bail law in Albany early this year.  The progressives even blocked Adams’ attempt to expand Kendra’s Law to allow judges to commit those they believe to be behaving irrationally to a mental health hospital.  Progressives believe the mentally ill should only be picked up by social workers and be taken to community-based temporary programs run by nonprofits.  NY’s ideological civil war, while not covered in the media, is fought behind the scenes on almost every major issue, prevents effective treatment of the city’s mentally ill, and continues to endanger New Yorkers walking the city’s streets and riding the subway.

Former National Institute of Mental Health Director Dr. Thomas Insel states anyone suffering from mental illness must be hospitalized for evaluation and if needed treatment. Thousands of seriously mentally ill people are untreated in city jails, streets, and subways or lost in homeless shelters run by community-based nonprofits. Any serious solution to the “criminalization of mental illness” must involve psychiatric hospitalization, which is the humane and necessary medical approach to help those in our society that cannot help themselves, states the former NIMH director.  Dr. Insel believes for troubled mentally ill criminal offenders, hospitals are much more effective than community-based temporary social service programs pushed by progressives. “We must ensure that individuals do not go through a revolving door from temporary service to temporary service, and instead seek long-term solutions,” states Dr. Insel. According to the Treatment Advocacy Center, NY desperately needs more psychiatric beds, but unless our statutes ensure that when an individual is gripped by insanity, they can be held, treated, and stabilized, the subway push nightmare will keep returning like a horrifying horse on a carousel.  Jewish Voice Separate the Mentally ill  from the Criminal Justice System to Make Our Streets and  Subways Safe

The Progressives Pushing for Temporary Programs Similar to de Blasio’s Wife’s Ineffective ThriveNYC; Pour Oil on the Current Mentally Ill Fire

PA Williams’s report calls for more community-based not-for-profits but fails to analyze the ineffectiveness of de Blasio’s wife’s ThriveNYC neighborhood mental health program which funded community-based nonprofits. 

The day after Adams announced his new mental health policy of involuntary 72-hour evaluations progressive Public Advocate (PA) Jumaane Williams made the TV rounds – from conservative Fox News, local news, and liberal MSNBC attacking the mayor’s new approach. PA Williams put out a report a week before the mayor’s announcement that urges the city to move away from using police officers as the first line of response and use social workers to respond to mental health crisis calls and take them to temporary mental health centers run by nonprofits.  PA Williams and his fellow progressives who want to remove police from responding to mental health calls do not understand that it is the failure of the government in providing proper mental health care treatment that has caused police involvement in the first place. If the mentally ill were effectively treated they would have limited police involvement. There is no cop that wants to deal with the mentally ill, they often smell, bite, and have uncontrollable rages that put cops in physical danger.  Progressives fail to understand that police involvement is evidence that their elected officials are part of a government that failed to properly medically treat the city’s mentally ill. Progressives are now trying to get mental health funding for their nonprofits, for programs that have no proven medical track record of working.

PA Williams’s report calls for more community-based not-for-profits but fails to analyze the ineffectiveness of de Blasio’s wife’s ThriveNYC neighborhood mental health program which funded community-based nonprofits.  Even former chief of policy and strategy for Thrive NYC, Gary Belkin, acknowledged the failures of the 1.2 billion dollar program that promised then failed to rectify decades of “broken promises” for New Yorkers suffering from mental illness. The PA Williams’ report, while focusing on improving social service responses to those undergoing a mental health crisis, made no mention of the lack of long-term hospital beds, which is the main reason the untreated mentally ill are preying on New Yorkers on the subways and streets causing the crisis.

The current political fight on who will pick up the mentally ill from the streets and subway, police, social workers, or temporary community-based programs will accomplish nothing which anyone who has a family member that suffers from mental illness understands. Those close to a loved one who is diagnosed with mental illness will tell you the disease breaks your heart with setbacks that occur over years and the violence capable of that sick family member requires long-term care and effective medication monitoring. Offering the mentally ill temporary help at a community-based non-profit program which the progressive want, is like trying to treat cancer with an aspirin.

The current ideological and political civil war between the mayor and the progressives will leave the emotionally sick on the city’s streets and subways.  It will also result in billions being wasted on politically compromising budget deals to include unmonitored community-based short-term care with unproven and audited programs.  The politically compromised solutions caused by NY’s divided government will ignore the real, expensive but proven solutions of long-term hospitalizations and proper outpatient monitoring, needed for those suffering from mental illness.

Many of the progressive elected leaders in the city are using the mental health crisis to find funding for their ideological liberal wish list programs:

Progressive City Councilwoman Shahana Hanif Twitter @CMShahanaHanif “The forced hospitalization of unhoused New Yorkers will not keep us safe. Housing, healthcare, and union jobs will. This Council says no to the Mayor’s cruel plan to sweep our neighbors out of sight. Bilingual counselors in elementary schools  Not divesting in 3k. Racial and immigrant justice. Shackling people in hospitals not going to work – hospitalization is not a public safety strategy.”

The mentally unwell individuals ordered by Judges, police, and social workers into 72-hour psychological evaluations at overcrowded psychiatric facilities like Bellevue hospital are caught in a vicious cycle because the state lacks the infrastructure, hospital beds, and the ability to monitor and ensure those required to take medication to keep taking the psychiatric hospitals require them to take. Since there is a systemic lack of available beds at psychiatric hospitals or healthcare infrastructure to treat and monitor the emotionally sick, requiring medicine to function normally, the court or police-requested 72-hour evaluations are worthless, functioning as turnstiles returning the mentally ill to the streets, subway, or jail if they commit a serious crime. Many 72-hour evaluations result in the patient being released after being prescribed medication to control their behavior, which they quickly stop taking. The mentally ill suffer from anosognosia, which means they are unaware of their own illness or the dangerous consequences to others caused by their sickness, and therefore uninterested in seeking treatment.

Simon Martial’s sister, the homeless man suffering from mental illness who pushed Michelle Go onto the train tracks in front of an oncoming train, begged one of the psychiatric hospitals, ‘Let him stay hospitalized, because once he’s out, he [doesn’t] want to take psychiatric drugs, and it was the medication that kept him from acting violent.” After murdering Ms. Go Simon is now in a mental hospital like his sister wanted.  The Legal Aid Society defended Simon in court before he killed Ms. Go. According to published reports, in 2017 Simon told a psychiatrist at a state-run facility that it was just a matter of time before he pushed a woman to the train tracks.  “It doesn’t make sense to take people who are mentally ill homeless and just discharge that person back to the street unsupervised,” said Dr. Mitch Katz, the president of the city’s public hospital system, which operates some of New York City’s largest psychiatric wards.

A recent State Comptroller DiNapoli’s audit stated that there was no proof that any of the billions the city spent on mental health community-based programs work.  The Comptroller report determined that the Department of Homeless Services (DHS) frequently gives scarce rooms in treatment of the city and nonprofit homeless shelters to New Yorkers suffering from mental health issues — failing to transfer the mentally ill to specialized facilities even when beds open up. DiNapoli’s audit discovered that several homeless New Yorkers suffering from mental illness were misplaced by DHS and were perpetrators of high-profile crimes.  Jewish Voice January 2022 NYC’s Non-Profit Political Complex Has Recklessly Spent Billions on the Homeless Who Still Occupy Our Streets and Subways

Politicians’ Lack of Treatment Plan Over Decades Caused A Ticking Time Bomb of Mentally Ill Occupying Streets and Subways Hurting New Yorkers

The murder of EMT Lt. Alison Russo-Elling looks every bit like yet another horror produced by New York’s refusal to face the dangers of violent mental illness.

The latest collapse of NY’s mental health care system started with the state’s 2006 Berger Commission decision to close hospitals and cut one-third of the state’s mental health beds to cut costs. The Commission created a vicious cycle revolving door:  1) Police arresting the mentally ill who are harassing people or committing a crime; 2) The courts sending the mentally ill to Riker’s or Bellevue or another psychiatric hospital for 72-hour evaluations; 3) Mental Ill released because of a lack of long-term hospital beds despite requiring hospital admission for long term treatment; 4) The violent mentally ill who stop taking their medications are repeatedly arrested, sometimes making the papers after committing a murder, such as Simon Martial, a homeless man suffering from a mental illness, arrested 10 times and hospitalized 24 times before killing Michelle Go by pushing her into an oncoming train on the  Times Square Subway Station R train platform.

NY has a long and sad history of not treating mental illness: for decades they were simply warehoused, hidden from the public view, in institutions like Willowbrook, until reporter Geraldo Rivera exposed the terrible inhumane conditions at mental institutions in the 70s.  After public outrage forced those state institutions to close, adults suffering from serious emotional problems were hidden on Rikers Island, in homeless shelters that did not treat their illness, or ping-ponged between the streets, jails, and mental hospitals that did not have enough beds for necessary long-term care.

The 2019 Bail Law Reform Ended the Politician’s Policy of Hiding the Mentally Ill in Jail

It was not the pandemic that increased the number of mentally ill on the city streets subway and attacks on the average New Yorker, it was the progressive activists’ 2019 bail reform law that eliminated the option of hiding the mentally ill in jail. The new bail law mandated judges to release even those they believe to be dangerous to themselves and others or suspect to have stopped taking their prescribed psychiatric medications.  A good outcome of the bail law was that it ended the politicians’ ability to hide those who suffer from mental illness on Rikers Island. The bad outcome was that thousands of mentally ill ended up untreated in the streets and subways preying on New Yorkers.

Both Cuomo and de Blasio failed to rebuild the very expensive mental health infrastructure when the city and state were flush with cash.  de Blasio stopped the building of a mental health hospital on Rikers that the Bloomberg administration started to build and gave the mental health money to his wife’s nonprofit ThriveNYC, a political slush fund that failed to treat the mentally ill effectively.   Now with the City and State facing budget deficits, and the economic recession in the wind, New York has to find funding for its chronically underfunded mental health system.

Dr. Michael Zingman, a psychiatry resident at Bellevue Hospital, states “New York needs more psychiatrists working and monitoring the street homeless population in between hospital stays.”  Take the case of Waheed Foster, a homeless mentally ill man who stopped taking his psychiatric medications and nearly beat to death Elizabeth Gomes at the Howard Beach Subway Station. Doctors, the courts, and government must find a way to monitor the mentally ill who need medication to control violence and be able to institutionalize them if they stop taking their meds. Many of the mentally ill are taking readily available drugs that contain fentanyl, which could explain why there is an increase in violence coming from that group.

Not treating the mentally ill creates a domino effect or chain reaction that hurts all New Yorkers and not just with violence. The MTA, heavily in debt in part because of low ridership and revenue collection caused by the crimes of the mentally ill taking over the subways, is eager to start congestive pricing to collect its one-billion-dollar fee. The MTA $23 dollar fee will further destroy the city’s economy and Manhattan’s small businesses, pushing more of the middle class out of the city.

Doctors, Not Politicians, Must Design and Run New York’s Mental Health Programs, Analyze and Change Them to Become More Effective

To get around NY’s polarized politics that is blocking a cure to NY’s mental health crisis, the mentally ill policy needs to be controlled and designed by experts in the mental health care field, and not the politicians.  Adams needs to create a medical board modeled after The Centers for Disease Control and Prevention (CDC) led by mental health doctors.  Medical experts, police, and judges must work together to come up with a Marshal-type plan that treats and monitors mentally ill programs for their effectiveness.  Progressives’ main demand is that police should not be involved in picking up the mentally ill from the city’s streets and subways.  Progressives do not understand that the reason the police and courts are the frontline responders for the mentally ill at this juncture, is because the city lacks an effective plan, and the state lacks the infrastructure to treat them.

Community-based programs for the mentally ill sound politically good but forget about the lessons learned or not learned by the billion dollars wasted in ThriveNYC nonprofit.  Managed by our former Mayor de Blasio’s wife, ThriveNYC promised to rectify decades of “broken promises” for New Yorkers suffering from mental illness.  Anyone riding the subway or who has been attacked by someone suffering from emotional problems knows that the billion dollars funding provided to ThriveNYC billion dollars failed NYC’s mentally ill.  ThriveNYC spent city funds on the same temporary, nonprofit, community-based programs that progressives are demanding that the city fund many of the same as ThriveNYC nonprofits, instead of long-term treatment in hospitals.  The nine (9) million that Manhattan DA Bragg announced to be paid by his office’s recovered funds to nonprofit community-based programs will be as ineffective as the ThriveNYC’s billion-dollar waste.

Councilman Robert Holden Twitter @BobHoldenNYC:  “The city’s shelter system needs significant reform.  We give so-called “nonprofit” providers millions of dollars and see nothing for it.  It’s time to do more than audits & start holding the providers accountable for failing to deliver on the contracts they have with the city.”

NYC Comptroller Brad Lander removed providers from the agency watchlist despite repeated malfeasance. Lander’s office, which is supposed to serve as the city’s fiscal watchdog, approved about $550 million in contracts with nonprofits that are members of an umbrella group that his wife, Meg Barnette, oversees. NYC Councilman Bob Holden is demanding the Department of Investigation probe possible conflicts of interest between Comptroller Brad Lander and his wife’s role as a consultant for nonprofits his office is supDonatebalance of natureposed to oversee.

Tom DiNapoli Twitter @NYSComptroller: “My latest audit found yet again a failure to oversee and hold accountable homeless services providers. Expenses charged to NYC with no explanation, unapproved bonuses to employees, and unconscionable food waste.”

It Will Take a Joint Effort by NYC Elected Officials from the Federal, City, and State to Create a Mashal Plan to Properly Treat the Mentally Ill 

NYC needs to set up a Marshall-type plan to create a mental health infrastructure designed and operated by mental health doctors to provide the needed treatment to those who are indeed in the throes of crippling psychological conditions and risk harming themselves or others.  The Marshall Plan, named for Secretary of State George Marshall, restored the economic infrastructure of postwar Europe.  Similar to the transit experts running the MTA, airport experts running the Port Authority, medical experts, and not the politicians should run NYC’s mental health system, ensuring that it’s properly and effectively run.  Doctors must be in charge of the state and city’s policies and programs for the mentally ill so they can also monitor and change treatment as needed.

The unprecedented control that the New York State has in both Houses of Congress allows for the opportunity to gain funding for a Marshall Plan to properly treat New York’s mentally Ill.   Senate Speaker Charles Schumer and U.S. House Minority Leader Hakeem Jeffries should work with representatives from cities and states with similar homeless mentally ill populations to pass former Congresswoman Carolyn Maloney’s Michelle Go Bill, named after Ms. Go, who was murdered by a homeless man with untreated mental illness.  Maloney’s bill will allow Medicaid to use federal money to fund psychiatric hospitals with more than 16 beds to treat NYC’s mentally ill requiring long-term care, which the Medicaid law does not allow, ever since Congress established Medicaid in 1965.  Schumer and Jefferies can also finally fund the law passed in the 1960s by President Kennedy dedicated to his sister Rosemary who suffered from mental illness, to provide hospital beds for the mentally ill, which to this date has never been funded by Congress.

The Marshall Plan would also require the state to change the bail law to allow judges discretion to consider information as to the dangerousness of individuals to themselves and the community as well as their mental illness and/or failure to take their medications and place them in mental institutions for treatment with a medical expert’s consent.  The state must increase the number of mental health beds so that after court-ordered evaluations those suffering from mental illness can be placed in hospitals for long-term care. The state must also refurbish and redevelop the Creedmoor hospital campus and other closed mental treatment hospitals to provide desperately needed beds for the mentally ill.  These hospitals can house drug treatment centers and short-term transitional services for recovering patients or for patients who stopped taking their medications.  The hospitals can further provide long-term care for the seriously ill.  The Marshall Plan would require the city hospitals to give monthly blood tests to anyone ordered to go through mental evaluations by the court and placed on medications to ensure they continue taking their medication.

NYC Media and Progressives Work Together to Block Needed Hospitalizations for the Mentally Ill, Which Most New Yorkers Support

“Somehow, it’s become a scandal among activists and media that NYC’s mayor wants more severely mentally ill people living on the street to get evaluated and if needed to be hospitalized without their consent.  89% of New Yorkers say it should be easier to admit people who are dangerous to themselves or others to mental health facilities, while coverage of Eric Adams’ new plan to do that has been nearly 100% negative—a staggering disconnect between the public and press.” Harry Siegel, Daily Beast

If the media ignores or is unaware of the decades the mentally ill were hidden in inhumane institutions and jails, today’s ideological and political polarization of treatment, and the recent flood of migrants’ using up the resources of the city’s homeless shelters, there is little doubt that comptroller DiNapoli next audit will find more dangerous and untreated mentally ill misplaced in the city’s homeless shelters.  NYC needs a Marshall Plan led by a psychiatrist who represents a mix of Dr. Fauci and Robert Moses to get the homeless off the city’s streets and subways and provide them with the medical help they need.



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