[“Demonizing the homeless is not new. There is no more manifest
example of the failure of the system than bullying the vulnerable and
criminalizing mental illness.”]
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NYC’S MAYOR HAS NO ANSWER FOR HOMELESSNESS – HE SHOULD ASK
FRONTLINE WORKERS  
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Bob Hennelly
December 11, 2022
Work-Bites
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_ “Demonizing the homeless is not new. There is no more manifest
example of the failure of the system than bullying the vulnerable and
criminalizing mental illness.” _

It’s impossible to have a real conversation about the homeless
mental health crisis without examining how it’s a direct consequence
of our winner take all scarcity-based housing market and for-profit
health care system, (Photo by Bob Hennelly)

 

On Nov. 29, New York City Mayor Eric Adams declared at a press
conference
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that his “compassion” driven response to the city’s homeless
crisis would be to enhance
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the state’s existing authority to involuntary commit the mentally
ill in their ranks to ensure people “in desperate need” were no
longer allowed “to slip through the cracks.”

“As a city, we have a moral obligation to support our fellow New
Yorkers and stop the decades-long practice of turning a blind eye
towards those suffering from severe mental illness, especially those
who pose a risk of harm to themselves,” Mayor Adams said. “It is
not acceptable for us to see someone who clearly needs help and walk
past them.”

Adams, himself a former NYPD officer with extensive experience in the
subway system, blamed the deepening humanitarian crisis on the
existence of “a gray area where policy, law, and accountability”
had become “unclear”. This, he reasoned, led to a “culture of
uncertainty” that had caused “untold suffering and deep
frustration” that he proclaimed he would not “allow” to
continue.

Not highlighted in the mayor’s City Hall rollout was reference to
New York State’s decades-old decision to close mental health
facilities and neighborhood hospitals — nor the ongoing choices,
made amid the pandemic, by the city’s wealthiest private hospitals
to close their inpatient psychiatric units. Nor was there a
recognition of how the increasing scarcity of psychiatric care and
beds came as tens of thousands of affordable housing units disappeared
while city housing increasingly became a luxury good.

In the press release that accompanied his address were boiler plate
testimonials supporting the policy from mayoral appointees including
New York City Police Department (NYPD) Commissioner Keechant L. Sewell
and Fire Department of the City of New York (FDNY) Commissioner Laura
Kavanagh. Missing entirely was the real-world, street-smart
perspectives of the thousands of first responders, transport workers,
social workers and healthcare professionals on the front lines of the
deepening humanitarian crisis that takes a real toll on them as well.

As a candidate for mayor, Eric Adams emphasized his working-class
public union roots — and the unions responded with their endorsement
of the then-Brooklyn Borough President. Yet as mayor, his approach to
governing and labor relations has resembled the pro-business worldview
of Mayor Michael Bloomberg where the unions were expected to fund
their own cost of living raises with concessions and givebacks. This
rightward branding to ‘make do’ comes as the city he leads
continues to unravel from the lingering consequences of a mass death
event, as well as everything else ranging from declining student test
scores to a mass exodus of key municipal civil service titles from
cops to paramedics.

Now, some of the sharpest and best-informed criticism of the mayor’s
latest signature policy comes from the leadership of the unions that
were his earliest and most ardent supporters. In a Dec. 7  New York
Times
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op-ed, Anthony Almojera,_ _a lieutenant paramedic with FDNY EMS, and
vice president of the DC 37’s Uniformed E.M.S. Officers Union, Local
3621 described a dystopian street-scape where his colleagues have been
assaulted and even murdered by emotionally disturbed individuals that
are also homeless.

“I’m not opposed to taking mentally ill people in distress to the
hospital; our ambulances do this all the time,” wrote Almojera.
“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.”

Almojera continues, “Mr. Adams says that under the new directive,
this patient won’t be discharged until a plan is in place to connect
the person with ongoing care. But the systems responsible for this
care — sheltered housing, access to outpatient psychiatric care,
social workers, a path to reintegration into society — are horribly
inadequate. There aren’t enough shelters, there aren’t enough
social workers, there aren’t enough outpatient facilities. So,
people who no longer know how to care for themselves, who need their
hands held through a complex process, are alone on the street once
again.”

“Our ambulances are simply the entrance to a broken pipeline,”
Almojera writes. “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.”

The veteran FDNY EMS officer and author of the memoir  “Riding the
Lightning: A Year in the Life of a New York City Paramedic"
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suggests that New York’s mayor look beyond “a superficial fix”
to what is actually a national problem caused by a long
“neglected” health care system and chronic underinvestment in
“social services, housing and mental health care.”

According to the New York State Nurses Association [NYSNA], which
represents 40,000 nurses, the contraction of available psychiatric
beds has accelerated even as New York City sunk deeper into the latest
crisis as COVID raged and killed tens of thousands of New Yorkers and
over one million Americans.

“As the COVID-19 pandemic hit New York, Governor [Andrew] Cuomo
suspended the Certificate of Need applications which require hospitals
to go through a public process before closing or changing services,”
according to a NYSNA
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fact sheet. “Consequently, hospital administrations have been
emboldened, closing their inpatient psychiatric units, often without
clarifying to nurses or the community whether these moves are
temporary or permanent.”

NYSNA’s 2020 policy brief continues, “Private hospital systems
like NY Presbyterian and Northwell are taking these services out of
the community, despite decades of cuts to mental health care stemming
from mergers and hospital closures. The Berger Commission and other
efforts to shrink NYS hospital capacity, together with declining
Medicaid reimbursements, and the reality that psychiatric patients
simply aren’t as lucrative as other patients, have created powerful
incentives for hospital systems to shed inpatient psychiatric beds.”

“Meanwhile, the city’s public hospital system and the correctional
system are picking up the burden,” NYSNA observed. “This
contributes a greater likelihood that individuals with serious mental
illness will have a violent encounter with police. The acute
underfunding of public hospitals means that the healthcare
professionals in our public system are not provided the resources to
treat this new influx of psychiatric patients, many of whom have
complex diagnoses.”

At her Dec. 7 press conference before the City Council’s Stated
Meeting, City Council Speaker Adrienne Adams was asked by Daily News
reporter Michael Gartland if the Adams administration had offered the
City Council any details on how the city would fund the additional
psyche beds the new approach would likely require, she said the
Council was “still waiting for a full, comprehensive plan.”

“The conversations do have to be much deeper,” Speaker Adams told
reporters. “Conversations around mental health, preventative
measures—the city’s need for deeper investments in our mental
health infrastructure---how to deliver people the long-term help that
they need. The first thing that comes to my mind is supportive
housing. What are we going to do once we determine someone is going to
be hospitalized or evaluated? What is the time frame?... It’s always
going to come back to supportive housing.”

It’s impossible to have a real conversation about the homeless
mental health crisis without examining how it’s a direct consequence
of our winner take all scarcity-based housing market and for-profit
health care system. Without addressing those issues the use of law
enforcement to “improve” street conditions by forcibly taking the
indigent mentally ill off of the street without a real plan becomes a
blunt  force instrument that’s only guaranteed to inflict more
trauma.

In doing so,  the city will be following a long tradition going back
to the 1600s when England enacted it’s so-called Poor Law
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required vagrants to “be committed to a house of correction or
fined.”

“The American colonies and state governments modeled their public
assistance for the poor on the Elizabethan Poor Laws and the Law of
Settlement and Removal,” according to the Virginia Commonwealth
University’s Social Welfare History Project. While the mayor’s
efforts no doubt springs from an authentic desire to relieve the
suffering of the undomiciled mentally ill, it also re-enforces the
public appearance that he’s taking strong action.

New York City-based sociologist Dr. Steven Pimpare is the founder and
director of the Public Service & Nonprofit Leadership Program and a
Faculty Fellow at the Carsey School of Public Policy at the University
of New Hampshire who previously taught at Columbia University, NYU,
Simmons University, and the City University of New York. He is the
author of _Politics for Social Workers: A Practical Guide to Effecting
Change_
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_published in 2021 by Columbia University Press

“This is a quality-of-life problem for the affluent, not a
humanitarian problem,” Pimpare said. “Demonizing the homeless is
not new. There is no more manifest example of the failure of the
system than bullying the vulnerable and criminalizing mental
illness.”

Perhaps the Mayor would be well advised to consult more with the
workers on the frontlines.

_WORK-BITES is taking a bite out of all that. We’re a team of
dedicated labor writers with decades of combined street cred covering
every facet of the American Labor Movement, and dedicated to upholding
the public’s inalienable right to know. Like the rest of our working
class sisters and brothers, we’re fed up with powerful people
playing the rest of us like chumps. We’re resolved to applying the
highest standards of journalistic integrity to chronicling workplace
injustices — spotlighting exploitation — revealing criminality —
and heralding the truly heroic._

_If the worldwide corona virus pandemic has done anything, it’s
obliterate the outdated notion the bosses have any concern for us or
our families. Despite the elites, we remain essential — and we know
it. WORK-BITES is dedicated to telling those stories and telling them
to you straight.  BECOME A MEMBER
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* homelessness
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* mental health
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* For Profit Health Care
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* afforable housing
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* New York City
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