Mayor Eric Adams has announced a policy that amounts to the mass internment of mentally ill people in New York. Clarifying openly that they need not pose a threat to anyone’s safety, Adams has decreed that hundreds or even thousands of people with disabilities will be collected from the street, taken into official custody, and force into mental hospitals against their will. Freedom for severely mentally ill people is now a nonentity in New York City.
Adams’s brutal authoritarianism has come as a shock to metal health advocates in New York City and across the country. In response, there has been an outpouring of justified anger at the mayor for his callous treatment of New York’s most vulnerable, and least popular, city residents. The outrage towards neo-confinement is fully warranted. But, for all that it’s an anomaly relative to recent policy, New York’s reinstatement of coerced hospitalization comports with a long history of malignant control.
Mentally ill people have never had their bodily autonomy respected in this country. Before the 1850s, the mentally ill tended simply to be banished, locked in cellars. After Dorothea Dix attempted to bring their suffering to light, a vast system of asylums opened across the country. Though Dix and her fellow reformers envisioned the asylums as a humane solution, the institutions quickly became hellacious dungeons, in which a peak number of 400,000 Americans would be essentially incarcerated by the mid-twentieth century. America typically punishes disfavored groups rather than attend to their hardships, so after the asylum/snakepits were finally closed, Ronald Reagan decimated the mental health budget, and the mentally ill were abandoned.
Now, despite a potent surge in welfare spending brought along by the Biden agenda, America is once again cracking down on mentally ill people’s freedoms. We could have funded the social services that mentally ill people need to live free, but it is hardly a surprise that a country obsessed with controlling marginalized bodies would force people into institutions instead. (To her credit, New York Governor Kathy Hochul has proposed a large increase in mental-health funding, but Adams has not budged from his plans to institutionalize people.)
This is a classic form of systemic oppression, which one theorist of mental-health history, Michele Foucault, called biopolitics. Why is biopolitical control aimed at the oft-sad lives of the mentally ill? Though policy often instructs the culture, in this case system oppression is downstream from cultural contempt. The mentally ill have been reviled in Western culture for almost 2,000 years. From the time 4th-century missionaries asserted that mentally ill people were subject to damnation, non-mentally ill Westerners have regarded people with mental illness as a tainted and dangerous race. This demonization continues in the media today, with TV shows such as Steve Carrell’s The Patient portraying mentally ill people as psychopathic killers. Most politicians form their impressions of mentally ill people based upon the centuries-old prejudices and contemporary mental-health minstrel shows that suffuse our culture. From these muddied waters comes a disposition towards oppression.
The mental health lobby, heroic though it is, holds roughly as much purchase in governing circles as the anti-poverty lobby–meaning, none. Continuing a bitter tale that has unfolded for nearly two millennia, our country’s politicians seem hellbent on shunning mentally ill people from a society that ought to belong to everyone no matter their brain chemistry.
Treatment, housing and purpose. I have found through 15+ years of advocating for my son and others who suffer from severe mental illness that if each of these basic needs is not supported the whole bench collapses. I’ve been witness to that collapse perhaps 30-50 times in New York City and the Triangle in North Carolina.
My son takes his medications with consistency. One injectable drug he receives provides him with a baseline stability that prevents him from becoming so psychotic that he poses a physical threat to anyone. Nonetheless he hears voices all the time- every minute/hour/day of his life. I can’t begin to imagine how he copes with that kind of disruption. Once he gets housing outside of a hospital setting, if he smokes a joint (or smokes a cigarette in a smoke-free environment)- both comorbidities which are completely predictable and to be expected- he’s homleless. Tossed out with nowhere to go. He loses his clothes, meds, his cellphone and the whole cycle starts over again. It is entirely predictable. Imagine a nursing home tossing a diabetic resident to the street for eating a candy bar.
Psychiatrists function like mechanics: they medicate him, and get him out the door and move on to the next vehicle. It’s as if they tune up a convertible with no functioning roof knowing full-well that it will be parked on the street where it will deteriorate in the rain…..but that’s not their problem. It’s a vicious circle. Wraparound services exist but they are difficlut to access and few and far between. I’m intimately familiar with mental health care in New York City and North Carolina (Chapel Hill and Durham) where he has lived since the onset of his disease in 2008- right after he was discharged from the Navy. New York City is an absolute nightmare- Mayor Adams just wants the mentally ill homeless out of view, warehoused anywhere. Hospitals in the City have too few beds and routinely turn patients away when they damn well know need help. Adams’ proposal is a purely political showmanship.
In the Triangle the same systemic problems persist within the mental health ecosystem as in New York City. The only difference is one of scale and population density.
Thanks for shining a light on this national issue Alex.
Mayor Adams coduct is not a surprise to this former New Yorker. It is shameful and I doubt the NY City Council will do anything to change it except possibly a speech or two lamenting it. As for the “mental hospitals” to which these unfurtunate people are to be taken, they cannot meet this challenge. It will also not make the subways nor streets safer.
Eric Adam’s lack of empathy to mentally ill persons may be the result of an early family exposure to someone with a serious mental health problem.
I believe that the behavior of the vast majority of “mentally ill” individuals demands a wholly sympathetic public policy response. The dilemma arises, it seems to me, in those cases where mentally ill individuals misbehave in public in such a way as to threaten to tear apart the social fabric, such as on a few streets in New York City or San Francisco. This poses a quite difficult challenge to civil society — may we rise to the challenge in a spirit of intelligent, compassionate humility.