Embedded Files
February 28, 2023
Dear Mayor Adams, Commissioner Vasan and Governor Hochul,
As NYC healthcare workers, we are alarmed and outraged by Mayor Eric Adams’ directive to forcibly relocate people experiencing homelessness under the pretense of providing mental health care, and his proposed legislative agenda that would expand criteria for involuntary psychiatric admission. By employing an interpretation of the Mental Hygiene Law that allows police and frontline workers to detain “persons who appear to be mentally ill and who display an inability to meet basic living needs,” and proposing to apply those same criteria to involuntary hospitalization, the Mayor’s plan criminalizes people experiencing serious mental illness or poverty and violates civil liberties, without increasing mental health care access.
Mental health care is indeed inaccessible in NYC. Individuals experiencing severe mental illness face numerous systemic barriers to care, including: a paucity of non-carceral providers, financial barriers to outpatient care, limited peer-led community resources, and closures of psychiatric hospital beds. However, involuntary transportation to emergency departments (ED) for evaluation does not address the sources of these barriers to mental health care. Coercive care is ineffective, fragmented and increases risk of harm and trauma. The Mayor’s plan misdirects resources and will further overwhelm EDs, Comprehensive Psychiatric Emergency Programs and scarce inpatient psychiatric beds, rather than increase access to desperately needed resources and care.
Further, the Mayor’s plan increases the risk of harmful criminalization and stigma, particularly for Black and Latinx New Yorkers. It is well documented that Black and Latinx people are disproportionately likely to experience homelessness in NYC due to structural racism in housing, healthcare, policing, and other systems. As such, the vague criteria “[ability to meet] basic survival needs,” and “ability to adhere to essential outpatient treatment” target those already facing structural barriers to basic services and care, namely disabled, non-white, poor and working class, and LGBTQ+ people. Plainly, this policy only further entrenches white supremacy, structural racism, and carceral ableism. As NYC healthcare workers who recognize racism as a public health crisis, we refuse to be complicit in such a proposal.
Finally, the solution to an inability to meet “basic needs” is robust resources to meet those needs, such as permanent supportive housing, financial support, and universal mental health, substance use and medical care. Comprehensive mental health care must include a continuum of services from low intensity outpatient visits to frequent, high intensity individualized care, to a trauma-informed crisis response and recovery support system that includes peer support and peer respite, crisis prevention, de-escalation, and emergency care. Furthermore, the definitive solution to homelessness is safe, permanently affordable housing. We need legislative infrastructure for health care and housing systems that are made for people, not profit, including:
Rent Guidelines Board and Emergency Tenant Protections Act reforms
Social Housing Development Authority
At its core, this directive criminalizes poverty and homelessness and weaponizes psychiatric hospitalization.
We must respond to mental illness and homelessness with access to safe, affordable, permanent housing, financial support, community care, and universal comprehensive health care, not forced psychiatric hospitalization.
The undersigned,
Matthiew Chen, Medical Student
Alyssa Ruiz
Nabilah Nishat, Medical Student
Shravya Gurrapu, Medical Student
Olivia Ding, MD
George Danias, Medical Student
Talha Arif, Medical Student
Maggie Tugend, Medical Student
Shaun Kohli, Medical Student
Ashanay Allen, Medical Student
Daniela Shill, MPH, Medical Student
Rebecca Chen, Medical Student
Helen Ding, MAT, Medical Student
Anna Jaysing, Medical Student
Sabrina Daoui, Medical Student
Maria Bower, Medical Student
Farimata Mbaye, Medical Student
Christine Lee, PhD
Jaydee Choompoo, Medical Student
Gillian Wright, Medical Student
Aparna Raghu, Medical Student
Alexandre da Silva, DNP, PMHNP-BC
Rosemary Busch Conn, MD
Samira Rabbanifar, MD
Alexander W. Legge, MD
Katherine Nordgren, MD, MPH
Sharon Chen, FNP-BC
Jacqueline Dragon, Medical Student
Stephanie Song, Medical Student
Spencer Dunleavy, MSc, MSc
Kim Peloza, Medical Student
Jennifer Avril, HIV Activist
Daniel McInerney, Medical Student
Angelica Saada MD
Shane Solger, MD
Zoey L. Thill, MD, MPP, MPH
Anuj Rao, MD
Bruce Trigg, MD
Jackson Roberts, Medical Student
Megan Chung, Medical Student
Lauren Jansma, Medical Student
Aidan Pillard, MPH
Cameron Clarke, Medical Student
Michael Zingman MD MPH
Julie Byrnes, Medical Student
Xander Harris, Medical Student
Alexandra Ewenczyk MD
Mabelitza Guzman Cordero, MPH student/dental student
Amir Hassan, Medical Student
Karl Reis, Medical Student
Gerardo Ramos-Lemos, Medical Student
Angela Liu, MD
Shravya Gurrapu, MD
Coraima Rihan Veliz, RN
Nesreen Rihan, MD
Helen Xu Medical Student
Radhika Sundararajan, MD
Alexander Jordan, MD
Omar Mirza, MD
Katherine Cocca-Bates, NP
Saadiyah Bilal, MD
Kristen D. Manter, MD
Alina Neganova, RN
Vivian Kim, MD
Kelsey Badger Medical Student
Sejal Shah, MD
Gretchen Grappone, LICSW
Erica Cao, Medical Student
Anna Salajegheh, MD
Faduma Hassan, Medical Student
Ethan Cowan, MD, MS
Harry Fillmore, Medical Student
Frances Hessel, MD
Varun Kejriwal Goel, MD
Ezequiel Ramos, Medical Student
Matthew Dickstein, Operations
Michelle Tong, Medical Student
Kimberly Gordon-Achebe, MD
Nicolas K. Fletcher ND, MHSA, MD
Takashi Matsuki, MD
Hunter L. McQuistion, MD
Catherine Castillo, MD
Joachner Philippe, Medical Student
Josimar Hernandez Antonio, Medical Student
William Terry, LCSW
Iman Hassan, MD
Deepika Slawek, MD
Anna Koerner, Medical Student
Emily Rutland, Medical Student
Stephanie Song, Medical Student
Stuart Chen-Hayes, Professor, Clinical Mental Health and School Counseling
Emily Warfield Genetta, LMSW
Lindsey Maclay, Medical Student
Kenny Venere, DPT
Meg Broderick, Medical Student
Emily Dowdell, MA
Sierra Davis, Certified Nurse Midwife
Hannah Firestone, LMSW
Linda Johnson, MA
Scott Duquette, Graduate Student, Social Work
Yasmin Issari, Medical Student
Franzi Ross, Social Work Student
Angela Retegui, RN
Stephanie Cherestal, PhD
Reba Watsky, MD
Alexander Kalicki, Medical Student
Tamsin Pargiter, MSW
Mirnel Azcona, MD
Curtis N. Adams, Jr., MD
Risha Khetarpal, MD
Sosunmolu Shoyinka MD, MBA
William C Torrey, MD
Altha J. Stewart, MD
Michael Reynolds, Medical Student
Angela Kirori, Medical Student
Pedro Garcia, Medical Student
Shane Solger, MD
Oni Blackstock, MD, MHS
Sam Kokoska, Medical Student
Nikita Israni, Medical Student
Gabrielle Wimer, Medical Student
Jenn Sugijanto, Medical Student
William B. Jordan, MD, MPH
Catherine Stratis, Medical Student
Emily Rutland, Medical Student
Jess Ho, Medical Student
Andrew Goldstein, MD
Alex Graff, Medical Student
Emily Menand, MD
Terence Hughes, Medical Student
Sewit Bereket, MEdical Student
Sandhya Kumar, MD MPH
Amanda Wang, Medical Student
Jeremiah Douchee, Medical Student
Carol Kessler, MD MDiv
Alina Kung, MD
Chanelle Diaz, MD
Marc Shi, MD MSc
Katja Brutus, Premedical Student
Ellie Miller, CNM
Serena Hoost, Medical Student
Carli Salvati, LMSW
Giorgio Handman LMSW
Catherine Rivas, MPH
Amanda Ramsdell, MD
Libby Wetterer, MD
David Muller, MD
Sydney Katz, MD
Alice Tang, MD, MHPE
Lauren Wessler, MD
Shravya Gurrapu, Medical Student
Kareena Lashley, MD
Nicole Turturro, MD MPH
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