Mental Health and Disorders

In the Democratic primary’s last days, and with New York’s economy starting to regain its footing, a chronic problem gains new urgency.Random slashings on the subways. Groups of men clustered outside Midtown Manhattan hotels serving as homeless shelters. Anti-Asian attacks on the streets.In the closing days of New York’s Democratic primary for mayor, the city’s chronic struggle with homelessness has taken on increasing urgency. As the city moves to reopen for business and tourism, public concern — and the candidates’ attention — has focused on a small number of people who are mentally ill and potentially violent.The issue is complicated. Homeless people are not involved in every unsettling incident, and they also have been targeted in vicious killings and other attacks. Their advocates warn against demonizing a large group of people who are struggling just to survive. Most of the 48,000 people in the main shelter system are families with children, not single men.Before the pandemic hit, the shelter population had increased since Mayor Bill de Blasio took office, even as he doubled spending on homeless services to more than $3 billion. The number of families in shelters has dropped sharply since early last year, largely because of an eviction moratorium that has been extended through August. If it expires then, hundreds of thousands of tenants who collectively owe over $1 billion in back rent could lose their homes.Now, a spate of attacks on the streets and in the subway, combined with an increase in gun violence, have fed a perception in many quarters that the city is in danger of sliding into chaos. The candidates seem to be split, seeing the issue through two different lenses: the plight of people with an illness that can last their whole lives, and the safety and quality of life of everyone else.At the final debate on Wednesday, Andrew Yang, the former presidential candidate, left no doubt where he stood.“Yes, mentally ill people have rights,” the Democratic candidate Andrew Yang said at a mayoral debate this week. “But you know who else have rights? We do.” Andrew Seng for The New York Times“Mentally ill homeless men are changing the character of our neighborhoods,” Mr. Yang said. “We need to get them off of our streets and subways and into a better environment.” Later, he added: “Yes, mentally ill people have rights. But you know who else have rights? We do: the people and families of the city. We have the right to walk the street and not fear for our safety.”Candidates with more progressive agendas took a softer stance. Scott M. Stringer, the city comptroller, described his plan to build 30,000 units of so-called supportive housing, where people with mental illness would get a range of services. Maya Wiley, a former counsel to Mr. de Blasio, lamented that the Rikers Island jail complex had effectively become the city’s biggest psychiatric facility.Unlike some of Democratic rivals, Maya Wiley does not favor assigning more police officers to the subway system.Jonah Markowitz for The New York TimesThe causes of the apparent increase in the number of homeless people on the streets and in the subway of pandemic-era New York are many.When the lockdown hit last year, the city moved thousands of people from barrackslike group shelters across the city into unused hotels — many of them in densely populated middle-class and wealthy Manhattan neighborhoods — to stop the spread of Covid-19. Many people living under precarious conditions lost their jobs and, thus, their homes. With workers doing their jobs remotely, far fewer people were in the main business districts, leaving those who live on the streets to stand out. Some hospitals used inpatient psychiatric beds for Covid patients. Many libraries and other places where homeless people typically spend their days closed.The city is accelerating its efforts to move homeless people off the Manhattan streets. On Wednesday, Mr. de Blasio said that 8,000 people would be moved from 60 hotels back to group, or congregate, shelters by the end of July. Starting next week, the police will begin sweeps along 125th Street in Harlem to clear it of homeless people and those using drugs, according to a senior city official who spoke on the condition of anonymity because the plan has not been publicly announced. A spokeswoman for the mayor said the effort was focused on “helping people with substance abuse issues access harm-reduction resources” and that offer would be on hand to “assist as needed.”The leading Democratic candidates have proposed many plans to address the homelessness problem. Here are some of them. More details can be found in voter guides produced by RxHome and the Family Homelessness Coalition and City Limits.Reduce or end reliance on congregate shelters.Kathryn Garcia, a former sanitation commissioner who calls shelters “a band-aid solution to a long-term problem,” says she would cut the shelter population in half. Shaun Donovan, a former city housing commissioner under Mayor Michael R. Bloomberg, said he would end the use of congregate shelters entirely in his first term. (Mr. Donovan’s tenure was the only time during Mr. Bloomberg administration that homelessness fell). Ms. Wiley cites “real concern” that people who stayed in hotels during the pandemic “will be unwilling to come to shelter if we shift back to congregate settings.”Build more “deeply affordable” housing — a lot more.All of the candidates say they will do this. Mr. Stringer says that Mr. de Blasio, despite highlighting his record on creating affordable housing, “has built more housing for people who make over $150,000 a year than for people who make $40,000 or $30,000.” He says he would require most new residential buildings financed with city subsidies to house people with very low incomes.Expand the use of shelters that offer more privacy and have fewer rules.So-called safe haven and stabilization shelters offer single-occupancy rooms and fewer rules and restrictions as to who qualifies for them than group shelters do. Many of the candidates want to build more of such shelters, including Raymond J. McGuire, a former Wall Street executive, and Mr. Yang, who said, “It’s a sign of the city’s broken politics when the choice is either temporary hotels or overcrowded shelters.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Get more people into psychiatric treatment.Mr. McGuire, Mr. Yang and Ms. Garcia all say they would press for wider use of Kendra’s Law, which allows courts to require treatment for people with mentally illness.Add psychiatric beds.Mr. Yang said that the number of psychiatric beds in city hospitals had decreased 14 percent and that he would double the current number, although he did not say how he would pay for it. Eric Adams, the Brooklyn borough president, and Mr. Yang both favor adding psychiatric “respite beds” for people with mental illness who are not deemed sick enough to be admitted to a hospital but are too sick to return to a shelter or to the streets.Focus more on providing mental health services to people in the streets and less on arresting people.“We cannot continue criminalizing being Black and brown, criminalizing mental illness, criminalizing having substance abuse issues,” Dianne Morales, a former nonprofit executive, said at the debate. “That is not the answer for creating a safe city.” Ms. Garcia supports sending “crisis teams” into the subway that include mental-health professionals “who will make a determination and get people the treatment that they need.” Ms. Wiley says Mr. de Blasio’s approach, which she called overpolicing, “never tried to solve homelessness and merely led to displacement, for example, moving those experiencing homelessness from the subways to the streets.”Close the prison-to-shelter pipeline.Mr. Donovan notes that more than half of the people released from state prisons to New York City go directly to homeless shelters, a cycle he pledged to break by providing housing vouchers to people leaving jail.Increase pressure on shelter operators to find permanent housing for clients.Mr. McGuire says he would shorten shelter stays by holding operators responsible for moving people into permanent housing and by “shifting contracts and investment to the most successful operators.”Build more domestic violence shelters.Mr. Yang has noted that domestic violence is one of the main reasons that families seek shelter and that only 23 percent of domestic-violence victims in shelters are in ones that are designed for them. He says he would build more of those.More police in the subway.Mr. Adams, a former transit police officer, says, “We should have a police officer on every train.” Ms. Garcia wants officers “walking the platforms and riding the actual trains, not just standing around.” Mr. Yang, Mr. McGuire and Mr. Donovan also want more police in the subway. Ms. Morales, Mr. Stringer and Ms. Wiley do not.Help tenants and landlords alike in order to prevent evictions.Mr. Donovan favors a “holistic approach” that would “provide direct rent payments for hard-hit tenants” and “offer stabilizing funds to landlords” who agree not to evict.Joseph Goldstein contributed reporting. More