As the state and city budget seasons shift into high gear, we’re already getting a trickle — soon to be a raging river — of big-budget proposals coming from private-industry groups, advocacy organizations, and politicians. There are calls to spend nearly $2 billion to pay off delinquent utility bills. $5 billion to provide universal child care. $1.7 billion to build out CUNY over the next five years and make the university tuition-free for city residents.
These are all interesting and worthy proposals. But it’s important that Mayor Eric Adams, Governor Kathy Hochul, and state lawmakers not lose sight of the catastrophe unfolding underground, and that they treat the situation like the emergency it is. They need to follow the strategies — including a dramatic increase in funding — that experts say are needed to get control of a crisis of seriously mentally ill New Yorkers who are living in our subways and showing up in violent incidents as victims and victimizers.
We’ve all seen the horrific headlines and sickening videos. Michelle Go was pushed to her death in the Times Square subway station by a man named Martial Simon who had been diagnosed with schizophrenia and hospitalized 20 different times over a span of decades.
Another woman was suddenly attacked, while sitting on a bench at the Wakefield-241st station in the Bronx, by a man named Frank Abrokwa who smeared a bag filled with his own feces in her face and hair. A 57-year-old city Health Department researcher named Nina Rothschild was kicked down a flight of subway stairs and smashed in the head 13 times with a hammer in the course of being robbed.
And a single weekend in February saw eight people punched, stabbed, slashed, robbed, beaten with a pipe, or threatened with a hatchet. Felony assaults in the subway increased nearly 25 percent last year despite a drop in ridership, and arrests are up 54 percent this year.
Most of the disorder appears to be the kind of “ordinary” criminal behavior that can be tamped down by a straightforward police response, which Mayor Adams, an ex-transit cop, has promised to deliver. But some of the high-profile violence is coming from suspects who are homeless and clearly mentally ill — and experts say the problem reflects a perfect storm of too little funding, too much turnover, and not enough coordination between agencies.
“The city grew by 400,000 people since 2010 and we’re down about 800 psychiatric beds, which is about 14 percent of the total, between the beds being flipped to medical beds and beds being flipped to be being used for COVID. Not having the beds is an invisible aspect of the problem we’re facing,” says Joe DeGenova, the president and CEO of the Center for Urban Community Services, a nonprofit that provides services to poor and homeless New Yorkers.
“There are less beds available for psychiatric services. There are more people who need them,” DeGenova told me. “And the reimbursement rates for the psychiatric beds have not kept pace with the cost of providing the service. It’s a supply/demand problem.”
Anecdotally, he says, it is harder than ever to persuade hospitals to accept new indigent psychiatric patients.
Homelessness adds fuel to the fire. “Without housing, people rarely have their mental health. Housing is key,” says Amy Dorin, president of the Coalition for Behavioral Health, an alliance of 110 nonprofit community-based agencies. Social-service organizations, she told me, need “more prevention services to prevent mental illness and substance abuse earlier on, and more treatment programs.”
The agencies that do offer these services, says Dorin, are seeing rates of personnel turnover as high as 48 percent. “It’s very hard to provide the care that we want if people aren’t coming into our field or staying. This was a major advocacy issue for the state and for the city,” Dorin told me. “We suggest that the city do things like loan forgiveness, or tuition reimbursement. Things that will encourage the workforce to come and stay and do the work that we need them to do.”
At City Hall, the strategy appears to focus on routine quality-of-life policing, which is much simpler and cheaper than finding and treating mentally ill New Yorkers.
“No more just doing whatever you want. No, those days are over. Swipe your MetroCard. Ride the system. Get off at your destination,” Mayor Adams announced at the Fulton Street station last month. “The system was not made to be housing, it’s made to be transportation.”
The mayor said that NYPD officers would begin ordering all people off the trains at the end of selected lines and enforce MTA rules of conduct that prohibit stretching out on seats, sleeping on the subways, staying in a station for more than a hour, and so on. With assistance from Governor Hochul, the mayor said, the city would begin sending out 30 mixed teams of cops, social workers, and Health Department employees to persuade homeless people to sign in at a shelter and/or accept medical treatment. An additional 500 short-term shelter beds would be made available to help accommodate those in need.
It all sounded logical. But nearly a month later, one could pass by the World Trade Center stop on the E line and see people stretched out in subway cars, dozing as cleaners scrubbed and mopped around them. At the other end of the line, Jamaica Station still has homeless encampments outside a major subway and commuter railroad hub.
Critics warned that the Adams plan, at best, might simply shift the problem from the subways onto the streets.
“It’s a very magical kind of thinking that we’re going to get people out of the subway when you don’t have any place to put them,” said Beth Haroules, an attorney for the New York Civil Liberties Union. “You can remove that person, but what are you doing for the person? You make the neighborhood feel better or you make people on the subway feel better, but you’re not solving the problem.”
And that is the heart of the matter. People in need of care often end up on the streets because they can’t find permanent housing, and because far too many New York City homeless shelters are still dangerous places where robbery and drug use take place, leading many people to take their chances on sidewalks or subway cars. The psychiatric or addiction-treatment services some of these folks need isn’t always available because the agencies that provide help are underfunded and stretched thin.
The bottom line is that we need a rapidly expanded, dramatically better funded social-service infrastructure that can step up and bring professional, coordinated, and sustained care to seriously mentally ill New Yorkers. But that requires leadership that understands the problem and is prepared to make a major investment in actually solving it.
Dorin told me her coalition of more than 100 providers asked the state legislature for $500 million to address the staffing and capacity-building needed to take on the problems of homelessness and mental illness. The request, she says, was denied.
That’s a mistake. Legislators may think they have better things to do than prevent a repeat of tragic incidents like the murder of Michelle Go. But they don’t.