Mayor Eric Adams is renewing his push for legislation in Albany that would clarify and expand the criteria for someone to be hospitalized for psychiatric care against their will in response to last week’s stabbing spree that left three people dead in Manhattan.
The mayor’s renewed call comes even as he acknowledges that state lawmakers have demonstrated little support for the measure.
“We’ve been back and forth to Albany to say, let’s codify [the standard] in law and give real clarity around the authority we have of dealing with people with severe mental health illness,” Adams told reporters following the Nov. 18 attack.
He added: “We’re getting ready to go up to a new legislative session in Albany. We have to take those who can’t take care of themselves off our street and give them the humane care that they deserve.”
Officials said the attack was unprovoked and carried out by a homeless man who had several previous brushes with the law. Ramon Rivera, 51, the alleged perpetrator, was apprehended by agents with the U.S. State Department’s Diplomatic Security Service, near the United Nations at East 42nd Street, hours after the first attack occurred. An attorney for Rivera has requested that his client undergo a psychiatric evaluation before entering a plea.
Adams seized upon the incident as evidence of the need for the stalled mental health reforms. The New York Civil Liberties Union and other critics argue the measure violates an individual’s civil rights under state and federal law and further stigmatizes people who are homeless and struggling with mental health issues.
The bill touted by Adams is known as the Supportive Interventions Act. It would codify guidance on involuntary commitments that the state Office of Mental Health provided in a 2022 memo. That memo states that a person can be forcibly transported and admitted to the hospital for psychiatric care if they are unable to meet their own basic needs — not only if they pose an imminent threat of physical harm to themselves or others.
The new law would also ease some of the other requirements for involuntarily admitting someone to the hospital or placing them in court-ordered outpatient treatment.
“It clearly clarifies the standards for holding a person for care in a hospital,” Adams said. “Clarity allows people not to feel reluctant to make the decision.”
When the state memo on involuntary commitment came out in 2022, Adams announced that police officers and outreach workers would start using that interpretation of the law when determining whether to hospitalize someone against their will.
He has been able to move forward with the new protocols despite legal challenges and criticism from mental health and homeless advocates — but he maintains the standard needs to be further clarified and tweaked through state legislation to be fully put into practice.
Trepidation among police and clinicians
Between January and October of this year, an average of 126 people per week were taken to the hospital involuntarily in New York City, according to the mayor’s office. But Adams said there is still some trepidation among police and clinicians about putting the guidance he and Gov. Kathy Hochul have championed into practice.
Adams made a similar case for state lawmakers to pass the Supportive Interventions Act last year, after Jordan Neely, a man who was homeless and had a schizophrenia diagnosis, was killed on the subway. Daniel Penny, a former Marine, is currently standing trial in connection with Neely’s death.
Penny pleaded not guilty to manslaughter and criminally negligent homicide after putting Neely in a chokehold on an uptown F train in May 2023.
The victims of the Nov. 18 attack were Angel Lata Landi and Wilma Augustin, both 36, and Chang Wang, 67.
Despite Adams’ yearslong advocacy campaign for the Supportive Interventions Act, it has failed to gain traction in the state Assembly during the last two legislative sessions, and has yet to be introduced in the Senate.
State Sen. Jessica Scarcella-Spanton, a Democrat representing Staten Island and South Brooklyn, said she plans to introduce it in her chamber in the upcoming session, following discussions with the mayor’s office.
Meanwhile, state Sen. Brad Hoylman-Sigal and newly elected state Assemblymember Micah Lasher, both Manhattan Democrats, have announced an alternative bill, known as the HELP Act.
It includes some of the provisions in the Supportive Interventions Act — such as expanding the types of mental health clinicians who can evaluate whether someone should be held for psychiatric care — but does not seek to change the current standard for involuntary commitment.
“What is considered feasible in Albany is an important North Star when introducing new legislation,” Hoylman-Sigal said.
He added that he wants to protect the state’s existing standard for involuntary commitment because of his “own values and belief system” and because “that definition is, I think, considered sacrosanct by a number of my colleagues.”
The Supportive Interventions Act would also make additional changes to the Mental Hygiene Law. They include requiring clinicians to take into account someone’s medical history and recent behavior when deciding whether to admit them involuntarily and adding shelter staff to the list of people who can take someone to the hospital against their will.
It would also require hospitals to evaluate all psychiatric patients upon discharge to determine if they should be required to undergo court-ordered outpatient treatment. Noncompliance could land patients back in the hospital.
Both the Supportive Interventions Act and the HELP Act would require community organizations to be notified if someone on their caseload is hospitalized for psychiatric care and involved in the discharge planning process.
Asked about the HELP Act, mayoral spokesperson William Fowler said, “We are grateful for this support, but still believe we need to go further to fully repair the treatment laws.”
‘Back to the Legislature’
Scarcella-Spanton said she believes she can convince her colleagues to change the law.
“I’m also very open,” she said. “So if there are issues that are brought up with the way that the legislation has been worded, I’m willing to work with my colleagues to get it to a place that they’re comfortable with.”
But many critics continue to push back on Adams’ focus on expanding involuntary mental health interventions.
“It’s all directed at how you sweep people out of the public domain to make everybody feel fine and feel safe, but it doesn’t address the underlying issue,” said Beth Haroules, a staff attorney at the New York Civil Liberties Union. The NYCLU argues that Adams’ involuntary hospital transport policy risks infringing on people’s individual rights under state and federal law and exacerbates bias against homeless people and those with mental illnesses.
Harloules said officials should instead focus on creating a comprehensive system with broader access to mental health services.
The need for involuntary hospitalization for psychiatric care when treating people on the street is rare, and it’s more likely people will need to go to the hospital for medical reasons, said Dr. Tony Carino, director of psychiatry at Janian Medical Care, which provides psychiatric and social services to homeless people.
He added that his staff already works to coordinate with hospital staff on psychiatric evaluations and discharge planning if a client is hospitalized.
“We just need to do more to bring [programs] up to scale and have more permanent supportive housing, more intensive mobile treatment teams and more street psychiatry, which we’re working on,” Carino said.
Hochul previously attempted to use the state budget to formally change the language around involuntary commitments, but only succeeded in making more incremental changes to state policies on court-ordered treatment.
Asked about the stabbings last week, Hochul said, “I want people to know that I will go back to the Legislature, I’ll go back with every tool in my kit to find ways to address this because this is not acceptable.”