As new guidance from Mayor Eric Adams’ office gives law enforcement more power to take people to the hospital against their will, experts, advocates and the city’s largest police union worry officers are unprepared for the task.

They say a policy that is supposed to help people in need of treatment could instead cause more harm.

Police were already allowed to force someone to go to the hospital for a psychological assessment if they believed the person posed a threat of serious harm — a policy that results in hundreds of civilian complaints each year. Under the new directive, announced by Adams on Tuesday, the definition of “serious harm” has grown to include people who clinicians or police believe are unable to meet their own “basic human needs.”

The Police Benevolent Association, which represents rank-and-file officers, urged the city to provide “extremely clear guidance and training.”

“We need our leaders to back us up when we carry out these duties,” PBA President Patrick J. Lynch said in a statement. “And — above all — we need our leaders to recognize that each new responsibility is a strain on our severely understaffed, overworked and underpaid ranks.”

The policy change comes at a time of heightened fears about public safety as the city grapples with a pandemic-era crime surge. While shootings and homicides are down this year and overall crime levels are far below the last century’s historic highs, police data show transit crime and most other major felonies are up. Several high-profile random acts of violence involving people seemingly in the throes of mental crisis — including the fatal shoving of a woman onto the subway tracks in January — have stoked fears and increased pressure for Adams to take action.

“This culture of uncertainty has led to untold suffering and deep frustration. It cannot continue,” the mayor said at a press conference Tuesday announcing the new directive. “We need to change that culture and clarify our expectations.”

But it’s unclear at this point what criteria officers will be trained to consider when deciding whether someone qualifies for an involuntary hospital transport. The NYPD said in a statement that it is “currently in the process of aligning its policy, guidance and training in conformance with the mayor’s directive.”

We need our leaders to back us up when we carry out these duties. And — above all — we need our leaders to recognize that each new responsibility is a strain on our severely understaffed, overworked and underpaid ranks.
PBA President Patrick J. Lynch

The NYPD patrol guide currently instructs officers to use “crisis communication techniques” to try to convince people to go to the hospital voluntarily. The policy tells officers to slow down encounters with people experiencing a mental health crisis, so that they have time to de-escalate the situation. It also recommends that officers maintain a safe distance — ideally 20 feet or more. Force is only supposed to be used “when it is reasonable to prevent serious physical injury or death.”

Following calls to better train officers for encounters with people experiencing mental illness, the NYPD rolled out a curriculum used at many departments across the country called Crisis Intervention Team training, or CIT. But the department paused the program during the pandemic. According to the Mayor’s Office of Community Health, about 16,000 officers have gone through the training — out of more than 33,000.

Don Kamin, who helped the state develop its CIT training for law enforcement agencies outside of New York City, said even officers with de-escalation training can ramp up tensions when someone is in emotional distress.

“The mere presence of the police can escalate a situation even before they have a chance to say or do anything,” he said. “And, quite frankly, not every police officer has, nor should have, the ability to work with individuals in distress in the first place.”

More than 3,100 complaints have been filed against officers who forcibly transported someone to the hospital — or threatened to — in the last five years, according to data obtained by Gothamist from the Civilian Complaint Review Board. Those complaints included a man who in January 2020 was strapped to a stretcher and taken to the hospital after a superintendent called the police when she found him looking through the recycling outside the apartment building she managed. The agency also investigated a complaint regarding a man who was tasered, cursed at, handcuffed and taken to the hospital after officers found him standing in the middle of Queens Boulevard without a shirt, socks or shoes in October 2019.

‘A job that they are not equipped for’

Philip T. Yanos, a clinical psychologist and professor at John Jay College of Criminal Justice, said he’s concerned that giving officers more discretion to force people to go to the hospital will create more risk for individuals who need help.

“It's going to actually be possibly traumatic to them, possibly dangerous to them physically,” he said. “But it's not going to help them.”

Yanos has convinced patients to go to the hospital voluntarily and watched officers take patients by force. Sometimes force is the only option, he said. But his preference is always to bring someone with their consent.

“It definitely feels very different to have someone be picked up by EMS, but to go voluntarily, versus somebody being forcibly taken and resisting,” Yanos said. “That whole resisting process is where things can go badly, because that kind of brings in the police training of certain ways to subdue someone and things like that.”

Yanos said he understands that the mayor is trying to do something that will make people feel safer.

“Maybe it'll have that impact,” he said. “But is it going to actually reduce crime? Is it going to not lead to tragic incidents? Is it going to address and improve anybody's circumstance who’s experiencing homelessness? I can't see how that could be possible.”

Bronx Defenders Executive Director Justine Olderman called the directive “short-sighted” and an outdated approach to address people’s fears of crime.

“What we are trying to do is essentially force people to do a job that they are not equipped for, that they didn't sign up for, and is in many ways completely antithetical to what their primary responsibilities actually are,” she said.

When Keli Young first heard the news, she was overcome with fear. Young works closely with people experiencing homelessness and mental health complexities as a campaign coordinator for VOCAL-NY, and she worries this policy will have the opposite of its intended effect.

“It's going to make it harder for health care and outreach workers whose approaches are grounded in love, compassion and care to reach people,” she said. “It's going to push people further to the margins of society, because they fear being arrested.”

Young wants people to get the treatment they need, but she doesn’t think coercion is the right approach. Instead of asking police to force people to go to the hospital, she thinks the city should invest in long-term solutions, like affordable housing and community-based health care. Otherwise, she said, people will continue to cycle in and out of the system.

“We're putting people in these facilities that are already underfunded and overworked. And then what?” Young said. “I think that's a big question that is left unanswered by his plan.”

Isidoro Rodriguez contributed reporting.