By Jumaane D. Williams, Public Advocate for the City of New York

In October of 2019 my office released a report, “Improving New York City’s Responses to Individuals in Mental Health Crisis,” which was both a condemnation of the city’s mental health crisis response and a guide for restructuring and reforming those systems. This report was informed by conversations with and the work of mental health and justice advocates, and was crafted in response to the number of avoidable deaths at the hands of an inadequate, insufficiently trained crisis response system. While Kendra’s Law mandated some Assisted Outpatient Treatment (AOT) programs for those deemed most at risk, all communities are improved when everyone has access to care and mental health services. This law is a tool that can be used for those most at risk, but without proper systems of care for all, it can also be abused by the same structures this report hopes to address. If everyone received culturally competent, affordable care, the measures mandated by the law would be implemented with far less frequency or necessity. We implored the prior de Blasio administration to follow this new framework, to take critical steps to reduce harm, and to truly address the urgent needs of New Yorkers experiencing mental health crises, and of a city where the emergency is only mounting.

In the three years since our initial report, that urgency has not been evident in the actions taken by the administration. While some progress has been made in line with our office’s recommendations, the prior administration was unwilling to more fully embrace the kind of changes our city needs. The impacts of the pandemic on both our individual and collective mental health, the trauma incurred, have only heightened the need for systemic reform. The ongoing reckoning with how we define and produce public safety has also put a spotlight on the need to holistically address this crisis as an issue of health, rather than simply law enforcement.

JUMAANE D. WILLIAMS, center. Photo courtesy of the Office of the Public Advocate.

An adequate mental health response system and infrastructure requires deep investments into the provision of social services. We must ensure that individuals do not go through a revolving door from temporary service to temporary service, and instead seek long-term solutions. For individuals who are justice-involved and face mental health challenges, the answer is not additional policing nor involving law enforcement in the City’s mental health response. Instead, the City must work to move in the direction of entrusting trained mental health and behavioral experts with responding to mental health crises rather than police.

Given the ways in which the landscape of crisis intervention has shifted, and the fact that on the city, state, and federal level we have different administrations than at the time of the report’s release, I feel we now have an opportunity and obligation to assess where changes have been implemented, what reforms are still needed, and any new recommendations that have arisen in the last three years. This review has been framed and informed by both the data and the real, human stories of the last three years, as well as the City’s action, or lack thereof.

Time has passed, but the moment for action, the moral mandate for reform, is ongoing. It is my hope that you, your administration, our partners in government, and New Yorkers review both our original recommendations and this new assessment, and use it as a framework for a renewed commitment to mental health support in our city. My office and I are eager to engage with both your administration and communities across our city in order to re-center and re-imagine mental health responses in our city. This ‘past and present’ review is most effective only if it provides a path toward the future.

Since 2019, the list of names lost to inadequate mental health infrastructure has only grown. It is our responsibility now to realize the reforms needed and the urgency of action, to prevent more suffering and loss.


Jumaane D. Williams