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Mayor Adams: If severe mental illness is causing someone to be unsheltered and a danger to themselves, we have a moral obligation to help them get the treatment and care they need.

Brian Lehrer: Mayor Adams from his Tuesday speech. It's The Brian Lehrer Show on WNYC. We'll begin today by picking up where we left off yesterday talking about Mayor Adam's plan to involuntarily commit more New Yorkers who appear to have serious mental health problems. We spent about a half hour of yesterday's show on it, and there's just so much more to say. Public advocate Jumaane Williams will be with us in just a minute.

Where we ended yesterday was on the thought that a psychiatric crisis might present as an individual situation, but the prevalence of how many such crises we have these days and how they disproportionately occur in certain groups is really a social situation. Individuals lose their freedom because of a failure of society. Maybe it's the politicians who should be locked up against their will until they solve the problem with better policies because what's really crazy is that the powers that be have let it get to this point.

When you think about it, this issue and the city's response to it are so much bigger than the narrow question of when an individual is in bad enough shape to be hospitalized against their will. It's about poverty and inequality. It's about public safety. It's about race. It's about how to build our healthcare system and our transportation system and the lack of affordable housing. It's who we see as part of our community and who we see as other. It's about what it means these days to be a New York Democrat or a New York Republican.

Really, it's about the meaning of city life. With us now is New York City public advocate Jumaane Williams. Among other things, he released a report just two weeks ago that said the city has been defunding some important mental health services even while Mayor Adams relies more on the police who he says are not sufficiently trained to deal with many mental health emergencies. The report cited a decline in the number of so-called respite care centers where people with mental health issues could stay for a while as an alternative to psychiatric hospitals.

There were eight of those centers in 2019, but just four now, according to the report. Also, this round of budget cuts this year because of the city's fiscal situation, you've heard about those, included a $12 million cut to the Behavioral Health Emergency Assistance Response Division, which is designed to deploy mental health professionals, not police, to certain mental health calls. That program got cut by $12 million. The NYPD did not. Public advocate, it's always good to have you on. Welcome back to WNYC.

Jumaane Williams: Thank you so much for having me. It's always a pleasure to be on. I like the way you framed the beginning of that is perhaps we need to look at the lawmakers and the people who are looking at making the decisions who actually don't fund what needs to be funded for years and decades, and then try to send police to fix the problem, which we see too often.

Brian Lehrer: Can I first ask you to look beyond the immediate question of when people should be involuntarily committed and start with some of your thoughts on underlying issues? Why do there seem to be more very unstable people on the streets in recent years? Why do you think they distribute so disproportionately by race?

Jumaane Williams: Well, one, I always want to make sure we're clear. I think everyone needs a mental health check-in once in a while. Same way we need to go to a dentist if we can. We need to check in physically. I think we all need to have mental health check-ins. There are times when that doesn't happen and it rises to the point of acute mental crisis and some people have mental illnesses.

To answer your question, what we've seen during this pandemic is everything made worse. We haven't seen anything new. We've seen everything made worse. We kept saying that this was going to be the case if housing is made worse, if housing and food insecurity is made worse, that everything else would follow. If we had people before the pandemic who were unable to get the care they needed for mental health illness and the continuum of care that was needed, we knew that was going to get worse.

If we had people who weren't able to get the mental health check-ins and then on top of that now facing homelessness, now can't feed their family, we knew this was going to be a problem. It's a problem all across the country. True to form, our response seems to be heavily again on the law enforcement side where there is something that actually needs a medical response and infrastructure for.

Brian Lehrer: Is the mental health care system itself, even the best mental health system that the city could construct, a big band-aid in what we really need to solve our poverty and inequality?

Jumaane Williams: There's no question that we need to solve and really address poverty, inequity, and inequality. If you do solve those things, I think you'll see the amount of acuity that comes with the pressures that that provides will go down for sure. Even if that is the case, I think you still need an infrastructure that can help people who need the assistance and continuum of care. Now, of course, if you dealt with the poverty and inequity, you, in theory, would address that as well.

What we do see is people who have the means to get the assistance they need even when it comes to mental health, the more affluent communities, which too often are the non-communities of more color, usually white communities, they get the continuum of care they need and it doesn't progress to the stages that we are. If you have a mental health crisis and you're homeless and you can't eat, there's a lot of pressures there, a lot of issues there. What's frustrating is that those of us who have been sounding the alarm for a very long time and ignored for a very long time, and then told that this is the only course of action that we can take, and we're like, no, that's just not a true thing.

Brian Lehrer: Does that inform your view of what a proper moral response is to the mental health crisis in our city today? If it looks like an individual issue when an individual is spiraling into crisis, and on one level it is, but it's also more deeply a social issue, driving the large numbers of people and the disparities in who they are, does that change how the individual should be treated by the city or the state at that moment?

Jumaane Williams: I think it should put a moral lens on how we're treating people. If we're not providing the infrastructure and addressing the issues that are needed, is it morally okay to just say all we're going to do is offer you some handcuffs? I will say we put out a few months ago, Brian, another report on public safety, particularly on gun violence. We did an overlay of where we see the most gun violence.

It also happened to be the places that we saw the deepest issues of affordable housing. We saw the most chronic absences of people from school. We saw the most mental health calls. Again, that's never an excuse to allow the violence that's occurring. As you're pointing out, we saw that there were concurring issues that were happening at the same time. Very often we try to just solve one without addressing the other, thinking that the problem will go away. We know that it doesn't.

Brian Lehrer: Public Advocate Jumaane Williams, our guest, if you're just joining us. Just like yesterday, all I needed to do was really introduce this topic. Our lines on the phones have started filling up. There are a couple of lines left. I'll give out the phone number for everybody who doesn't have us on speed dial, 212-433-WNYC. Listeners, is anyone out there right now who has experienced severe mental illness and wants to react from your life experience to the mayor's new plan to involuntarily commit more people? 212-433-9692.

Anyone who has been or is currently homeless in part due to mental illness, help us report this story or anyone else may call. This is such a central question to life and politics in the city these days. 212-433-WNYC or you can tweet or comment or question @BrianLehrer. I saw you on New York One yesterday, public advocates say there are aspects of the mayor's plan that you like as well as those that you don't, especially relying too much on law enforcement. What do you like that the mayor is doing on this front?

Jumaane Williams: Well, one, we are saying and confirming that there is an issue that has been ignored for far too long. We have seen a slight increase in drop-in centers, which are good. The parts of the program, the plan that we're talking about, increasing drop-in centers, increasing mobile crisis teams, increasing beds is good.

The problem is when you know more about the fact that someone can be involuntarily detained and put into hospital, and much less about the continuum of care, including how much money are going to go into the aspects that we are seeing are good and when they will come online, and be structuralized, that's a red flag. If you ask me, or someone other times when people need to be taken to the hospital because they need assistance, the answer is yes, but I don't think that should be the lead of the plan. If that's the lead of the plan, then we have failed.

One, you can only involuntarily, put someone in the hospital for two, or three days, which means they'll cycle, and cycle, and cycle. Two, we simply don't have the infrastructure. We don't have the beds, we don't have what's needed to do what's being proclaimed to do. It raises a lot of red flies as well as we're now, expanding the definition of who can be taken, and those raising red flags. We will be sending a letter to the mayor to try to get some answers to the questions because the announcement leaves a lot wanting.

Brian Lehrer: Here's one of the questions that I was left with. I don't expect that you're going to have the answer to this. Maybe this is one of the things that you're going to be asking the mayor, but maybe you do have the answer to this. Is it clear to you, from the mayor's plan, how many people over what period of time, they project will be involuntarily committed? Do they have a projection of how much reduction in crime or fear of crime, which is one of the goals here, or how they will measure success in any way?

Jumaane Williams: I haven't heard the answers to those. It would be good to get the answers to those. What I do know is we haven't had the amount of beds needed for a long time. They've been shut down for quite some time. Even the promises that were made about the beds from the state that will be open post-pandemic, we've gotten less than half of those. I think it is correct to try to push forward a response to what many of us have been saying, which there are people who need some mental health responses.

I think some of the push was a little premature in that we don't have what's needed. Even if you take the premise of what was said, which I can't take the whole premise that police officers now should be the decision-makers of who gets involuntarily put into hospitals. Even if you take that, if you just concede to that, you simply don't even have the infrastructure to get to what you're getting at, which is we don't have the beds to even house the people that would be needed. More importantly, there has been no response about what the continuum of care would look like.

Brian Lehrer: Listener on Twitter asks, will someone who is involuntarily put in psychiatric care get a bill for that treatment? Do you know the answer to that?

Jumaane Williams: I don't know the answer to that. It's a good question. I would hope not. The person happens to have health insurance perhaps, but these are good questions to be asked. I want to make clear, and I always want to make clear that, one, this is not a Kendra's Law. Kendra's Law can be worked in conjunction with this.

I think Kendra's law is a tool that's needed as well. I do think, again, that sometimes people may need to be hospitalized, but if that is the linchpin of the plan, if that's the lead of the plan, it's not going to work. As you were alluding to before, the people who will affect them most will be primarily Black, and Brown working for community members, who simply have not been able to access the continuum of care that's been needed for a very long time.

Brian Lehrer: Here is Lis, who says she lives in Washington Heights, but is calling from Georgia. Lis, you're on WNYC with Public Advocate Jumaane Williams. Hi, there.

Lis: Hi. Thank you so much for taking my call. Jumaane, I agree with you a billion percent. I have an MBA in healthcare, and I worked at Bellevue Hospital in the Department of Psychiatry as a psych administrator. I've seen this policy before. I am not suggesting in any way that it's a good idea.

Brian Lehrer: I don't want to spend a half time. Yes, go ahead. Continue.

Lis: Sorry, I don't think it's a good idea to leave mentally ill people decompensating on the streets, that's not good for them. It's not good for society. Warehousing people untreated in mental health facilities, where we don't have the space, where they don't have the support, they don't have housing, they don't have jobs, they don't have families, they don't have hospitalization is not really the answer either.

We need to do all of the things that Jumaane was suggesting in terms of really taking care of people from the beginning. This pendulum of we're going to do nothing, or we're going to do this thing that looks like it's effective, but really isn't, has to stop. We have to treat what's actually going on. This is just like the '80s all over again, and it's very scary to me because it's not going to help anybody.

Brian Lehrer: Yes. Lis, can I ask you whether you want to reveal to the listeners what you told our screener about why you're in Georgia?

Lis: Oh, I would love to. I just didn't want to say that on the air, because it's off-topic. I am knocking doors for Warnock because Herschel Walker scares the crap out of me. I will feel better knowing that Rafael Warnock is continuing to represent the state of Georgia. I'm on my way out to knock some turf in Duluth in Gwinnett County and wish me luck.

Brian Lehrer: How about that? Did you do it in 2020 as well, if you have a connection to Georgia? I'm just curious if you see any difference in the vibe between Warnock's election campaign two years ago, and the one now.

Lis: I didn't. I was a little scared of COVID, and so I was not doing door-to-door work back then, but I was writing a lot of postcards. A lot of the people that I'm working with here through unite here, the Union, and through Feed the Vote, many of those folks were here two years ago. I think a lot of the differences that they're seeing are, frankly, attributable to COVID, and people feeling more comfortable with having folks knocking on their doors.

There are a lot of folks who are really disgusted with Herschel Walker and don't really understand how is it possible that he has gotten so close. To me, the most depressing thing is when I'm knocking on doors of people who look like I do, and they say, "I don't like either of them." It's really clear to me that the reason why they don't like either of them is that these voters are white, and they feel uncomfortable being represented by a Black man. That is unspeakably, depressing to me.

Brian Lehrer: Lis, thank you for going off-topic with us. Really interesting to hear that report as you Canvas in Georgia. Public Advocate, never mind the Spur International politics there from what we're talking about about New York. When she talks about those racial perceptions, how concerned are you getting back to the topic that darker skin New Yorkers exhibiting certain behaviors will be involuntarily committed at a higher rate than white New Yorkers exhibiting the same behaviors?

Jumaane Williams: Is it a welcome distraction? I think it is very important. To just go back to something she put out, which was really important is the binary that's put forth is what sometimes allow people to say maybe we should do this because no one wants people who are needing assistance on the street. If you're riding the subway, and if you're trying to get around, you don't want that around. You want to feel safe for various number of reasons. When offered the binary of, "Okay, in order to do that, we will now involuntarily remove people."

That is not a true solution, that's a false binary. It sometimes, allows bad things to happen when we position it as if I'm doing this so to solve that problem, and you're like, "Okay, but we have to pause, and say, is that really the only solution that we can do, and has that helped in the long run in the past?" That's what we have to frame, the plans that we put forth also may try to prevent people from being on the streets, and being in places where people might not feel comfortable, my people might not feel safe.

More importantly, where people are crying out for help that they haven't gotten, and actually get it. I always want to make sure that I too want public safety, I too want to know when my family's on the train that they're okay, I too, when my sister calls, because she's dealing with someone who's clearly unwell and is spitting near her, and is afraid, and says, "Can I call someone? I just don't want to call the police?"

I have to say, "No, there's no one else. We have to call 911." I'm saying, let's create a separate digit number so that we can get the help that people need. That's important, that none of this is allowing people to remain in places that they shouldn't be, and not getting the help. To answer your question directly, yes, it is clear to me as with anything else that happens that communities with more melanin in their skin will feel the brunt of this policy that we're expanding, and changing, and not providing the care that's needed. That's how we got here in the first place.

Brian Lehrer: I mentioned this yesterday too. I'll mention it again to you and see what you think. The mayor did not mention crime in his speech on this. He only framed it as care for people with serious mental illness. How much do you think this is really a plan to sweep more people off the streets, to increase public confidence in the safety of the city?

Jumaane Williams: Public safety is about a lot of things. Crime is a big part of that. We always want to be clear that we understand that people who are either mentally ill or dealing with acute mental crisis are not likely to be violent or to commit crime. We have to be a 100% clear about that.

What we do know is some of the are high profile cases have involved people who have not gotten the care that they needed. You can't ignore that either. I very much believe that's a part of it. We also know that when it comes to issues of homelessness and now mental health and mental illness, very often we mix up trying to fix and deal with a problem with not seeing the problem.

We want certain populations not to see the problem so we can take down encamp and sweep people off the streets, or we can voluntarily move people from the subways. Maybe some people won't see this problem. Perhaps the people who are being affected will be in a neighborhood that can't make the same amount of political noise so we can pretend the problem has gone away and gotten better.

That's something that we just have to avoid and then we have to stop and we have to really begin to address what's happening. That means we have to invest in the things that we're talking about. There's no other way to do it. Unfortunately, our leaders haven't been investing in them. You'd rather put a billion dollars into a stadium than a billion dollars into billing out some infrastructure that will be more effective in addressing the issue we're talking bout.

Brian Lehrer: A little knock at Governor Hochul there in the Buffalo Bill Stadium. Marina in Manhattan. You're on WNYC. Hi, Marina.

Marina: Hi. How are you? I have a very, very close person that was sent in and out of hospitals over the years. I have to tell you, inside every one of those facilities was atrocious. Their warehouse, their drugs, they're sent drugged, they're sent out on the street. This person got no help whatsoever.

I don't understand why you would just send more people inside these facilities that, clearly, you're not giving them care there's no care. It's just drugging them or releasing them with no help. It was an absolute abomination. He got no help whatsoever. I don't understand why this is considered a good idea just to put more people in the facilities that can't even handle the people that they have right now.

Brian Lehrer: What's the alternative, Marina, since you've had this very close to you, have you thought about that?

Marina: I didn't hear that. I'm sorry. Could you say it again?

Brian Lehrer: What's the alternative to the system, the way it exists since you've been touched by this?

Marina: I think they need the money is being spent stupidly. It should be spent in improving the hospitals and improving their facilities and improving the care once you send someone inside. Some of the doctors that this person was given were completely incompetent. It was frightening how there was no actual care. I just think the money should be spent on that rather than on more jails. That was the alternative. It was what we were always up in jail. When at--

Brian Lehrer: There was--

Marina: I think the money, the way that money is allocated, it should go to mental health help rather than more police. The police are just the wrong, wrong, wrong thing.

Brian Lehrer: Thank you, Marina. Thank you very much. I know that's your position too, or at least that they're being over-relied upon to deal with these issues, Public Advocate, I want to play two clips of the mayor from Tuesday, in which he did speak about the role of the police in responding to mental health calls. Here's one in which he describes a hotline for police officers that they're setting up.

Mayor Adams: We'll be launching a hotline staffed by clinicians from our H&H hospitals that will provide guidance to police officers who encounter individuals in psychiatric crises. State law already authorizes a police officer to make a judgment call to have a person involuntarily removed to a hospital. Many officers feel uneasy using this authority when they have any doubt that the person in crisis meets the criteria. The hotline will allow an officer to describe what they are seeing to a clinical professional, or even use video calling to get an expert opinion on what options may be available.

Brian Lehrer: Public advocate, is it hard for you to imagine many police officers calling a clinician in the middle of a call an emergency mental health call, "Hey, I'm calling this hotline and talk to a psychologist." What do you think this can have a big impact in a good way?

Jumaane Williams: There's a few things here. We are just stubbornly resistant to operationalize police not being the first people to respond to everything. That actually overburdens our law enforcement, that overburdens our police officers when they have to actually address everything. Two, I do think police officers should be more problem solvers. Having access to those type of numbers, I actually think is helpful in the long run.

I do believe the way it is now is flipping the wrong way. What should be happening is the mobile crisis teams that the mayor discussed should be staffed up, should be funded up, and should be fully integrated so that they're the ones that actually are responding to someone who calls, hopefully, one day a separate number. That someone can say, I need someone because they're having a mental health crisis--

Brian Lehrer: Don't we have that now with 988?

Jumaane Williams: We have a 988 national number, but New York system does not integrate with 988. When people call that number, it is problematic for them to get the actual local assistance they need because our system doesn't talk well with them. We have to correct that so that you can call that number and get a mobile crisis team or get someone who has the expertise.

I always say if they decide that an officers need it, there should be one around nearby upstairs or they're able to call to say we may need some assistance. Initially, saying we have to have a criminal response is going to be problematic because when the officer uses the tools that they have, which are not ones that are meant for this, it's problematic for the person who needs assistance. It's problematic for the officer who will get rightfully admonished, but we shouldn't set them up for the type of failure that we're setting them up for. I think that's a great idea but it should be professionals who are answering and responding these type of calls and they can call the officers that they needed.

Brian Lehrer: There are these alternative response teams that you're describing that don't involve police at all. There are just police responses that you and so many people are saying are inadequate because the police aren't adequately trained in this area. The mayor talked about another program, will play another clip that's both, as he sees it, to pair police officers with mental health professionals, listen.

Mayor Adams: We will develop a special cadre of clinicians paired with NYPD officers dedicated to the difficult work of getting New Yorkers in crises into care. These specialized intervention teams will have the training, expertise, and sensitivity to ensure that those in need are safely transported to a hospital for evaluation.

Brian Lehrer: Good, bad, irrelevant. What do you think?

Jumaane Williams: On first blessed, if someone wants to hear it, it sounds feasible, but here's the problem. One, they did try something similar early this year and the non-police folks who were supposed to be part of the team seemed to have been faded out.

It's just the police, second, regardless of how you try to frame this thing, oftentimes, the presence of a uniform causes a heightened tense situation because people think they're getting arrested. Even when you have the best-trained officer or an officer who actually wants to do the right thing, the presence of a uniform, the gun, the badge can in of itself raise tensions.

Lastly, and if you speak to EMTs and others, oftentimes a person who has a gun is a person in charge. Often we've heard people say they wanted to do one thing, but the officer wanted to do something separate. Now, I do believe that if an officer is needed, they should be called by the professional, or even if someone thinks that they need an officer, but the default could not be that an officer is there one that takes away an officer from doing something else that might be more up their alley and more productive.

Two, when we talk about things like overtime pay, the NYPD has unlimited access, regardless of whatever put in the budget, has unlimited access to overtime. The Department of Mental Health doesn't. The EMTs do not. At what point do we begin to say, "Listen, if we believe that we have to treat this like a medical emergency, at what point do we start funding it that way, and stop saying that everything has to go through the police department that has unlimited access to resources?"

Brian Lehrer: I know you got to go in a minute. I want to ask you one other thing. Part of our conversation yesterday with yesterday's guest, was about a change that people feel has taken place in the type of subway crime these days, even though the number of serious crimes is around the same as before the pandemic. It's that more of the violent crimes in the past were committed by people who knew each other against each other, and now more than in the past, it's random attacks by mentally disturbed people, and that randomness is what freaks the public out.

I don't see that the NYPD keeps statistics exactly like that. Do you think the stats on random attacks in the subways exist and have they gone up relative to the past, or are we all just blowing up in our minds a few high-profile ones like the horrible subway platform killing of Michelle Go, and then it looks like an epidemic?

Jumaane Williams: I do think a couple of things are happening at once. There is an increase in crime general. That's happening all across the country. There's an increase of homelessness and an increase of people who need mental assistance acutely and are not able to get it. All those things are happening at the same time, which can create a larger-than-you-may-think sense of fear. We can't ignore that nor should we because that sense is real to people who are dealing with it, especially if you've been or seen a crime happen.

What's also happening is that there is an overreporting of the amount of crime that's happening. When you put a graph of the increase that's occurred versus how much has been reported, how much is blasted on the TV, on the radio, on newspapers, on Twitter and social media, it blows it all out of proportion. We have to be able to have a proportional conversation, while understanding that no one really cares about the proportional conversation.

They just want to make sure they feel safe. That's sometimes hard to do, and instead of actually trying to do that, people just try to go to one side or the other, and that's unfortunate because you have to respect what people are feeling. I actually think the best way to do that is to put forth a plan that does what actually New Yorkers say they want, which is people to get the care and continuum of care that they need. This plan is short on that part.

Brian Lehrer: We're past our scheduled time by a couple of minutes. Do you have another appointment right now or can I ask you one more follow-up question?

Jumaane Williams: Sure.

Brian Lehrer: You've mentioned a few times, and it's good for New Yorkers to keep in mind that this is going on in many US cities right now. Certainly, people who follow the news from California know they're having this conversation in San Francisco, they're having this conversation in LA, other cities, too, with the proliferation of unhoused people with apparent mental illness driving the homelessness of those people and leaving them on the streets, and it's driving many liberal people to reconsider their impulse to just leave folks alone. I'm just curious, from your perspective, if you've looked at it, are any cities getting this the most right, that New York might learn from, in your opinion?

Jumaane Williams: One, I think it's important to point that out. People are not going to believe this and sometimes don't want to hear it, New York City is actually one of the safest cities in the country, particularly big cities, regardless of what's being put out there. Again, that doesn't matter if you're the person who's dealing with the issue. I think we've had an opportunity that's being wasted to reopen our cities differently than we had them before the pandemic.

The problem is we're not doing that. We're not laying groundwork so that we can reopen addressing these issues. We're putting money into the same places and the same infrastructure that we always have, and that's such a waste. That's happening in Republican and Democratic cities, and it's hard to watch. I do think that there are aspects of how we're addressing public safety as being done in different cities that we can all learn from, and I think people can learn from what's happening in New York City.

The main thing that has to happen is our elected officials have to have the courage to do something different than what we were doing before the pandemic. That I haven't seen happen in most places because we seem to respond to the fear without really trying to address the main concern. We're allowing other people to set the framework of what the conversation will be, and then we respond to that, instead of what actually can help us.

Brian Lehrer: New York City Public Advocate Jumaane Williams, we always appreciate when you come on. Thank you so much.

Jumaane Williams: Thank you for having me. It's always a pleasure.

Brian Lehrer: We're going to take a few more phone calls on this before we go to our next guest and turn the page to another topic because so many of you are calling in. This is such a central issue, as I said, at the top of the show, that touches so many things in New York, healthcare, transportation, housing, public safety, and so many of you are calling in with either personal experiences or just thoughts and opinions. We're going to let it ride few more minutes before we turn the page. Katie in Queens is an ER nurse, she says, and calling in right now. Katie, you're on WNYC. Hi, there.

Katie: Hi, Brian. Thanks for taking my call. Mr. Williams is probably gone, but I'm grateful he's our public advocate. It's very frustrating to see the mayor's announcement and feel like one more systemic problem is being put on the shoulders of individuals. By individuals, I mean, the police officers who are clearly not properly trained to handle this situation and make these decisions in the field, and then the healthcare workers. I work at a big hospital in Queens. We have a large behavioral health psychiatric unit, and we're already overwhelmed. We're already struggling. We have a huge nursing shortage going on.

The behavioral health providers are already struggling with inadequate quantities of follow-up care and housing. It's really like another slap in the face to hear the mayor say this. It's not even a bandaid. It's like a Orwellian poster going up over another poster. Here's what we're going to do now, and we're not really going to do anything different. This is a huge systemic problem.

We need much more infrastructure, healthcare workers need much more support and clearly, police officers need more training because we see what happens in a lot of these situations. We're exhausted. Healthcare workers are exhausted. To hear this just means a further influx. We're like the Statue of Liberty. Come. Please come to the ER. We know people need help, but we're breaking. We're breaking.

Brian Lehrer: Katie, I hear the creed occur for the ER workers and other hospital and healthcare workers in the system right now. Here's somebody else who I think has worked in that system. Elizabeth in Ridgewood, New Jersey, you're WNYC. Hi, Elizabeth.

Elizabeth: Thank you for taking my call. I'm a licensed psychologist, and I have been working in the field my whole adult life. I'm in my 60s. I've worked in a variety of settings including Rikers Island, a committed unit, a community mental health center, a county psychiatric hospital. What I feel is most important, which certainly is going to cost time and money, but it's the relationship between the provider and the patients. Sometimes that's the most important thing because it helps the patient come back for treatment, or the relationship between the patient and the facility can be important.

I will never forget when I was on my internship with a psychiatric hospital, in an outpatient clinic, I had a schizophrenic patient who is very ill. I saw him for several months, but then he disappeared. Apparently, he was hospitalized, and I lost track of him, but you want to know something? When he was discharged from the hospital, he came back spontaneously to his Friday, one o'clock appointment because he was attached to that facility in a positive way and to me in a positive way.

Brian Lehrer: Well, then let me play for you, Elizabeth, if it's okay, one more clip of the mayor, and something that he said in his speech on Tuesday laying this all out. This had to do with not allowing people who are involuntarily committed to leave the hospital too quickly just because they seem a little better. Listen.

Mayor Adams: All too often a person enters the hospital in crisis and gets discharged prematurely because their current behavior is no longer as alarming as it was when they were admitted. The law should require hospitals evaluaters to consider not just how the person is acting at the moment of evaluation but also their treatment history, recent behavior in the community and whether they're ready to adhere to outpatient treatment.

Brian Lehrer: Elizabeth, with your experience and also keeping in mind the previous caller, the ER nurse, who talked about how people are already overwhelmed, how do you hear that?

Elizabeth: You know what, Brian? I think it's a problem in our society between individual rights and community rights. It's hard to keep somebody committed. You're taking away their individual rights to freedom. I do believe that continuity of care is incredibly important and I do agree with the previous caller that there are not enough trained mental health workers to deal with this huge problem. I think these people don't vote and that's why they're not taken care of.

Brian Lehrer: Now you're getting to the real politic of it. Elizabeth, thank you very much and we'll make that the last word in this segment. We really appreciate those of you with personal experience in this area calling in, so much as we always try to use people with personal connections to whatever story we're discussing to help us report this story.

Elizabeth, thank you and all our callers in this segment thank you as well as one more thanks to New York City Public Advocate Jumaane Williams. Obviously, as central as I think this is and many people think this is to the life of our city will, obviously, continue to cover this as the plan actually gets implemented so there's that. Brian Lehrer on WNYC. Return the page. Much more to come.

 

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