NYC leaders divided over involuntary hospitalization of people with mental illness

New York City leaders are divided over involuntary hospitalizations of people who show signs of severe mental illness, as lawmakers in Albany debate whether to expand officials’ power to remove them from the streets and subways.

City councilmembers criticized Mayor Eric Adams’ involuntary removal initiative, where people experiencing mental health crises are taken to get psychiatric care against their will, in a report and hearing on Monday that highlighted disparities and shortcomings in the program. But Adams shot back, saying the legislators behind the analysis should “move out of the sterilizing environment of the City Council Chamber.”

“The administration has continuously relied on involuntary removals as a catch-all solution without providing funding for the necessary treatment measures for people in need of long-term services,” Councilmember Linda Lee of eastern Queens, who chairs the Council’s mental health committee, said in a statement.

“They need to go and do what we do, go on the subway system, look at the population in need,” Adams responded at a press conference later Monday. “We're going to respond to that need.”

It was the latest episode in an ongoing debate about whether city and state authorities should have more power to involuntarily commit people with mental illness, including homeless New Yorkers, to health care facilities. Proponents say the practice ensures the safety and well-being of those individuals and the broader public, while opponents say it violates people’s autonomy and often fails to provide them consistent help. Civil rights advocates have also raised concerns about the policy being wrongly applied to those who are not in urgent need of care.

State lawmakers are considering changing the law to allow more professionals to perform mental health evaluations for involuntary commitments and to clarify that officials can weigh a person’s ability to care for themself in deciding whether to hospitalize them. Gov. Kathy Hochul has supported the proposal, and Adams has championed involuntary removals as a way to connect those who have severe mental illness with long-term care and services. The issue has also featured in the 2025 mayoral race.

The Council’s report was based on data from 2024 that the Adams administration was legally obligated to share. It found that many people who were taken for mental health hospitalization against their will were not admitted for inpatient treatment, and that for most of those who were, it was unclear whether they received medical or psychiatric care.

The report also found that five times more people were transported from private homes than public spaces, which councilmembers said cast doubt on the mayor’s claims that the initiative mainly helps those dealing with mental illness in places like the subway. And the data showed significant racial disparities: 54% of people transported last year were Black, even though Black New Yorkers make up only 23% of the city’s overall population.

The Council cautioned that the program’s efficacy is hard to fully assess as the administration did not provide some key data on locations and hospital admissions.

“The number of transports is not equivalent to the number of people transported, because there is no tracking of whether the same individual has been involuntarily transported multiple times,” the report noted.

Still, Adams defended the practice, arguing the racial disparities cited by the Council reflected the demographics of the city’s homeless population.

“We are not going to say, ‘Hey, this person needs to be involuntarily removed, but hold on, they’re Black, so we’re not going to do it, they're Hispanic, we're not going to do it, they're white, we're not going to do it,’” he said. “We're going to go where the issue is, and we're not going to play race politics. Where the services are, we're going to go to.”

The Council report recommended that the city invest more in intensive mobile treatment programs, transitional support programs, crisis respite centers and mental health clubhouses. At a separate Council hearing Monday, lawmakers called on the administration to speed up the work of intensive mobile treatment teams, which refer New Yorkers with serious mental illness to treatment and housing.