Comes word that the authorities in New York City will begin removing more mentally ill people from the streets there. Mayor Eric Adams (a Democrat, for the record), announced this week that he's directed health-care types to start committing people, involuntarily if need be, if they are thought to be a harm to themselves or others.
The Washington Post reports: Mayor Adams has told cops and outreach workers "to intervene when someone is thought to be so mentally ill that it prevents them from meeting their basic human needs, causing them to be a danger to themselves." And these unfortunate folks can be committed involuntarily "even if they are not an imminent threat to the public."
Until now, the semi-official way to handle such things has been to ignore it. And walk by. Maybe avert our eyes. As so many of us do in other American cities.
The ACLU, a couple of nonprofits, and the usual suspects have lost it. Why, the cops are hospitalizing people! A more holistic approach is needed! (Sound familiar?)
The new approach might be just what the doctor ordered, figuratively. These poor folks, many homeless, need help, and may not realize it. The whole situation reminds us, as so many things do, of the late great Dr. Charles Krauthammer, who was published on this page for decades.
In 2013, after an unstable man named Aaron Alexis shot up the Washington Navy Yard, killing 12, Dr. Krauthammer wrote the following in his column. The masterful writing, and thinking, deserves to be quoted here at length. The rest of this editorial are his words from Sept. 23, 2013:
On Aug. 7 . . . Alexis had called police from a Newport, R.I., Marriott. He was hearing voices. Three people were following him, he told the cops. They were sending microwaves through walls, making his skin vibrate and preventing him from sleeping. He had already twice changed hotels to escape the men, the radiation, the voices.
Delusions, paranoid ideation, auditory (and somatic) hallucinations: the classic symptoms of schizophrenia.
So here is this panic-stricken soul, psychotic and in terrible distress. And what does modern policing do for him? The cops tell him to "stay away from the individuals that are following him." Then they leave.
But the three "individuals" were imaginary, for God's sake. This is how a civilized society deals with a man in such a state of terror?
Had this happened 35 years ago in Boston, Alexis would have been brought to me as the psychiatrist on duty at the ER of the Massachusetts General Hospital. Were he as agitated and distressed as in the police report, I probably would have administered an immediate dose of Haldol, the most powerful fast-acting antipsychotic of the time.
This would generally relieve the hallucinations and delusions, a blessing not only in itself, but also for the lucidity it brought on that would allow him to give us important diagnostic details--psychiatric history, family history, social history, medical history, etc. If I thought he could be sufficiently cared for by family or friends to receive regular oral medication, therapy and follow-up, I would have discharged him. Otherwise, I'd have admitted him. And if he refused, I'd have ordered a 14-day involuntary commitment.
Sounds cruel? On the contrary. For many people living on park benches, commitment means a warm bed, shelter and three hot meals a day. For Alexis, it would have meant the beginning of a treatment regimen designed to bring him back to himself before discharging him to a world heretofore madly radioactive.
That's what a compassionate society does. It would no more abandon this man to fend for himself than it would a man suffering a stroke . . . .
Instead, what happened? The Newport police sent their report to the local naval station, where it promptly disappeared into the ether. Alexis subsequently twice visited VA hospital ERs, but without any florid symptoms of psychosis and complaining only of sleeplessness, the diagnosis was missed. (He was given a sleep medication.) He fell back through the cracks . . . .
I know the civil libertarian arguments. I know that involuntary commitment is outright paternalism. But paternalism is essential for children because they don't have a fully developed rational will. Do you think Alexis was in command of his will that night in Newport?
We cannot be cavalier about commitment. We should have layers of review, albeit rapid. But it's both cruel and reckless to turn loose people as lost and profoundly suffering as Alexis, even apart from any potential dangerousness.
More than half of those you see sleeping on grates have suffered mental illness. It's a national scandal. It's time we recalibrated the pendulum that today allows the mentally ill to die with their rights on--and, rarely but unforgivably, take a dozen innocents with them.