Transcript: Mayor Adams Celebrates Adams Administration Victory on Legislation to Address Serious Mental Illness Passed in New York State Budget

May 8, 2025

Deputy Mayor Suzanne Miles-Gustave, Health and Human Services: Good morning, everyone, welcome. My name is Suzanne Miles-Gustave, I'm the deputy mayor for Health and Human Services, and we're here to talk about something very important.  
For too long, many of our fellow New Yorkers have been suffering on our streets and subways with severe mental illness. No administration has done more than this one to face this challenge head on. And today we are gathered to share some good news on our advocacy to finally get lasting help for those who need it most. And with that, I will turn it over to Mayor Adams. 
 

Mayor Eric Adams: Thank you so much, D.M. And you know, you think about Michelle Go, at the beginning of my administration, a young woman with a promising career, and I still communicate with her parents on the anniversary of her death. She was a victim of a person with severe mental health issues, and we watched her life was cut short.  
 

And decades after decades, we walked past those who were our fellow citizens who were dealing with severe mental health issues. And we ignored those crises and ignored them and left them up to their own form of finding the help that they need. And we had a revolving door mental health system, where a person would come in for one day, receive medication, and then we let them back out on the streets.  
 

And as I stand here with many of my bids, who are behind me, they know better than many New Yorkers. It impacted their businesses, it impacted tourism, it impacted the quality of life in our city. So in the spirit of Michelle Go, we are here to see that our cause throughout the years of making sure that we address this issue and get help from Albany.  
 

We started our part in this pursuit of assistance right here at this station, when we rolled out the subway safety plan, which addressed unsheltered homeless, among other issues. It was extremely important at the beginning of the administration to set the tone right. Soon after we released a major policy shift for the city that expanded our work to give people involuntary help, I was one of the first and most empathetic voices to call for wider use of involuntary removals and commitments.  
 

And the majority of New Yorkers were supportive of this. People were stopping us and telling us it's the right thing to do, the right way to go. They too became exhausted at watching individuals on our subway tracks, individuals on our street corners, individuals in our business districts, who clearly needed care. And the majority of New Yorkers stated, “Please, let's do something about it.” But at this time, our directive was often forcibly portrayed as controversial.  
 

Many critics, some of whom are now supporters today, even said it was deeply problematic and an overreach. But we were not afraid to do the right thing, and we would never stop advocating for change to state law. And over the last three years, I have directed our agencies to do what we can on the city level to address this issue because it is the right and compassionate thing to do.  
 

Three years later, I'm proud to announce that our advocacy has led to real progress as Albany has finally taken action to make lasting change. And although it is rare, random attacks are still committed by people who desperately need help. We cannot continue to ignore them, and we are not. And that is why the amendments to this year's state budget voted on last night will reform the state involuntary commitment laws, and they are so important.  
 

This is a major victory for New Yorkers, a major victory for those who need help and need care. The state budget adopts many of our requests to reform the involuntary commitment laws and fill the cracks in the system. And here's how.  
 

Our clinicians have told us that the law was unclear on who they could transfer to hospitals for evaluation, which often resulted in quick discharge in times when people needed the help. I was a police officer watching individuals who we brought in for care is out hours later without any real care. These discharges were premature.  
 

Now the state has heard our calls to clarify that inability to meet basic needs is a form of danger to self.  Inability to meet basic needs is a form of danger to oneself. Huge shift. This is important classification that will show our teams to get more help to more people. It will allow us to get more help to more people.  
 

These amendments also require hospitals to work more closely with outpatient providers, give more decision-making authority to psychiatric nurse practitioners in our hospitals, empower families to get their loved ones involuntary help. Far too often family members feel helpless when it comes to giving help to their loved ones that are going through mental health episodes.  
 

And it would improve assisted outpatient care to close the gaps in the system that prevent people from getting lasting treatment. This is a huge step in the right direction and I want to thank our partners in state government for getting it done. The progress we have made in the last three years is remarkable. We have connected over 8,400 New Yorkers to shelter and over 840 are now in permanent affordable housing.  
 

We've launched new outreach programs like SCOUT and PATH to serve the hardest reached New Yorkers and in the nine months since including PATH alone, launching PATH, we had over 13,500 contacts and ensured those unhoused New Yorkers are provided service nearly 4,000 times. We've opened 1,400 safe haven and stabilization beds and invested in a $650 million homeless and mental health plan that would give patients a place to continue their treatment after being discharged from the hospital.  
Let's be clear, there's more work to be done, but we're moving in the right direction that started out in the beginning of this administration. We did not get everything we wanted from Albany, such as empowering more clinical staff to conduct involuntary removals and make admissions decisions. We need Albany to recognize that the risk of psychiatric harm is grounds for involuntary hospital care. We're clear on that.  
 

And hospitals should be required to screen all psychiatric patients for assistance, outpatient treatment, not just allow them to return to the street without the care that they need. As well as being required to perform evaluations, consider broader context, not just how someone is behaving in the moment. We need to look at the full scope of the person's behavior in their actions and in their history.  
 

We'll be back again to continue fighting for these reforms. Everyone knows in Albany, it takes sometimes several sessions till we get to the full product and we will continue to move forward on it. But today is a good day. I want to thank the governor, the majority leader and assembly speaker and all of the colleagues in Albany who pushed for this, as well as so many business leaders, advocates, doctors and family members who have partnered with us to get this done.  
 

I want to specifically thank our Deputy Mayor Raspberry for the countless number of hours in Albany to make sure that we had the voices of New Yorkers front and center. And Brian Stettin, who we brought on board to look at this issue and he was a constant reminder of how we could successfully start taking away those barriers and obstacles that prevent us from giving care to those who are in need.  
 

It was a team effort and we're going to continue to move forward until every person, every member of our family that are dealing with mental health crises can get the support that they deserve. Thank you very much. Thank you, team. 
 

Deputy Mayor Miles-Gustave: Thank you, mayor. Thank you so much. And next, we will have that partner, that real leader in this work, whose history on this issue dates back to the passage of the original Kendra's Law, our expert on severe mental illness, Brian Stettin. 
 

Brian Stettin, Senior Advisor for Severe Mental Illness, Mayor’s Office: Thank you, D.M. and mayor. And good morning, everyone. So I just wanted to speak to a few pieces in the budget that just passed that come directly from our legislation, the Supportive Interventions Act, and just kind of walk through with you why these are a big deal. And I'm just going to highlight three of the six or seven that we're really excited about.  
 

First one, as the mayor mentioned, is the fact that we're now going to have explicit language in the law that makes clear that a person is not meeting their basic human needs of food, clothing, shelter, or medical care, that is someone who is a danger to themselves. And this has sometimes been written about in the media as an expansion of the state's authority. It's actually not.  
 

It's a clarification, because the law we've had for decades is vague. It talks about other conduct that demonstrates someone is a danger to themselves or others. But it's kind of left in the eye of the beholder what that means. The courts have filled in that gap to a great extent and have given us case law that makes clear that when someone's in extreme self-neglect, they are a danger to themselves. And we've been acting on that as a matter of policy. We've absolutely embraced that in a way that no administration has before.  
 

The problem is that you still have some disability rights-oriented organizations who were never happy about those court decisions in the first place, who push this message that we're misinterpreting the law. And their messaging sometimes gets into the heads of some of the folks we have out there doing outreach, of doctors who are making decisions when we bring people to the hospital about whether to admit them, and even sometimes judges who are making decisions when people challenge these commitments.  
 

And these are not cases we can appeal, even though the case law is on our side, because once the person's released from the hospital, you can't really get them back. So having this explicit in the law and ending this debate once and for all is a huge deal.  
Another thing I'll mention, again, the mayor touched on assisted outpatient treatment. You know, people sometimes ask us, “Well, what happens after hospital care? Where's the follow-up?” That's what AOT is all about, right? This is a hugely successful program, also known as Kendra's Law, that we've had for decades that allows us to identify somebody who's kind of stuck in the revolving door of the mental health system, who has great difficulty adhering to their treatment, and keeping them engaged under a court order so that we can be more proactive when we see them start to slip away from treatment.  
 

One of the real challenges with Kendra's Law is figuring out when to let that court order expire. They tend to be imposed for a period of up to a year, and then we have to decide whether to renew or not. We can't always get those calls right. Sometimes a person leaves the program, and we start to see them begin to backslide.  
 

Under this new legislation, it's going to be a lot easier to get somebody in that situation back into the program without having to reassemble all the evidence that was challenging that we had to do initially, and rightly so, to get that person into the program in the first place. We're going to be able to bring back someone who has graduated from the program within the last six months, and shown signs of reverting to some old habits and patterns, get them back into care and back on the right track.  
 

Another key thing I'll mention is giving more authority to our psychiatric nurse practitioners. We're under a great need to bring more hospital beds, psychiatric hospital beds, into the system. We're all aware of that. We're trying to bring more city H+H beds. The state is working on that as well.  
 

One of the underappreciated challenges in getting more beds online is having the staff in the hospitals to provide the care. It's not just about the beds. It's also about staffing them. We have a severe shortage of psychiatrists. We are extremely reliant, for that reason, on psychiatric nurse practitioners who are highly qualified and well-trained professionals who have the professional ability to diagnose mental illness and dispense and provide medications.  
 

We haven't given them enough authority to actually decide somebody meets the criteria needs to come into the hospital. The law has always given that authority only to physicians, and so that's led to bottlenecks in our hospitals. It means the doctors that we do have spend a lot of time going to court to testify because no one else can do it, and those staffing inefficiencies prevent us from opening more beds.  
 

We've taken an important step with this legislation in that we're giving now more authority to psychiatric practitioners to help make those decisions. We didn't get all the way on that, but they're going to have more of a role in the process that I believe is going to give people a greater comfort level to see that these nurses are, in fact, fully capable and can do it just as well, and I hope is going to be a stepping stone for us to get them even more authority and allow us to open more beds. So those are just a few high-level items. I can take questions about more things and appreciate your time today. 
 

Deputy Mayor Miles-Gustave: Thank you, Brian. Thank you so much. Next, we'll hear from one of our great partners, Tom Harris of the Times Square Alliance. Thank you, Tom. 
 

Tom Harris, President, Times Square Alliance: Thank you very much, and thank you, mayor, for focusing on the challenges faced providing service and support to those suffering with mental illness. When this was proposed as a cultural shift in the way we treat people with mental illness, it was usually followed by, “It will never happen, there's too much resistance.”  
 

The mayor, Brian Stettin, and New Yorkers refused to accept the status quo, and we are here today because of Mayor Adams and Brian Stettin's stick-to-itiveness and tenacity. I'm here with Fred Cerullo and Barbara Blair. As neighborhood organizations with boots on the ground, we see firsthand when the system fails and how people suffer on the streets, sometimes dying slowly, being denied the care that they need. The comprehensive care achieved in these reforms will close those gaps and help provide that service and support to those suffering on our streets.  
 

None of this would be possible without the feedback from the service providers who are out on the street who told us what was wrong with the system. We communicated that, and Brian Stettin spoke with them at length to try to come to a bill and a reform that would actually help people.  
 

Again, without Mayor Adams' leadership, Governor Hochul refusing to back down, the legislature realizing that the problem needed to be solved, and Brian Stettin for his comprehensive plan, we would not be here today, and more importantly, we wouldn't be able to help those suffering on our streets. Thank you. 
 

Deputy Mayor Miles-Gustave: Thank you, Tom, so much. And now we'll take on-topic questions. 
 

Question: So the City Council has criticized your policy of involuntary removal, saying there isn't any data to show that it's leading to long-term treatment in housing. What are the steps after people are involuntarily removed to make sure that they don't end up back on the street? 
 

Mayor Adams: And Brian will go into that, and fully understanding the complexities of getting someone who's not of the right mind, that they need care, to get them in for care. And as I've stated over and over again, part of the question you should have for our city councilmembers who's opposed to this is how many of them have been on the subway?  
 

How many of them have been engaged with someone that is dealing with a severe mental health issue? How many of them have walked past a person who could potentially push someone on the tracks? And I think their lack of fully understanding the scope of this is making them theoretical when we have to be practical on addressing a real problem in our city that everyday working-class New Yorkers are concerned about the mental health issue when someone is unable to take care of themselves.  
Brian, you want to go into the follow-up? 
 

Stettin: Thank you, mayor. I appreciate the question. One of the things that the City Council has misunderstood about the information that we've put out there, they've really kind of harped on a report that we issued about involuntary removals and transports in general, which was a report they asked us for.  
 

90 percent of involuntary transports that happen over the course of a year in the city have nothing to do with this work that we're talking about today. This need to find people who are in psychiatric crisis, identify them based on their inability to meet basic needs, and bring them to the hospital for care. That's what we've been walking away from in the past.  
 

90 percent of it is police responding to 911 calls of somebody behaving erratically and going to a scene, very often in a private home, and bringing that person to the hospital. Now, a lot of those people don't get admitted to care because it's not actually mental illness that caused them to behave the way they did. And that's something the hospitals are appropriately releasing people when they find.  
 

And it's kind of weird to me that we're being criticized as abusing people's civil rights when in fact it's being very careful about people's civil rights that have so many people leaving the hospital quickly when they're just coming in because they've kind of lost it and had a tantrum. And so, actually, we should be applauding the police for not arresting those people, for taking a look at whether they need psychiatric care.  
 

The 10 percent or so of this work that's about the people who are in the most severe crisis, where we've really kind of leaned in and put new teams on the subways and worked more with our outreach partners and identifying people who have been on our top 50 lists for years. We absolutely are carefully tracking how people do, and we've established all kinds of procedures within Health + Hospitals Corporation, our city public hospital system, where we're steering all those individuals when we have them brought to the hospital, not by police, but by clinicians.  
 

And we have put out some information about the fact that we're tracking those individuals, we're making sure they get connected with the right teams. Our SCOUT and PATH programs, for example, everyone gets connected to an SOS team or an IMT team, and we're placing them not just in congregate shelters, but specifically in safe havens. And we're going to have more to say about that soon, but this is really important work that's new, that we're working out some kinks with, and we ask for patience, and we're going to have a lot more to say about it. 
 

Question: Yes, to the mayor. You are running for re-election. And I know you don't like to think about this, but in the event that you do not win, how confident are you that your successor will follow through on these policies that are so important to you? 
 

Mayor Adams: Yeah, my successor is going to be me, so we're sure we're going to follow. But I think that's a great question. That's why it's codified in law. And so, whomever comes after me, they're going to have to follow the law, and clearly we know this problem of those who are dealing with severe mental health illness who can't take care of themselves. And we need to be clear on that.  
 

To expect someone to make a decision when they can't take care of themselves and make the decision, that is just inhumane. And no matter, if you look at who came before me, both Mayor Bloomberg, Mayor de Blasio, and now I have inherited this problem. This has been a long-standing problem, and no one wanted to touch it. No one wanted to address it. But we said no to it.  
 

We're not going to walk past New Yorkers who visibly can't take care of themselves. Their clothing is soiled. They are yelling out. They are doing things that are dangerous. And you talk to passengers all the time. They say, “You see this person can't take care of himself. Why are we ignoring that?” And so, no matter what happens in the future to come, the law is codified on what we must do and what we should be doing. That's important. 
 

Question: Sir, but some laws exist, and some administrations don't necessarily make enforcing of those rules and those policies and those laws a priority, which is why I'm asking about, potentially, should we lose re-election? 
 

Mayor Adams: And I think you're right. People make the determination of what laws they're going to enforce or to implement. But I think that what we have done with this administration, we are no longer giving any administration the opportunity to say the problem does not exist.  
 

We have compelled Albany to move. They moved. And now that the law is clear, we're not going to see clinicians, we're not going to see hospitals state that they don't have the clarity to move forward. We clarified the law. And if any administration would like to have to call in Michelle Go of the future and speak with their parents and say they have not done enough, that is up to them to decide. I was not going to allow that to happen.  
 

When I spoke to Michelle Go's parents, when this first happened, I stated I was going to be committed to make sure the law was changed. And I'm living up to that commitment in the spirit of Michelle Go. Now it's to ensure our entire city makes sure that we take care of those who are in need. 
 

Question: It's two questions. One's detail oriented. So maybe Brian will answer. But for you, Mr. Mayor, acknowledgment that we just don't have the beds right now. You're trying to bring many online. But as you go about implementing this, what will you do with all these people? As you go about implementing this without the beds right now, again, I know you're planning, but without the beds right now, how will you implement this?  
 

And then I think this may be for Brian, how are you going to make sure the clinicians are implementing these changes with compassion and not accidentally going too far? So on the beds, if you could, Mayor. 
 

Mayor Adams: Well, it was a huge mistake that the former governor cut many of these beds. I thought it was poor management on his part, understanding that this was a crisis, what happened over COVID. I think his inability to manage several crises at one time created a crisis because of his actions.  
 

And so we know we have a shortage of beds. We know our what's called private hospitals must play a role also in opening the beds as well. Health + Hospital, we have been doing our part, but our entire hospital system must play a role in ensuring that these beds are available. But while we deal with the bed issue, we have to be clear that we cannot allow people to stay in a position that they're harmful to themselves and harmful to others, right? 
 

Stettin: Yeah. And let me also speak to the first part of your question, Henry. You know, the challenge we have of bringing more beds into the system, if you look at who that's really impacting day to day, it's mostly about people who are in need of fairly short term hospitalizations, who are not as acutely ill, who are not being kind of prioritized in the triaging that we have to do under the current situation, who might at some point become extremely dangerous to themselves or others later. And there's no question we've got to do more to prevent people from falling into that trap.  
 

Among the people who are the most profoundly ill, who we do encounter in a psychiatric crisis on the subways or in other public spaces, we're bringing those people to H+H. I can tell you they're not getting discharged early because we don't have a bed. We are finding the beds for them. We have restored all the beds that were lost during COVID. We opened three extended care units for people to get that kind of long term care.  
 

The state, to its credit, OMH, has really stepped up by bringing more state beds into the system for people who need to go longer. So these are all folks who we're tracking closely. And I can promise you, you know, we don't get it right in every case. But it's not because the bed isn't there. We're finding those beds and making sure those people get care. Could you repeat the second part of your question? 
 

Question: Implementing this change and making sure it doesn't overcorrect and you're pulling in people who don't need to be pulled in. 
 

Stettin: Yeah, sure. So, you know, I approach this entire challenge as a lawyer. And you know, what I can tell you is that that is why we have due process, right? That is why built into this system of care and the fact that, you know, there's no question there's a deprivation of liberty involved when you hold somebody in a hospital who doesn't want to be there. That person has a right to a day in court.  
 

Immediately they are connected with the mental hygiene legal service, which provides them with a free attorney. They have an immediate right once a decision is made to retain them in a hospital beyond that 72 hours to challenge that in court and force the hospital to come and present clear and convincing evidence with the hospital having the burden of proof that that person meets the criteria. And even if they don't challenge that commitment, if we hold them for up to 30 days, they get an automatic court hearing as a right.  
 

So that's what's built into the system to make sure that it's not just about, you know, even in some nonexistent world where we had doctors who were just dying to find opportunities to hold on to people in hospitals in order to warehouse them, we have judges who make sure that doesn't happen. 

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