The Problem Isn’t Who Knocks on the Door

New York debates cops versus clinicians on 911 calls and ignores the real crisis: there’s nowhere to send the seriously mentally ill.

Photo by Eleni Afiontzi on Unsplash

One of Mayor Zohran Mamdani’s big ideas is to replace cops with clinicians on mental health calls. Like many of his proposals, New Yorkers tend to react to this idea with some version of “nice in theory, doubtful it will work in practice.” Mamdani’s “Department of Community Safety” does, indeed, face many practical obstacles. Also, though, it doesn’t make much sense as a question of theory.

The Department of Community Safety fails to respond to the problem underlying mental illness-related violence, which is the lack of treatment capacity in New York’s mental health system. That problem was recently highlighted by The City, in an article about the January 26 shooting of Jabez Chakraborty, a Queens-based man diagnosed with schizophrenia.

Cops shot Chakraborty (critically, though not fatally) after he charged at them with a kitchen knife. Chakraborty’s family explained to The City about how, prior to the shooting, they had desperately sought help from New York City’s mental health system and were stymied.

Crisis response reform does not address that problem.

A clinician responding to a 911 call will be in a position to provide, in that moment, only very light-touch treatment interventions. Noncop response is traditionally understood as a “diversion” program. Instead of routing someone into the criminal justice system, they’re diverted into treatment.

Jabez Chakraborty’s family did not need government-directed diversion. That’s what, per The City, they had already been long engaged in on their own:

After Jabez drank bleach in mid-December in an attempted suicide, the Chakrabortys turned to one city institution after another seeking assistance for their son, who was diagnosed with schizophrenia three years ago — all while trying to avoid police involvement, which they knew could lead to fatal consequences.

What they needed was better access to treatment.

The Mamdani campaign’s Department of Community Safety plan relegated treatment capacity to little more than an afterthought.

It recommends that the city government “[c]omprehensively survey existing City programs, including overcoming silos and developing a plan to scale up successful ones.” In other words, Mamdani has a plan to make a plan for strengthening treatment capacity. Meeting that challenge will take a lot more than turning a few empty subway retail spaces into homeless service hubs.

The practical problems with Mamdani’s proposal are better known and include New York’s multibillion-dollar budget deficit, which will hinder its ability to hire sufficient clinicians; the city’s mental health workforce shortage; and dispatchers’ difficulty in assessing the dangerousness of calls. (The knife Jabez Chakraborty threatened the responding cops with he obtained from a kitchen drawer. Should every call to an apartment with a kitchen be considered dangerous?)

But how is this supposed to work in theory? A mental health worker arrives at a call to greet a floridly symptomatic schizophrenic man. He is not arrested. But where to refer him? A psych hospital with no open beds? A housing system with a months or even years-long wait list? A therapist who specializes in easing teenagers’ anxiety over failing to get into Yale and having to settle for Vanderbilt? Diversion to where?

For the most seriously mentally ill cases, the answer to “diversion to where” should mean a psychiatric hospital. To her credit, New York Gov. Kathy Hochul, acting partly in response to former mayor Eric Adams’ lobbying, expanded New York’s depleted psych bed stock. And that spending did not come at the expense of supportive housing and other interventions favored by progressive advocates, which have also expanded.

However, Adams and Hochul are centrists; Mamdani is a man of the far left who, as best as can be determined from what little he has said about psychiatric hospitalization, embraces conventional progressive wariness towards that treatment mode.

The Department of Community Safety plan’s logic is sound if it’s based simply on defund and decarceration premises: keeping people out of jail is good, therefore any policy that reduces contact with cops, courts, and corrections is good. Noncop response programs are evaluated as successful if they reduce arrests. But that’s not a mental health metric.

Within mental health, the goal should be to reduce the rate of untreated serious mental illness. The Department of Community Safety vaguely gestures towards that goal but fails to seriously reckon with it.