From Involuntary Commitment to Supportive Housing

June 27, 2023

By Courtney Wise

In other news, ADHD is under-diagnosed in Asian Americans. A loving farewell to Patrick Arbore, founder of the Friendship Line. A word about anti-dopamine parenting. And more.

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For some unhoused in NYC, the road to home is easier after forced hospitalization

On a night that NYC’s wind chill was minus 4 degrees, Mazou Mounkaila found himself sleeping under an overpass in the Bronx. Paramedics and homeless-outreach workers told him he’d have to head to a shelter or hospital for safety; he declined both options. But he wasn’t left to freeze. Police arrived shortly thereafter, handcuffed Mounkaila and took him to Jacobi Medical Center, where he spent the next three and a half months in mental health treatment, reported the New York Times. 

Officers were acting under a policy enacted by NYC Mayor Eric Adams in fall 2022 which addresses homelessness in the city by allowing first responders to force people into treatment when mental illness renders them unable to “meet basic living needs.”

It’s a policy that plenty don’t approve of, among them NYU sociologist Alex V. Barnard, who characterizes Adams as moving to “sort of reframe coercion as compassion.” NYC’s policy has been met with legal opposition, too. Still, there are fans, namely BronxWorks, a social services agency that argues mandatory treatment is yielding positive results because it triggers longer-term, more attentive care. Ever since the policy was implemented last fall, BronxWorks has sent nine people into hospital-based treatment, most of whom, they say, are finally in permanent housing or on track to get there. “These are severely mentally ill people we’ve been chasing after for years,” said Scott Auwarter, BronxWorks’s assistant executive director. “Something’s changed out there. It’s working.”

Significantly, the Times notes that Adams’s new policy doesn’t typically send violent unhoused people into treatment, despite violence being of primary concern to citizens. His administration says that’s because the policy is designed to finally provide people who have been on the system’s radar, but not effectively treated, with needed help—whether or not they are violent. “This is really about focusing on a fairly small population of people that we know,” said Brian Stettin, Adams’s senior adviser for severe mental illness, “because they’re kind of stuck in the revolving door of the system.” Mounkaila, and six other BronxWorks clients, had been on NYC’s Top 50 List of Homeless People at Risk.  (For some context: At last count, New York City had 3,439 homeless people living on the streets and 67,880 in shelters.)

In a December 2022 issue of The Gothamist, six New York City residents who were involuntarily committed before Mayor Adam’s new policy went in effect were critical of the initiative. In one case, a man recalls being handcuffed to a bed for hours in front of other patients and receiving no treatment. In another case, Kam Brock, who is African American and works as both a musician and banker, was mistaken for a mentally ill person when she went to retrieve her impounded BMW in the wrong precinct; she was handcuffed, taken to Harlem Hospital, confined for more than 24 hours and medicated against her will. ““You can paint anybody to be anything when you’re a police officer,” said Brock, who filed suit against the city but was unsuccessful. “‘A young Black girl can’t own a BMW, a young Black girl can’t be a banker.’”

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ADHD under-diagnosed in Asian Americans 

Emily Chen is smart, talented, and accomplished. But for some time, she wasn’t okay. “I was using anxiety to motivate and power myself. I’d use it as a way to remember things,” Chen told STAT News. “Do I have an assignment due now? Do I have to be somewhere now? I was using all my energy just to stay afloat,” she said. Finally, “after navigating school and college in a near perpetual state of panic,” Chen was diagnosed with ADHD at age 23. Not surprisingly, she didn’t know any other Asian Americans with the disorder. 

Despite the ways scientific understanding of ADHD has evolved in recent years, the stigma that it’s just a fancy way to describe misbehaving children is still common. Though researchers now view it as a neurodevelopmental disorder that tends to run in families, people of color, particularly Asians, remain woefully under-diagnosed. STAT cited a 2021 study published in JAMA Network Open that showed for every 100 white children diagnosed with ADHD, there are 83 Black children, 77 Hispanic children, and just 48 Asian children, with the same diagnosis.

Researchers say that a lack of knowledge and understanding about ADHD in Asian American communities may contribute to the gap, in addition to the racialized trope of Asians as the “model minority.” The stereotype positions Asians as academically successful and well-behaved, causing them to be overlooked for conditions like ADHD, particularly when it may present as inattentiveness. “The Asian population in this country is often set aside, ignored, seen as the perpetual foreigner,” said Patrick Goh, a psychology professor at the University of Hawaiʻi at Mānoa. He wants to see more research on how ADHD and low diagnostic rates among Asians are affecting the community. But, Goh said, “it just isn’t happening.”

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Remembering Patrick Arbore, founder of the Friendship Line

Fifty years ago, Patrick Arbore was in his late twenties and volunteering at the San Francisco Suicide Prevention hotline. It didn’t take him long to realize everyone who called the line wasn’t suicidal. Some were just lonely. So came the inspiration for the Friendship Line, which Arbore created to serve people who were isolated and in need of someone to talk to. Arbore died recently, reports the San Francisco Chronicle, but the Friendship Line lives on, taking 350,000 calls each year. He also founded two other nonprofits, the Center for Elderly Suicide Prevention and Grief Services.

Arbore’s journey to the suicide prevention hotline was personal. He’d grown up lonely, isolated, and depressed in a household with alcoholic caregivers, eventually surviving his own suicide attempts. He volunteered to offer people support and that simple action grew into his life’s work. He offered people “a soothing voice and empathetic ear.” “I always marveled that he was able to hold all that grief that he heard about,” said Liz Strand, Arbore’s ex-wife and friend. “He was on a mission to help people in their time of greatest need and that is what juiced him. Seeing positive results in his work is what kept him going.”   

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In other news…

June is World Infertility Awareness Month and this 2-minute watch from CBS News is a helpful reminder that men suffer mental anguish from infertility struggles, too. “When I have couples going through this, you can see the stress in both of their eyes,” said a fertility specialist on the show. Though women are often imagined as the partner suffering terribly due to hormone shots and IVF cycles, she emphasized that “fifty percent of the time,” it’s the men she sees in her practice who are struggling with infertility. 

Kids addicted to screens and you want them turned off? Try anti-dopamine parenting. What’s that, anyway? According to this piece from NPR, anti-dopamine parenting incorporates strategies to combat kids’ urge to repeatedly do the thing that triggers a dopamine surge, whether that thing is pleasurable or not. In this case, the best way to help is to assist the kids in turning away from a screen. A couple of the tips? Be prepared to suffer through at least five minutes of whining and protest when you turn the screens off. “Dopamine surges are potent,” said neuroscientist Kent Berridge at the University of Michigan. But, “they have a short half-life.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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