NY mayor’s plan to force mentally ill off streets

Monday, December 5, 2022

by Don Sapatkin

The mayor of New York is pushing a plan to involuntarily remove homeless residents with severe mental illness from the streets and get them in treatment, the latest in decades of largely failed attempts. In California, where the governor will try his own controversial plan, Los Angeles is transforming a mothballed hospital into a sprawling campus with affordable housing and mental health services. The 988 crisis hotline went down for a day and no one said why. And a compulsive liar ­– truthfully it seem – blames his fibbing on mental illness. All this and a whole lot more in today’s newsletter.

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New York plans to force unhoused mentally ill people into treatment

New York Mayor Eric Adams announced a plan for police and emergency responders to more forcefully get severely mentally ill people off the streets and subways and into treatment, even if they must involuntarily hospitalize some who refuse care, the Associated Press reports. “No more walking by or looking away,” the mayor said, calling it “a moral obligation to act.”

The crisis of insufficient care for severely mentally ill New Yorkers dates back decades to the push to “deinstitutionalize” people with serious mental illness languishing in state hospitals. But only a fraction of community care and housing ever materialized, leaving many without long-term treatment and living on the street. A succession of mayors have announced failed efforts to help them, often in the wake of a highly publicized tragedy, according to a New York Times review. Adams faced a similar crisis days after taking office, when a former cabbie with schizophrenia pushed a woman to her death in a subway station after cycling through a series of short-term hospital stays, jails and shelters, each time ending up back on the street.

The capacity of emergency rooms and psychiatric hospitals have changed little over the years with many general hospitals closing inpatient psych units. Some psychiatrists told the Times that the latest plan might lead to a marginal increase in people treated but would come nowhere near solving the crisis. A Gothamist story questioned whether the police would be ready for their expanded role.

Adams’s directive drew cautious support from some advocacy groups but blistering criticism from others. Concerns that people would be locked away against their will were highlighted by Reason magazine. Cities across the country have recently been overwhelmed by overlapping crises of severe mental illness, homelessness and fears of rising crime. The opposition to Adams’s announcement is reminiscent of responses, reported by the Mercury News, to California Gov. Gavin Newsom’s more comprehensive plan to get severely mentally ill homeless people ordered into treatment by courts.

Calls to 988 crisis hotline go unanswered for a day

The five-month-old 988 mental health emergency hotline experienced a daylong outage on Thursday, greeting callers with a message about a “service outage.” Service was restored just before midnight, the Associated Press reported. Texts to 988 and chats via 988lifeline.org were unaffected.  The Substance Abuse and Mental Health Services Administration’s Disaster Distress Helpline (800-985-5990) was down as well.

Replacing a national 800 number, the 988 Suicide & Crisis Lifeline launched in July to a somewhat bumpy start and now fields roughly 8,000 phone calls a day. Federal agencies are investigating the cause of the interruption, and Intrado, the telecom company that supplies the line’s back-end infrastructure, didn’t return repeated requests for comment from the AP, which quoted one analyst’s speculation that the breakdown resulted from an upgrade gone wrong.

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A mothballed L.A. hospital to be transformed into ‘Healthy Village’

Los Angeles County General Hospital ─ a crumbling 19-story art deco landmark – holds an emotional bond for many Eastside residents who grew up in its shadow. Now, 14 years after the last patient was discharged, it is being reincarnated as a “Healthy Village,” with as many as 1,400 units of housing, medical and mental health care plus spaces for social services, community activities, arts and retail spread over its grounds, the Los Angeles Times reports.

The county, which owns the architectural marvel, has launched a multi-year process to reconfigure the building with $250 million in state and federal funds. On separate parcels, the county has been developing an 8-acre Restorative Care Village, a complex of short-term and permanent housing for homeless patients with medical and mental health needs. The two “villages” eventually will cover 35 acres.

The hospital has a colorful but checkered past. Its predecessor was the birthplace of Marilyn Monroe in 1926. Seven years later, the current building opened with 3,000 beds, and over the years featured in TV shots for Dr. Kildare and General Hospital. In the 1970s it became the backdrop for Chicano protests over the sterilization without consent of more than 200 mostly Latina women who came to deliver their babies. In 1989, AIDS activists held a weeklong vigil demanding a dedicated AIDS unit – and one opened later that year.

Everything about the place points to a bright future, said architect Michael Lehrer. “Here you’ve got the biggest and best, a glorious building that has the possibility of connecting past, present and future,” he said. “I think it could be very powerful.”

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Can This Man Stop Lying?

Good question. Here’s another: Is compulsive lying a form of mental illness?

Answer to the first question: unclear. To the second: perhaps – but only for a tiny sliver of outlandish fabricators. A fascinating 3,800-word piece in the New York Times traces the trials and tribulations of lifelong liar Christopher Massimine.

The 36-year-old son of a nurse and an auditor lied about everything going back to at least second grade. Some fibs – like saying he was born in September rather than May – offered no obvious benefit. He posted that he attended Burning Man, but the photos turned out to have been taken in Queens, where he and his wife now live. He even lied to the therapist who was using cognitive behavioral therapy to help him lie less. Massimine’s life fell apart a little over a year ago when an investigation by Fox13 in Salt Lake City found that the successful University of Utah theater producer had embellished his résumé.

Massimine spoke numerous times with Times reporter Ellen Barry in order, he said, to describe what he called a fundamental misunderstanding: These were not the lies of a calculating con artist, but of a mentally ill person who could not help himself. Friends characterized his behavior as “tall tales” or “embellishments” or “campfire stories” that never seemed malicious. No one called him out, one said.

Some professionals agree.In 1891, German psychiatrist Anton Delbrück coined the term pseudologia fantastica, still used today, to describe patients who concocted ludicrous stories that cast them as heroes or victims to impress others. A 2009 study published in Human Communication Research estimated that a “small group of prolific liars” constituted 5% of the population but told half the reported lies, an average of 15 per day. In a just-published book, Pathological Lying, psychologists Drew A. Curtis and Christian L. Hart propose adding a new diagnosis by that name to the DSM, the profession’s diagnostic bible.

Two months ago, Massimine tried re-entering the public eye with a Newsweek column that attempted to explain his lying and portrayed himself as a victim of office politics and online trolls. Anonymous commenters were not sympathetic. Sitting with a reporter later, his wife, Maggie, ticked off the “embellishments” he had listed in his column to make himself look better. While they were talking, her husband returned home and listened from the couch. “I disagree,” he said. “I think I’ve been good.”

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In other news…

Expanded mental health services are finding a home at campus religious organizations where students grappling with issues of faith or spirituality have long sought help, USA Today reports. Muslim students have been especially wary of college referrals to therapists who know nothing about their culture.

Pregnant women with opioid use disorder treated with buprenorphine or methadone, the two mainstays of effective addiction therapy, experienced similar maternal outcomes, according to a study involving 2.5 million pregnancies in the New England Journal of Medicine. But infants who were exposed in the womb had much better outcomes with buprenorphine. They included lower risk (52% with buprenorphine; 69% with methadone) of Neonatal Abstinence Syndrome, a form of withdrawal, and of preterm birth (14% with buprenorphine vs. 25% with methadone). The good news: NAS, while difficult for infants, is easily treated. 

Living in a cramped apartment can increase stress and have other mental health consequences, as many of us learned during these Covid years.

But using science-backed methods, you can make your tight space a happy place, according to a column in the Washington Post. Tips include no-brainers like decreasing clutter as well as the less obvious use of mirrors, colors, shapes and textures.

Four sailors assigned to the same Navy facility died by apparent suicide over less than a month, NBC News reported. The cluster involving a ship maintenance center in Norfolk, Va. followed three suicide deaths during one week in April of sailors assigned to the USS George Washington, which was docked at nearby Newport News. The latest development is sure to ramp up concerns that the Navy is facing a fleetwide mental health crisis. Desertions more than doubled between 2019 and 2021 while staying flat or declining at the other services. Some military law experts say that nearly unbreakable Navy contracts requiring up to six years of active duty may leave troubled sailors feeling they have no way out.

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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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