(5-9-23) Would Jordan Neely, a homeless, African American New Yorker with a history of mental illness, who was strangled to death in a subway car by a Marine Corps veteran, be alive today if New York had a so-called Care Court?
Care Courts are California’s latest attempt to reduce homeless, especially among those with mental illnesses, such as Neely. The destitute young street entertainer had been arrested more than 40 times, according to news reports, and was well-known to social workers. CNN reported that he was “on a list of homeless people identified as having dire needs.”
California officials describe Care Courts as “coercive compassion” an initiative that will involuntarily place people into treatment – if they meet certain criteria – rather than waiting for them to pose a danger to themselves or others.
Care Courts will allow a relative, mental health clinician, police officer and others to file a petition in the new civil court system to have the person, willing or not, enter the program. A clinician then will have two weeks to decide if the person, who is afforded legal counsel, qualifies for the program, which will accept those with mental health illnesses such as schizophrenia or other forms of psychosis. Care Court will also be an option if a person is involved in a criminal or civil court case and is determined to be unfit to stand trial.
The National Alliance on Mental Illness and others including: California’s Big City Mayors, California Professional Firefighters, the California Medical Association, and the California Hospital Association support creation of Care Courts.
Obviously, creating a Care Court has outraged disability and civil rights groups, including the state’s Protection and Advocacy organization, while it is being embraced by many parents and others who are frustrated by a neglectful system that allows their loved ones to resist treatment and “die with their rights on.”
The Washington Post recently published an extensive article about Care Courts. if you are unfamiliar them.
Not surprisingly, civil rights activists are horrified. This Op Ed in the Post is representative.
The hard truth that advocates of forced treatment ought to concede is that coercion often backfires. Each year in California, tens of thousands of people are already transported involuntarily to ERs and admitted to hospitals against their will. These involuntary hospitalizations may save a person’s life in the moment, which is no small thing, but research shows that many who undergo this process are traumatized and humiliated, leading to increased suicide risk and long-termdistrust of treatment providers. When delivered in a heavy-handed way, court-ordered treatment is not only ineffective but can also drive people decisively away from essential services.
For parents who are being forced to standby while an adult child with a serious mental illness is homeless and delusional on the streets, the fact that “involuntary hospitalizations may save a person’s life in the moment” is more than enough to support a Care Court.
In the 1960s, there was a movement led by lawyers by what today is the Judge David L. Bazelon Center for Mental Health Law to either end involuntary confinement completely or greatly limit its use, as I reported in my book, CRAZY: A Father’s Search Through America’s Mental Health Madness. Buttressed by judges’ rulings, states began requiring “imminent danger” to be present before an intervention. As time passed, states began having second thoughts and today most have moved to dilute the dangerousness criteria. Terms such as “unable to care for self or others” or “substantial likelihood of danger” began being written into commitment language after it became obvious that waiting for “imminent dangerous” often was a recipe for disaster.
Thanks to the Treatment Advocacy Center, 47 states and the District of Columbia currently have Assisted Outpatient Treatment laws. That includes New York City. Why was that law not used to help Neely? The same question can be asked about less coercive programs, such as Housing First and Assertive Community Treatment teams. Programs exist that could have helped Neely. But despite hand-wringing after the fact, our elected leaders are reluctant to pay for comprehensive support programs. Jails and prisons are cheaper ways to force those who are sick and homeless off the streets.
Helpful articles:
NAMI San Clara County: CARE Court: A New Dawn in Mental Health Treatment
By More Milo
It’s a rare moment when a proposed law reshaping the mental health landscape receives unprecedented support. It’s even more stunning when it’s enacted within eight months. This is what occurred after Gov. Gavin Newsom laid out his CARE Court proposal.
On Sept. 14, 2022, Gov. Newsom signed the Community Assistance, Recovery and Empowerment (CARE) Court bill at Crossroads Village in San Jose. The CARE Act will completely reshape the way those with severe mental illness receive treatment.
“Just a few months ago, I stood here and we laid out a vision, and a marker and a dream, and here we are and we made it a reality,” Newsom said.
CARE Court focuses on individuals diagnosed with schizophrenia and other psychotic disorders. Individuals who are often homeless or incarcerated. The new law will make it easier to divert them into community-based treatment instead of jails due to misdemeanors like trespassing and petty theft.
CARE Court could also be a next step after a 72-hour hold (5150) or a 14-day involuntary stay (5250) as part of a continuum of care. The objective is to eliminate the constant cycling of an individual through the hospital and jail systems where treatment is minimal and insufficient. The program is also aimed at getting individuals living untreated off the streets and into care.
The program is structured to provide court-ordered comprehensive treatment, housing, and supportive services for severely mentally ill individuals for one year, with the option to extend it for another 12 months. For the first time, families will have a proactive say in a loved one’s care. In the past, families had no input unless the individual in crisis gave consent.
This shift enables a family member to petition the court for treatment and serve as an advocate, supporting the individual as he/she works toward stability and recovery.
California shifts to an experiment in coercion to treat the homeless: A new court system seeks to find a middle road between jail and ignoring the mentally ill, many of whom live on the streets
By Scott Wilson, writing in The Washington Post.
The program, known as Care Court, will make it easier for the state to intervene in the mental health treatment of its most severely ill residents after spending $20 billion over the past five years to get people off the streets. But at the same time, California is preparing to eventually spend up to $215 million a year on a program, born amid a worsening homelessness crisis, that no one knows will work.
Jordan Neely Was Already Dead: New York reckons with a homeless epidemic and a killing.
For some New Yorkers, Jordan Neely was dead even before Marine Corps veteran Daniel Penny allegedly choked the life out of him on the floor of a subway train. Modern America, including New York, designates some categories of people as socially dead — part of an underclass that is subject to exclusion, indifference, or even outright hatred and violence. To be Black, destitute, homeless, and mentally ill in our city is to be one of those outsiders, existing in a kind of internal exile from society’s circle of care and concern.
“I don’t have food, I don’t have a drink, I’m fed up,” Neely screamed in the final minutes of his life, according to Juan Alberto Vázquez, a freelance journalist on the train who recorded the incident. “I don’t mind going to jail and getting life in prison. I’m ready to die.” It seemed to be a complaint shouted to the heavens, aimed at nobody in particular. Neely “didn’t seem like he wanted to hurt anyone,” Vázquez later said. But the doomed man’s words were sadly accurate about the choices he believed New York offered: prison or death.
As the local tragedy quickly became national and even international news, the city’s politicians began squabbling…. Read more here.
All The Ugly Layers: The Jordan Neely Story
Published by Medium by Lisa Bay Cooper,
The Beatles recorded the song, Eleanor Rigby, in 1966. The lyrics about an elderly woman who spent her time with little companionship posed the question: “All the lonely people, where do they all come from?”
Nearly 60 years later, the news cycle is focused on protests over the death of 30-year-old Jordan Neely on a subway train in New York. Reports say Neely was speaking in a belligerent manner to passengers on a train about being hungry, thirsty, and not caring if he went to “jail for a long time.” Initial reports quote a witness as saying a man approached Neely from behind and put him in a chokehold as both men fell to the train floor. When the incident was over, Neely was taken to the hospital where he died. Neely’s actions prior to the chokehold suggest he was having a mental health crisis.
Neely’s tragic death is worthy of societal soul-searching beyond the current news cycle. Like the Beatles’ song, should we pose a new question: Is there more we can do for people living with mental illness?
What better time to reflect on this question than Mental Health Awareness Month, which has been observed every May since 1949.
Author Lisa Bay Cooper is a former Capitol HIll correspondent whose son’s mental illness caused him to commit vehicular suicide and whose adult daughter is in recovery after finally receiving comprehensive mental health treatment.
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