Alliance Alert: The Alliance for Rights and Recovery is deeply concerned with the methods the current New York City administration is using to expand involuntary commitment. Mayor Adams’ plan has clearly resulted in far too many people being transported to hospitals even when they do not meet the criteria for removal.
Disturbingly, individuals are being taken against their will simply because they become agitated while speaking with co-response teams—a practice that is both dehumanizing and a misuse of limited resources. The City’s own data shows that 43% of co-response (nurses paired with police) team–initiated removals fail to meet the medical requirements for admission, even after the state already loosened standards. Rather than reserving involuntary commitment for the small number of cases that do fit medical requirements, the administration is instead pushing to expand criteria again, this time to include people with suspected substance use challenges even if they do not have a mental health issue.
We must be clear: we cannot hospitalize our way out of the homelessness crisis. Instead, New York City should focus on opening more safe shelters, investing in permanent housing, and supporting low-barrier housing initiatives that offer stability and dignity. It is also deeply concerning that the NYPD has failed to disclose what percentage of their far more frequent removals actually result in admission, leaving a major gap in accountability.
New York City and State must stop investing in failed coercive strategies and instead focus funding and energy on expanding a continuum of voluntary, community-based services— including Peer Bridger programs, Intensive and Sustained Engagement Teams (INSET), Assertive Community Treatment (ACT) teams, supportive housing, Housing First programs, and requirements for connection to community services for people who enter the emergency room but are not admitted. These are the kinds of true solutions the Alliance and our partners called for during the last legislative session and will be pushing for again this year.
Looking Ahead: The Alliance Annual Conference
These critical issues will be front and center at our upcoming Alliance Annual Conference. We will host multiple workshops on services that work and must be expanded to create a true continuum of care that helps more people access housing and recovery supports. Sessions will focus on effective programs and services, rights protection, confronting stigma, best practices for supporting unhoused people, and coalition-building for effective advocacy.
This conference is a can’t-miss opportunity to learn, connect, and support each other as we push for policies and programs that uplift people, not punish them.
Unbreakable! Harnessing Our Power, Building Our Resilience, Inspiring Hope and Courage
Alliance for Rights and Recovery 43rd Annual Conference
Villa Roma Resort and Conference Center | September 29-October 1, 2025
Register Today Here!
Adams’ Involuntary Hospital Transports Often Fail to Meet Admission Criteria
By Ethan Geringer-Sameth Crain’s Health Pulse September 12, 2025
The city’s co-response teams, designed to treat homeless individuals with mental health needs, sometimes take people to the hospital against their will, but they often do not meet the criteria for admission, according to the Adams administration.
The teams, which pair nurses with police officers to liaise with homeless New Yorkers, are a signature of Mayor Eric Adams’ quality-of-life agenda and the city has spent millions to deploy them. The goal of the program is to add a clinical perspective to the police teams tapped by Adams to address mental illness among the homeless, and who conduct the bulk of involuntary transports.
In more than 500 cases since last year, co-response team interactions have ended in involuntary transports to a psychiatric emergency room, usually run by the city’s public hospital system, New York City Health + Hospitals. The administration says the so-called “removals” are necessary to treat some of the people with the greatest needs. But in 43% of the instances when people were taken to a hospital by the teams, the person was not admitted for medical or psychiatric care, raising questions about the outcomes of more than 200 involuntary transports and the reasons why they happened in the first place.
“The data we have shows that people are being inappropriately brought to the hospitals, they are not receiving care [and] they’re putting them back out on the street, in many cases in worse situations than they were in before,” said Nick Encalada-Malinowski, civil rights campaign director at Vocal-NY, an advocacy group for homeless New Yorkers. “The reality is that whatever the situation that existed for people to be living on the street, navigating unmet mental health needs, still exists as soon as they are discharged from the hospital.”
Brian Stettin, Adams’ senior adviser for serious mental illness, who helped design the mayor’s strategy, said part of the reason some people are not admitted is because the standard doctors use for a psychiatric hold is higher than that of a police or nurse-led involuntary transport. Another reason hospitals do not admit patients is because a nurse’s determination of untreated psychosis in the field often turns out to be a drug-induced state that wears off as the individual sobers, Stettin said, speaking at a recent panel on the subject at New York Law School.
“There are a handful of cases where it’s questionable whether that person should have been removed at all but much more typically the rationale is that the person was actually experiencing a drug-induced psychosis,” he said. The Adams administration is now lobbying state legislators to amend the law to allow doctors to commit people with substance-use issues even if they do not have a diagnosis of mental illness.
In some cases, people are being taken to the hospital when they get agitated, even when they don’t need psychiatric treatment, a problem the administration is seeking to reduce, Stettin told Crain’s. Those numbers have been going down as the city emphasizes to co-response nurses that these individuals should not be taken to the hospital, he said.
The city would not say how many people who are removed ultimately fall into either category.
Tracking outcomes is still a work in progress, according to Stettin, who noted that the city did not report any data on involuntary transports before Adams made the program central to his agenda. While public city data shows a majority of people taken by the teams are brought to Bellevue Hospital in Kips Bay, the administration cannot say what percentage are connected to outpatient care, shelter or other services and how many actually receive that care. The data shows even more involuntary transports are conducted by police but, unlike the clinician-initiated ones, the city does not report how many people are admitted.
One of the programs, a state-operated team known as the Subway Co-response Outreach Teams, or SCOUT, pairs nurses with MTA police backed by a $20 million infusion from Gov. Kathy Hochul. SCOUT teams have involuntarily transported more than 200 people to hospitals though the transit agency doesn’t track outcomes either, according to Jeremy Feigelson, senior counsel at the MTA.
Dr. Omar Fattal, who leads mental health services at Health + Hospitals, said that not being admitted doesn’t mean a person did not receive care or get connected to community-based services. Every person brought in receives a psychiatric evaluation from a doctor. But many are deemed to be better suited for outpatient treatment or in need of social rather than health services, he said.
“Sometimes people not being admitted to inpatient and discharged back to the community is a good thing because it means that we connected them with ongoing services,” Fattal said.