I was hospitalized against my will. I know firsthand the harm it can cause | Mental health

As Mayor Eric Adams recently announced a dramatic expansion of New York City’s involuntary hospitalization policy, I heard in disbelief as he promised to provide the city’s most vulnerable with “compassion and care”. I found myself overcome with both rage and grief, reliving, as I often do, a warm spring day eight years ago.

I was flat on my back in an ambulance, strapped down, driving through towns unknown. They—whoever they were – were taking me across the state, hundreds of miles away from anyone who knew or cared about me, to the nearest inpatient facility with an open bed. I had not spoken to my family or my therapist. I was 19 years old.

Drawstrings were removed from my sweatpants, as were the laces from my shoes. I was hurriedly shuffled into the grayest room imaginable. A heavy door closed behind me, and would stay locked until they deemed me fit to leave. At the time, I had no idea when that day would come.

My inner monologue formed a loop in my head: don’t show too much emotion, or the nurses will assume you’re unstable. Don’t show too little emotion either, or the drugs must be too strong, they will have to readjust them. Smile, be polite, but not withdrawn. Hold out your arm when it’s time for the daily blood draw, even if you’re terrified of needles. Eat food that’s bland even by Massachusetts standards, and be grateful if there’s a fruit cup with dinner. Speak with the other patients enough to appear agreeable and cooperative, but not so much that you open yourself up to unwelcome comments or looks. Sit on a bed in a room that has been stripped of all warmth and feeling, a room that is designed to remind you that the people here think you are a threat to yourself.

You’ve been seeking care for almost six years already, but the doctor met with you for 15 minutes and you’re here now, so what they say about you must be true. Perform normalcy on the worst day of your life. Rinse, repeat, for as many days as you can until you are finally, hopefully, set free.

Unless you have experienced it, I don’t think you can fully understand what it means to lose autonomy over your own body, or to have to “earn the privilege” of 30 minutes of fresh air and sunshine.

All of this occurred under better-than-average circumstances. For one, I am a young, white, cisgender woman. I was not homeless – at the time, I was a student at a liberal arts college. I had private health insurance, which meant I could afford to be held at a private facility.

Most importantly, I had someone who was willing to fight for me. The minute she found out what happened, my mom dropped everything and immediately flew to the place where I was being held. She visited me every day, grounding me in a space that is unmooring by design. Most importantly, she let the facility know that there was someone on the outside who gave a shit, someone who would not let me wither away behind locked doors.

These were the “best of circumstances” – and yet it remains one of the most traumatic events of my life.

Eight years after that warm spring day, I can say with confidence that I am in a much better place than I was then. I graduated from college, moved to New York City, and got my first job advocating for criminal justice reform. I am working towards getting my law degree, and I plan to pursue a career as a public defender. But it is the memory of that week that compels me to speak today.

The United States has a long, sordid history of involuntary confinement. Since the 19th century, involuntary confinement has been used as a tool to remove people from society, either because they were disabled, or because they violated perceived societal norms.

The numbers are staggering – in 1955, when the US asylum system was at its height, over 558,000 people categorized as “severely mentally ill” were held in state psychiatric hospitals. Even after the deinstitutionalization movement of the 1970s, tens of thousands of people continued to be involuntarily committed, without even the limited due process protections of the criminal legal system.

Further progress was made following the passing of the Americans with Disabilities Act in 1990. In the landmark 1999 case Olmstead v LC, the supreme court found that unjustified isolation, ie denying people with disabilities the right to live in their community, is a form of unlawful discrimination. I found it notable that Adams’s announcement came just a few weeks after the passing of Lois Curtis, the lead plaintiff in the Olmstead case.

With progress also came backlash and retrenchment. In the same year that the Olmstead decision was announced, Kendra Webdale was tragically killed when a young man, who had lived with schizophrenia since his youth, pushed her into the path of an oncoming subway train.

In response, in part, to the media frenzy that followed, New York passed “Kendra’s Law”, the first involuntary commitment law in the United States. The law gives courts the authority to force people who have “a history of lack of compliance with treatment for mental illness” into “assisted outpatient treatment” (AOT). Individuals who don’t comply can face detainment by law enforcement or, in some cases, involuntary hospitalization.

In the years since, Kendra’s Law has been widely criticized both for its lack of effectiveness in treatment and for the way it disproportionately affects New Yorkers of color. Despite these clear shortcomings, Adams has been a longtime proponent of expanding its use.

Now, consider the impact of Adams’s newest policy, under which the NYPD can identify someone who they think has a mental illness and detain them if, according to the officer, the person “appears to be mentally ill and displays an inability to meet basic living needs”. This is a dramatic departure from the standard required under New York’s mental hygiene law, which allows police to take individuals into custody if that individual “is conducting himself in a manner which is likely to result in serious harm to himself or others”. The law provides specific examples of what is considered conduct likely to cause harm – notably, none of these examples include an individual’s “inability to meet basic living needs”.

New York City’s Civilian Complaint Review Board, an independent city agency that investigates reports of police misconduct and abuse, gets hundreds of complaints a year related to forcing people into psychiatric hospitals. Further expanding the NYPD’s already enormous power and surveillance capacity will probably lead to increased violence against some of our most vulnerable neighbors. Under the Adams administration, the NYPD has dramatically escalated so-called “sweeps” of unhoused encampments, which activists say “are designed to break spirits and get people out of sight”.

For individuals living with mental illness, encounters with the police can be traumatizing, violent and, at worst, deadly. That risk becomes even greater when the individual is Black. It’s also important to emphasize that, just as Black people with mental illness are at a greater risk of harm, arrest and/or incarceration by law enforcement, they are also at greater risk of racist treatment by mental health professionals.

Some alternatives do have the potential to generate positive outcomes without further traumatization. Working on guaranteeing access to safe and affordable housing, as well as providing access to quality, voluntary mental health care, could play a huge role in improving the quality of people’s lives. But that would require rejecting the mayor’s preferred “law and order” narrative in favor of something more nuanced: a vision of treatment that is more deeply rooted in personal autonomy, compassion and community care.

THere are several reasons that I call myself an abolitionist. I believe in a society predicated on care and community rather than punishment. I believe one state-sanctioned killing is too many. I am continuously enraged at the violence and dehumanization I witness every time I step through the doors of a courtroom or prison.

But if I am being honest, I am also an abolitionist because of what happened to me. What if, one day, it happened to you? To someone you know, to someone you love? What vision of compassionate care would you hope to receive?

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