The struggle to treat mentally ill people on the streets

Good morning. It's Thursday. Today we'll look at a program to treat seriously mentally ill people on the streets – and why an audit shows the city isn't doing enough to see it get results. We'll also find out why 16- and 17-year-olds in Newark can't vote as quickly as they'd hoped.

I asked Jan Ransom, who wrote The Times stories with Amy Julia Harris about the problems with the system, the audit and its reporting.

The audit found that the city had poured money into this program without checking whether it actually worked.

Yes. The auditors assessed a sample of the participants to find out what was going on and found that less than a third of those participants were regularly taking their medications.

One in four has never met a psychiatrist or psychiatric nurse for treatment.

Brad Lander, the comptroller, said this is a good program, but it is not working the way the Department of Health and Mental Hygiene is implementing it.

Why does it seem so difficult to check whether someone is taking their medications?

The teams often lost sight of their customers.

The audit found that if they are not seen, they do not receive their medication.

It's probably worth noting that the teams cannot force drugs on a participant who is resisting. If a team notices that someone is not doing well, if the person is suicidal or homicidal, or is behaving in a way that poses a danger to themselves or others, the team is obliged to do something, such as sending the person to to a hospital. additional treatment.

Wasn't IMT designed to reduce hospitalizations and also incarcerations?

The audit showed that the city does not regularly monitor this metric.

The last study the city did focused on people who participated in the program in 2018 and found that the incarceration rate for those people dropped by 22 percent.

As part of our mental health research, we found examples of people who had been cared for by IMT teams for years, had regularly ended up in hospitals and were arrested as often as before they had a treatment team.

We found a homeless man named Dejanay Canteen, whose name is King. Shortly after the program started, he had an IMT team. He struggled with schizoaffective disorder and had cycled in and out of hospitals and prisons.

Once he connected to IMT, that would change.

Did it?

From official documents we could see that the cycle continued. He was still arrested. He was accused of threatening a street vendor with a knife while trying to steal a pair of sunglasses. Police said he tried to steal the tip jar from a restaurant in a separate incident that also involved a knife. He is now serving seven years in prison for attempted theft.

What was the department's response to the audit?

Officials said this is a population largely resistant to treatment, that the nature of their problems is “complicated” and that it would be unrealistic to impose specific care requirements.

They said they would compile performance data to see how well the program is doing, but they won't do that until 2025. That's almost ten years after the program was launched.

In some of the reporting we looked back at what had happened over the years under various mayors and governors. We found that high-profile incidents—such as the recent subway shoving by untreated mentally ill people—prompt elected officials to do something. But we found there was little follow-up to see that what they were doing was actually working.

The current mayor, Eric Adams, has cited IMT as a major part of his mental health agenda in what he has called a crisis. The audit clearly showed that there is a problem with the city doing what is necessary to ensure these initiatives work as intended.

Aren't the city's public hospitals overwhelmed by almost 50,000 psychiatric patients a year, while private hospitals have cut back on psychiatric beds?

Absolute. The idea behind the IMT teams was to provide the most seriously mentally ill people with care that would meet them wherever they are. The teams had to step in and fill the void when long-term psychiatric beds disappeared in state institutions.

We've seen that the idea behind IMT can and should work, but based on the way the city has implemented the program, we don't know if it works or not.

Weather

It will be a mostly sunny day around 40 degrees, with temperatures dropping into the 30s on a mostly cloudy evening.

ALTERNATE PARKING

Effective today. Suspended tomorrow (New Year's Eve).

The latest Metro news

Last month, the Newark City Council gave 16- and 17-year-olds the right to vote in school board elections.

It turns out to be easier said than done to ensure that they can actually vote.

Advocates who had pushed for a lower voting age acknowledged this week that state and city officials needed more time to make adjustments to the computerized voting registration system. My colleague Tracey Tully says the goal was to register eligible 16- and 17-year-olds in time to vote in the next school board election, scheduled for April 16.

Henal Patel, director of rights and policy at the New Jersey Institute for Social Justice, said the timeline for this year's election cycle: with a registration deadline of March 26 for the April elections had always been ambitious. About 7,000 teens in Newark are likely eligible.

“You want to make sure this is done right,” she said. “We have much more hope for next year.”

The ordinance giving 16- and 17-year-olds the right to vote in upcoming school board elections was seen as a way to increase civic engagement in a city where only 3.1 percent of the 195,000 registered voters on the school board went to the polls . election last April, when there were eight candidates on the ballot. Mayor Ras Baraka, a former high school principal, called the measure “a training ground and an opportunity to prepare young people to actually participate in larger elections.”

Gov. Philip Murphy has said he supports lowering the voting age for school board elections across the state, and a state election official said this week that New Jersey remains committed to that effort. “The state tried to make this happen,” said Ryan Haygood, the institute's president and chief executive officer, who was one of the leading proponents of the lowered voting age. “And it will happen.”

METROPOLITAN diary

Looks great

Dear Diary:

My wife and I recently attended a performance of opera music at Carnegie Hall.

As usual, I wore my old-fashioned uniform: navy blue blazer, bow tie, pocket square and French cuffs.

We took the elevator to our seats and shared it with another couple. The man looked somewhat disheveled.