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AMEED ADEMOLU: We never know what we’re going to encounter in the field. We always suspect the unexpected. What we know for sure when a person has totally met the criteria for removal, the only thing for us to do in that moment will be to get them to the hospital.

NARRATION: Ameed Ademolu, a registered nurse, canvasses the subways every weekday with a team of M.T.A. police officers. Their job is to remove unhoused people showing signs of mental illness, and bring them to the hospital – even if it’s against their will. It’s part of a controversial initiative launched two years ago by the mayor of New York City.

ARCHIVAL (11-29-22):
NEWS REPORT: Mayor Adams announced his plan to take people with mental illness off the city streets. He’s directed police and emergency medical workers to involuntarily hospitalize more of them.

NARRATION: But this isn’t the first time New York decided to hospitalize people against their will.

ARCHIVAL (12-4-87):
JOYCE BROWN: You can’t go around picking up people like they’re cattle.
ED KOCH (MAYOR OF NEW YORK CITY): Such a person requires help. That’s what we’re trying to do. That’s my job. 

MICHELLE D. JAMES (JOYCE BROWN’S NIECE): Joyce Brown was my mom’s youngest sister. As a kid, it’s really kind of scary to be around someone that’s being kind of erratic, at best. She never thought that she was mentally ill.

NARRATION: But Brown resisted her family’s attempts to help, even as her mental health deteriorated over time, and she struggled with drug addiction. One day, she disappeared. 

MICHELLE D. JAMES: We went to Missing Persons in New York. We went to the morgue. We actually even went to the hospital, but nobody saw a Joyce Brown. We didn’t see her or hear anything until we saw the news.

ARCHIVAL (ABC NEWS, 11-6-87):
NEWS ANCHOR: There is a controversial new city program here by which the city puts psychiatrists on the street looking for homeless people who allegedly may endanger themselves or others.

ARCHIVAL (ABC NEWS, 11-6-87):
NEWS REPORT: A team in a van goes searching for them, deciding whom to take by force, if necessary, to a city psychiatric ward.

ARCHIVAL (CBS NEWS, 11-5-87):
NEWS REPORT: The first person committed says she’s not mentally ill, even though city officials say she has been living a filthy, incoherent life, shouting obscenities from this street corner. 

MICHELLE D. JAMES: That’s how we found her. It was hard for all of us to see because we just couldn’t understand, like, what happened, you know? What happened in these months that we didn’t see her?

NARRATION: During that time, New York City had implemented a new policy.

ARCHIVAL (1987):
MAYOR ED KOCH: It is terrible to see these people who are lying in their own feces, who are clearly gross mental cases.

NARRATION: The city had decided to expand the guidelines for who could be forcibly hospitalized. Until then it was only those who posed an immediate danger to themselves or others. Now, that danger could be in the foreseeable future.

DR. LUIS MARCOS (SENIOR VICE PRESIDENT OF MENTAL HYGIENE, NYC HEALTH AND HOSPITALS CORPORATION, 1981-92): If the person is obviously ill but denies it, isn’t that a call for help?

ARCHIVAL (ABC, 11-6-87):
DR. LUIS MARCOS: To be mentally ill, deteriorating in the streets when there is treatment available, is not freedom. It’s the worst kind of imprisonment. 

DR. LUIS MARCOS: For the first time, we’re going to go out and protect them and take care of them and treat them. You needed someone who believed in intervening in these cases, and I believed, absolutely.

ARCHIVAL (1988):
REPORTER: The very first person Project Help picked up was Joyce Brown.
JOYCE BROWN: I am an adult, a 40-year-old intelligent woman and I don’t need Mayor Koch or Bellevue to tell me where I can live. 

DR. LUIS MARCOS: She would talk to herself out loud. She would run in front of traffic. She was mentally ill, and she was examined by many psychiatrists, including myself. 

NARRATION: But the New York Civil Liberties Union had been gearing up for a fight.

ARCHIVAL (CBS, 11-5-87):
NORMAN SIEGEL (A.C.L.U.): Citizens have to be concerned about the prospect of government vans roaming the streets of the city. That’s not what this country is supposed to be all about. 

NORMAL SIEGEL (EXECUTIVE DIRECTOR, NEW YORK CIVIL LIBERTIES UNION, 1985-2001): You have to make sure that you’re checking the government, because otherwise you’re inviting the government to pick up non-dangerous people based on mere speculation about future conduct. I’m not opposed to involuntary commitment. What I’m opposed to is involuntary commitment that doesn’t meet the legal standard.

NARRATION: Brown, who was calling herself Billie Boggs, immediately challenged her hospitalization with the help of Siegel and his team.

NORMAL SIEGEL: We had psychiatrists go, and they concluded that although she had some mental health issues, she was not a danger to herself or others. So we agreed to represent her.

MICHELLE D. JAMES: We were just, like, really, really happy that we found her, but that quickly turned when we realized that she was going to be used as a pawn.

ARCHIVAL (1988):
JOYCE BROWN: I was incarcerated against my will. In prison. A political prisoner. The only thing that was wrong with me was that I was homeless. Not insane.

ARCHIVAL (ABC, 11-6-87):
NORMAN SIEGEL: If we throw individual freedom and individual liberty for homeless people out the window today in 1987, who’s next? 

NARRATION: The court ruled after a few weeks that the city did have the right to commit Brown, in effect lowering the threshold of what it meant to be a danger to oneself. But Brown was released after a separate ruling determined that she could not be forcibly medicated. 

ARCHIVAL (CBS, 2-19-88):
NEWS REPORT: Joyce Brown was transformed from street person to celebrity overnight. 
Well, here’s the most famous homeless person in America.
Please welcome Joyce Brown to people like us.  

MICHELLE D. JAMES: You would see these clips, and she’s at this place and that place.

ARCHIVAL (1988):
REPORTER: You used to go to the bathroom on the sidewalk, the stench from there was terrible, and you’re saying the only thing wrong with you is that you were homeless?
JOYCE BROWN: Yes, that is correct.

MICHELLE D. JAMES: We watched them kind of clean her up.

ARCHIVAL (CBS, 2-19-88):
JOYCE BROWN: Do I sound like a mentally ill to you? I’m as sane as you are.  

MICHELLE D. JAMES: Meanwhile, you got my aunt in the middle of this thing, and she’s mentally ill. Our concern was, what was going to happen when they were done?

ARCHIVAL (1988):
JOYCE BROWN: I was hurt by what they did to me, how they treated me, how they brought me to hospital, injected me with drugs, took my blood without permission.

NORMAN SIEGEL: She knew her rights, and civil commitment is a massive curtailment of liberty.

ARCHIVAL (1988):
NORMAN SIEGEL: Do not go outside the law. Stay within the existing law.

NORMAM SIEGEL: Whatever her problems were, she didn’t meet the legal standard.

ARCHIVAL (CBS, 2-19-88):
NEWS REPORT: If Joyce Browne really is mentally ill, how will she hold up to this kind of pressure?

ARCHIVAL (1988):
NEWS REPORT: Will she do better on her own? Or should she have remained hospitalized?

SAM TSEMBERIS (DIRECTOR OF PROJECT HELP, NYC HEALTH AND HOSPITALS CORPORATION, 1988-1992): I came into the Project HELP program right after this controversy. Over time, what was clear to us is that people kept returning to the street. They were discharged, there was no housing option, and they ended up back usually in the same spot we had met them the first time. We were kind of in this cycle of taking care of acute emergencies, but with no real resolution to the problem.

NARRATION: Meanwhile, Joyce Brown had sunk back into a cycle of her own.

ARCHIVAL:
NEWS REPORT: She’s been back on the streets, begging, and she’s been caught with heroin. 

NORMAN SIEGEL: My feeling on all this stuff is that mental health systems failed because we haven’t provided the viable options for people like Joyce Brown. 

SAM TSEMBERIS: The Joyce Brown story showed the controversy around stripping someone of their civil rights in the spirit of involuntary commitment. There are times when someone has to be brought to the hospital involuntarily because they’re a danger to themselves or others. That’s not the issue. The issue is, how broadly to expand that, and how many people are you bringing in without good reason? And what is the end result of that? 

NARRATION: In the years since, Tsemberis says his work has shown that there are better ways to help more people without using coercion.

SAM TSEMBERIS: We actually know what to do. If we had a robust system of care that was there continuously and providing everything that the person needed – treatment, housing – that would require less desperate measures. So the question is, what should you invest in, and what makes the most sense? 

ARCHIVAL (CBS, 11-19-24):
NEWS REPORT: Developing this morning, the suspect in a stabbing spree that left three people dead is behind bars right now and waiting to face a judge. 

ARCHIVAL (CBS, 11-19-24):
NEWS REPORT: The suspect struggled with homelessness and mental health.

NARRATION: The stabbings in November 2024 thrust debate over involuntary measures back to the forefront.

ARCHIVAL (CNN, 11-21-24):
ERIC ADAMS (MAYOR OF NEW YORK CITY): We need to be able to take the action to involuntarily move them off the streets.

NARRATION: Brian Stettin, who has been leading the city’s efforts on this issue, believes the best way to help people in psychiatric crisis, who don’t realize they need help, is to hospitalize them.

BRIAN STETTIN (SENIOR ADVISOR FOR SEVERE MENTAL ILLNESS, NEW YORK CITY MAYOR’S OFFICE): When you look at someone who is filthy, whose clothes are soiled, who smells of urine, who’s emaciated, your risk of harm to yourself may not be imminent. Right? It may not be that you’re on death’s door, but we can see the trajectory. And there actually is case law that is on our side here, right? So this is the Billie Boggs case of the 1980s. 

NARRATION: That’s because the highest court to rule on Joyce Brown’s forced commitment had upheld its legality.

For over a year now, the subway co-response outreach teams have been on a specialized mission: Remove those they say are the most troubled, and hospitalize them against their will when necessary. 

AMEED ADEMOLU: They are the most vulnerable members of our society. Oftentimes the help that is required, they don’t even have the realization of disorders in the first place.

NARRATION: Each SCOUT team, under the direction of a nurse, offers shelter or treatment options as they go, depending on the case. During a shift in December, Ademolu’s team encountered someone who met the criteria for involuntary removal.

AMEED ADEMOLU: This gentleman, he’s unable to meet basic needs. He had no idea where he’s at, had no idea how he got there, where he’s from, is just not mentally capable of managing his own affairs. And  at that point there is nothing else that could have worked but to bring him to the hospital.

NARRATION: The city says that their efforts are succeeding and the SCOUT teams alone have removed and hospitalized 115 people involuntarily. A portion of those people have then been admitted to psychiatric inpatient care. But as to what happens after that, the city declined to provide any details. 

BRIAN STETTIN: In a vacuum there are limits to what we can actually accomplish through this approach. There’s no question about that. We are not going to reverse decades of systemic neglect overnight. I think what we’ve tried to do in the meantime is focusing on the people who consistently refuse care.

SAM TSEMBERIS: The number of people who are homeless is going up and it’s going up. Involuntary treatment it’s not going to fix that. This is just a smokescreen and an appearance of doing something, but really looking at a symptom rather than the whole picture of what is actually going on.

NARRATION: Tsemberis says a key to successful intervention is for people to want that help themselves and that’s what many outreach workers are trying to facilitate, like the team at BronxWorks, a New York nonprofit.

JUAN RIVERA (ASSOCIATE VICE PRESIDENT FOR HOMELESS OUTREACH SERVICES BRONXWORKS): You have to understand that, like, this person that is out there got there over a period of time. So it’s going to take a while to try to get them going back in the opposite direction. 

ISSA ASIEDO (ASSISTANT PROGRAM DIRECTOR, HOMELESS OUTREACH TEAM
BRONXWORKS): The bulk of our job is this, this relationship that we build with the clients. Taking little steps and working at things one step at a time. Eventually some way, somehow, we break down some barriers. 

ISSA ASIEDO (SPEAKING TO AN OUTREACH CLIENT): If you’re serious about getting a bed, I could send somebody over here today to do some paperwork and try to get you in a bed. That sound good?

OUTREACH CLIENT: O.K.

ISSA ASIEDO: We just understand that we got to keep continuing to engage with them to the point that they want the services.

NARRATION: In the end, Joyce Brown also eventually accepted help voluntarily. Siegel helped find her a place in supportive housing in Brooklyn. It was there that she decided to go on medication, and found a degree of stability.

NORMAN SIEGEL: I liked her. I liked her and I learned from her. I learned to be a better lawyer, a better advocate, a better fighter for people’s human rights.

MICHELLE D. JAMES: She trusted them. Without them, you know, you couldn’t have convinced her to go to that women’s shelter. We cared about Joyce and we wanted her safe. That’s what we wanted. That’s all that we wanted. 

TEXT ON SCREEN: 

Joyce passed away in 2005.

(END)