The records were obtained from the New York Civil Liberties Union in a lawsuit filed in March against the NYPD and shared with POLITICO.
Adams focused on the intersecting crises of homelessness and mental illness as part of a larger effort to address voter concerns about crime and perceptions of public safety. His approach has sparked outrage and lawsuits from civil rights advocates such as NYCLU, who consider him both ineffective in addressing serious mental health problems and a dangerous violation of individuals’ constitutional rights.
Supporters have also criticized police involvement in implementing the Adams Directive in light of numerous cases of people in mental health crisis being killed or seriously injured by NYPD officers. Adams, a former police captain, responded by saying patrol officers would hand someone’s cases in crisis to others in law enforcement who have more in-depth training than the surface training a regular police officer would.
But the training materials, publicly disclosed here for the first time, indicate that any uniformed service member has the authority to unilaterally decide that someone should be involuntarily taken to the hospital due to an inability to care for themselves.
Beth Haroules, director of disability justice litigation for NYCLU, said the presentation also seems inconsistent with city officials’ commitment to provide police with thorough training on failure to meet basic needs standards and an update on crisis communication strategies. Between the slides and the video, which overlap significantly, the patrol officers appear to receive no more than 25 minutes of review.
The police academy, meanwhile, spends at least four and a half hours teaching entry-level officers about policing the emotionally disturbed, as the NYPD student guide calls it.
In an emailed statement, an unnamed police spokesman said officers already receive significant training in interacting with people with mental illness and their involuntary commitment authority. According to the department, more than 90 percent of patrol, transit and accommodation officers have been trained in voluntary and involuntary transports.
Police Academy recruits are taught about mental illness, how to recognize mental illness, effective communication and proper tactics, the spokesman said in a statement. In addition, a significant portion of our members have received crisis intervention training to educate members on how to respond effectively to critical incidents and improve their communication skills with the mentally ill.
We are willing to do our part, and this has the full support and attention of the NYPD, the spokesman added.
Since Adams announced the directive on Nov. 29, details about its implementation by frontline police officers and mental health workers have been scarce. City has yet to release data on how many people were involuntarily committed due to inability to meet basic needs criteria. And at least one agency, NYC Health + Hospitals, has indicated it’s not tracking that metric only the total number of involuntary hospitalizations.
The scenarios presented in the training sessions provide some insight into potential situations where police officers could use their extended authority. A similar presentation to doctors, which POLITICO obtained earlier, outlined several scenarios in which involuntary engagement might be appropriate.
In the case of the hypothetical Queens woman, the presentation notes that someone sleeping on the street during a code blue alert triggered when temperatures reach 32 degrees or below may be deemed not to be taking care of themselves and may be inadvertently taken into custody for a psychiatric evaluation at a hospital.
Another scenario involves a reasonably well-groomed man living in a messy house, who says he was just released from the hospital after being abducted by aliens, according to the materials. The agents called to monitor him CANNOT involuntarily transport the individual for psychiatric evaluation because he poses no threat to himself or others and does not appear unable to care for himself, the presentation states.
Signs that someone cannot take care of themselves, as listed in the presentation, include a strong smell of feces or urine, rotting flesh, extreme swelling of the legs or feet, unhealed wounds, no shoes, crutches or makeshift plaster , malnutrition and the presence of insects on the body.
A Dec. 6 internal memo to all NYPD commands, sent to POLITICO by the agency, also described examples of people who might meet the standard, such as someone who is inconsistent and on subway platforms or in the path of oncoming traffic.
Patrick J. Lynch, president of the Police Benevolent Association, which represents NYPD rank-and-file officers, said the union is consistently calling for more and better-quality training for our members, especially on sensitive and complex topics like responding to mental health.
Regardless of other policies the city puts in place, police officers will inevitably remain at the forefront of the mental health crisis, Lynch said in a statement. We need the most comprehensive training possible and we need our city leaders to support us as we implement their directives.
State law explicitly authorizes police and peace officers to involuntarily admit people for the purpose of psychiatric evaluation. But civil rights groups and criminal justice advocates argue that the NYPD is ill-equipped for accountability, at least in part due to inadequate training.
This is not the role of the NYPD, Haroules said. They shouldn’t be trying to navigate these very complicated social issues that involve health issues.
Indeed, in cases where a mental health professional is present, the training materials instruct NYPD officers to defer to that person’s judgment: the job of [uniformed members of service] at the scene of a doctor making this decision is supporting the doctor’s decision, not arguing with the doctor, the 15-minute presentation says.
Yet the doctors with the authority to inadvertently commit someone, who include psychologists and social workers on mobile crisis teams, are few and far between compared to the tens of thousands of uniformed NYPD officers who patrol the city at all hours.
The slides indicate that when a doctor is not present, NYPD officers can unilaterally decide if someone is unable to meet their basic human needs due to mental illness and must be involuntarily committed as in the example of the woman for street dressed inappropriately for the cold weather. (Under the administration of former Mayor Bill de Blasios, some people were involuntarily taken to hospitals during the Code Blue Warnings.)
As part of the Adams directive, NYC Health + Hospitals launched a support hotline where NYPD officers can ask for guidance in deciding whether a particular person should be involuntarily taken to the hospital. But a presentation to train Health + Hospitals physicians who staff the hotline, which NYCLU obtained in a public records request and shared with POLITICO, notes, NYPD officers do [sic] the decision.
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