Governor Andrew Cuomo has a plan to solve the problem of street homelessness in New York City; he wants to put them in Creedmoor, a massive institution for the mentally ill in eastern Queens. During its mid-century heyday, Creedmoor housed 7,000 people in dozens of buildings, many of which are now sitting empty. Cuomo’s proposal was seconded by Queens state senator Leroy Comrie, who said that “the homeless individuals [at Creedmoor] would have an excellent chance of being successful with a complement of services.”
Cuomo’s spokesperson said that the details of the governor’s plan will be spelled out in the forthcoming State of the State address, but it sounds like the plan is to turn Creedmoor into a homeless shelter. New York City already has plenty of these. Since 1981, homeless men in New York City have been granted a “right to shelter” under the Callahan consent decree. Callahan was later extended to include homeless women and homeless families. Anyone who demands a bed in the shelter system is entitled to one.
The estimated 4,000 to 8,000 people sleeping on Gotham streets or in the subways know that the city has beds for them. The Department of Homeless Services spends tens of millions of dollars annually just in outreach, and sends platoons of young social workers out to implore the street homeless to come inside. However, the offer of a bed in a shelter is rarely accepted. Some shelters, much like jails and prisons, are essentially run by gangs, and there is a great deal of crime and violence perpetrated against the more vulnerable residents. Some street homeless bridle at the rule-bound structure of the shelter system, which entails searches and requires residents to assist in the development of an “independent living plan.”
Mental illness is highly correlated with homelessness. Between one-quarter and one-third of all homeless people are afflicted with a serious mental illness such as schizophrenia or bipolar disorder. Additionally, 15 percent of mentally ill people have experienced at least one episode of homelessness at the time of their first hospitalization.
The outlines of the history of institutionalization are well known. Mass commitment of the mentally ill and clinically insane reached a peak in the mid-1950s, when 550,000 people were confined to mental hospitals. The introduction of Thorazine and other antipsychotic pharmaceuticals led to the deinstitutionalization of the mentally ill, who were believed capable, through the marvels of modern chemistry, of living lives that resembled normalcy. Deinstitutionalization was also spurred by cultural and intellectual currents. Thomas Szasz, the father of the anti-psychiatry movement, argued in The Myth of Mental Illness (1961) and The Manufacture of Madness (1970) that “mental illness” was the contemporary analogue of “demonic possession,” and that what he termed the “therapeutic state” was a radical police system of social control. Other theorists such as R.D. Laing viewed mental illness as an expression of social contradictions, and cast the sufferer as a kind of shaman who had gone to the horizon of inner human experience, and returned to us with valuable insights about ourselves.
At the same time, disgraceful conditions and abuses in the nation’s mental hospital system were disclosed in films such as Frederick Wiseman’s Titicut Follies (1967), and Geraldo Rivera’s 1972 television expose of Staten Island’s Willowbrook State School. Scenes of naked, howling children crowded into what Senator Robert Kennedy had characterized in 1965 as “rooms less comfortable and cheerful” than zoo cages shocked the nation, and sped the process of moving the mentally ill out of institutions and into, ideally, community-based outpatient programs.
Almost immediately, the number of mentally ill people in jails and prisons, and on the streets, spiked. The sad fact is that many mentally ill people, left to their own devices, will not stick to a medical compliance regimen, often do not have strong family support systems, and are incapable of living in society by themselves. Fifteen percent of the nation’s prison population is estimated to have serious mental illness; these 300,000 individuals, and the victims of their crimes, may have been spared much grief if society had less carelessly emptied its hospitals onto America’s streets.
Governor Cuomo’s plan to bring the homeless population to live in a mostly-abandoned state mental institution brings the history of deinstitutionalization to a sad full circle. First, we kicked people out of Creedmoor; now we want to bring them back, but on a gentler, more paternalistic, and presumably voluntary basis.
If Cuomo thinks that the problem of homelessness in New York City is just a question of outfitting a new homeless shelter on the same basis as the current system, then he can write a shorter State of the State address. The same people who resist entering the shelter system now will resist entering it tomorrow, no matter how the state dresses it up. If, however, Cuomo decides to take seriously the necessity of re-institutionalizing the chronic mentally ill, under humane standards in a hospital, then New York stands a chance of solving its problem of chronic, aggressive street homelessness.