The Emotional Baggage Follow-Up Series: Empathy for the Homeless in New York

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Soon after Eric Adams became mayor of New York last year, he conveyed that he was looking for empathy and emotional intelligence in his appointees. Certainly, those are qualities one values in psychiatry, but is rare to emphasize that in governmental employees, as I discussed in our column of January 3, 2022, “Start the New Year with Empathic Action, Like the New Mayor of New York.”

A year later, can we accurately assess what happened to that empathy?

It is unclear how successful the mayor has been in including empathy is his job hires, or what he used to do so. However, 1 controversial policy emerged where empathy would seem to be crucial. That concerns the homeless in New York City, let alone the homeless in other cities.

The New York Police Department began ongoing training in how to follow the plan to address mental illness in the city’s homeless population, especially those who seem to have untreated mental illness so severe that their basic needs are not being met. In that case, the police are supposed to bring these people to hospitals for treatment, as well as to use enforced outpatient treatment if necessary, as an addition. Prior research has found that outpatient commitment, called Kendra’s Law, does help outcomes.

The terrible irony in considering homelessness as emotional baggage is that they literally carry all they own in their bags.

It is not apparent whether the mayor got advice from the city’s psychiatric leadership, although the psychiatrist E. Fuller Torrey, MD, had long predicted this crisis after the inadequately funded and designed national deinstitutionalization movement emerged in the late 1960s.¹

Besides psychiatrists, the Consumer Advisory Board (CAB) for the Department of Mental Hygiene was not consulted. The CAB committee is comprised of peers with psychiatric diagnoses. The result is concern by disability rights activists, advocacy groups for housing, and human rights advocates, ignoring the activist mantra of “nothing about us without us.”

Many practical obstacles remain, including how to better prevent homelessness in the first place and to have adequate mental health and social services available for those who need and want them.

As if right on cue, new research on empathy around the world found that women are better empathizers than men²—probably not much of a surprise. Whether that has been taken into account in New York is also unclear.

Even so, empathy is not enough in clinical care nor political processes. It helps to know and feel how the other is suffering, but appropriate and expert therapeutic and social action resources are a necessary follow-up to empathy.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.

References

1. Barry E. Behind New York City’s shift on mental health, a solitary quest. The New York Times. December 11, 2022. Accessed January 5, 2023. https://www.nytimes.com/2022/12/11/health/fuller-torrey-psychosis-commitment.html

2. Christensen J. All around the world, women are better empathizers than men, study finds. CNN. December 27, 2022. Accessed January 5, 2023. https://www.cnn.com/2022/12/26/health/empathy-women-men/index.html