The governor’s ongoing push to increase involuntary commitments of people with untreated severe mental illness continues to gain steam in Albany.
The union representing New York nurse practitioners is backing Gov. Kathy Hochul’s plan to give them the power to sign-off on involuntary commitments via the state budget, a significant power currently reserved for doctors. In a letter from the Nurse Practitioner Association to the governor and legislative leaders, President Gregory Rys endorsed Hochul’s proposal, saying the nurses are ready and capable to take up the mantle.
Hochul has sought to ratchet down restrictions on involuntary commitment and other mental health treatment since taking office, often using the state budget as a mechanism. While the governor argues the greater powers are necessary to move some people out of cycles of homelessness, hospitalization and arrest and into treatment, some Democrats and mental health advocates say those resources are better used in voluntary outreach and peer-support services, which have shown signs of success and do not lead to abuse or exacerbate distrust.
Legislative leaders rejected Hochul’s measure in their own budget proposals last week and have indicated that involuntary commitment will likely be a sticking point in negotiations. The backing of part of the plan by the union, which represents 30,000 nurse practitioners, including 4,500 registered in psychiatry, provides a political and symbolic boon to the governor in what may be the final weeks of budget negotiations.
But talks are far from over and on Wednesday the Democratic chairs of the state Senate and Assembly mental health committees held a press conference opposing the governor’s package on involuntary commitment, which includes making it easier for police to remove people from the street to a hospital for assessment. The start of the fiscal year is April 1, though lawmakers have blown that deadline in recent years, in part over negotiations related to other involuntary treatment expansions.
Involuntary commitment for an extended psychiatric stay currently requires the signature of two physicians. Under Hochul’s plan, psychiatric nurse practitioners will also be able to sign off. Nurse practitioners have the training and expertise but are often underutilized, contributing to delays in intervention when people can decompensate further, wrote Rys. The proposal would be particularly useful in health care deserts, especially in rural parts of the state, when two physicians may be hard to immediately come by, the letter stated.
As part of the package, Hochul is seeking to expand other involuntary approaches, including court-ordered community-based treatment, like medication. Hochul is also seeking to codify language that clarifies that clinicians may involuntarily admit people if they appear to be unable to meet basic needs of food, shelter and medical care. In practice, the expansion will let police consider those factors when deciding whether to take an individual to a hospital for evaluation against their will, said Beth Haroules, a lawyer at New York Civil Liberties Union.
