New York Governor Kathy Hochul is seeking to make sweeping rollbacks to the state’s involuntary commitment laws. Except it’s not just her aim to further entrench the authority for forced psychiatric treatment. This program is intended to streamline the process of involuntarily placing people in hospitals. It also seeks to expand the scope of professionals eligible to initiate this process. Critics warn that these strategies would exacerbate trauma and mistrust in the marginalized communities most often faced with criminalization — including those struggling with mental illness.
The proposed amendments to Kendra’s Law would add psychiatric nurse practitioners, among other categories of professionals, to those legally allowed to recommend involuntary treatment. This expanded authority can lead to scenarios in which an individual’s past trauma or mental health issues become the rationale for their future incarceration. Advocates for mental health reform express concern that this could pathologize normal human experiences, further stigmatizing those who seek help.
Research spanning several decades indicates that involuntary psychiatric interventions often result in adverse outcomes, including increased trauma and diminished trust in healthcare systems. Experts warn that the revival of involuntary commitment under the guise of care could have detrimental effects on marginalized communities.
Governor Hochul’s proposal is not the only example of this kind of policy manipulation, even within New York itself. The trend of reinstating forms of confinement has gained traction nationally, as evidenced by similar initiatives from figures such as Robert F. Kennedy Jr. His “Make America Healthy Again” initiative includes a plan to develop “wellness farms.” While these farms seek to provide therapeutic environments, they have raised fears of coercive force in mental health treatment.
New York City Mayor Eric Adams has taken proactive measures by directing police and emergency medical technicians to forcibly hospitalize individuals deemed “mentally ill.” This directive, put into practice in 2022, has faced backlash for permitting interventions even when there are no clear signs of a threat. Whatever the impetus, these actions represent a profound policy shift towards involuntary commitment. Mental health advocates and others mourn the proposed change as a troubling regression for mental health care.
In California, Governor Gavin Newsom’s Care Courts establish a system of involuntary court-ordered treatment. This decision is a powerful example of the national shift towards making psychiatric treatment mandatory. As states continue to experiment with these punitive measures, they overlook smarter alternatives that preserve the autonomy and dignity of all individuals.
Mental health reform advocates are particularly focused on the need for alternatives to involuntary commitment that have proven to be effective. From housing-first initiatives to non-police crisis response teams and community-based voluntary mental health services—we know that compassionate care provided without coercion saves lives and is more effective. These methods focus on support and empowerment instead of punishment and control.
Disability justice scholar Liat Ben-Moshe explains the intricate relationship between prisons and asylums. Specifically, as she argues persuasively throughout the book, these two systems in tandem surveille, punish, and seek to control populations of color and other marginalized communities. This finding helps inform a bigger conversation occurring nationwide about the dangers of pushing involuntary treatment laws even further.
Jordyn Jensen, executive director of the Center for Racial and Disability Justice at Northwestern Pritzker School of Law, articulates concerns regarding the language surrounding these initiatives. She points out that terms like “wellness farms” and court diversion programs mask a troubling reality: coercive practices are being rebranded as therapeutic care.
“Coercion is not care.”
The recently mandated reorganization of the Department of Health and Human Services (HHS) has only made these challenges worse. The shuttering of essential programs to help older adults and disabled people get their basic needs met has thrown countless people into crisis. One of our biggest concerns is that the Administration for Community Living (ACL) has fragmented its programs across multiple agencies. This has led to confusion and a lack of accountability.
As policymakers continue to advocate for involuntary commitment laws, it is crucial to reevaluate the impact of such measures on mental health outcomes. This trend towards punitive, coercive treatment strategies has created significant ethical implications regarding care, control, and autonomy within mental health services.