Internal NYPD documents reveal officer training on involuntary hospitalizations

NEW YORK — Two NYPD officers patrolling a Queens public housing complex spot a woman outside in a tank top and slippers muttering incoherently to herself. The woman says the street is her home, but the temperature is expected to drop below freezing later that day. How should they respond?

The hypothetical scenario is among five posed to police officers in a 15-minute presentation on situations that may warrant involuntary hospitalization. The training was prepared to brief patrol officers on Mayor Eric Adams’ recent directive that people may be forced to undergo psychiatric evaluation when a mental illness is seemingly preventing them from meeting their own basic needs, putting them at risk of harm.

The presentation slides are also incorporated in a 9-minute video that describes when someone experiencing mental illness should be brought to the hospital against their will and walks officers through a step-by-step protocol.

The records were obtained by the New York Civil Liberties Union in a lawsuit filed in March against the NYPD and shared with POLITICO.

Adams has homed in on the intersecting crises of homelessness and mental illness as part of a larger effort to address voters’ concerns about crime and perception of public safety. His approach has drawn outrage — and legal action — from civil rights advocates like NYCLU, who see it as both ineffective in tackling serious mental health concerns and a dangerous infringement of individuals’ constitutional rights.

The advocates have also criticized police involvement in implementing Adams’ directive in light of numerous instances of people in a mental health crisis being killed or seriously injured by NYPD officers. Adams, a former police captain, has responded by saying patrol officers would hand off cases of someone in crisis to others on the force “who have a deeper training than the surface training that an everyday police officer would.”

But the training materials, publicly disclosed here for the first time, indicate that any uniformed member of service has the authority to unilaterally decide someone needs to be brought involuntarily to a hospital because of the inability to care for one’s self.

Beth Haroules, director of disability justice litigation for NYCLU, said the presentation also seems inconsistent with city officials’ pledge to provide police with in-depth training on the “unable to meet basic needs” standard and a refresher on crisis communication strategies. Between the slides and the video, which overlap significantly, patrol officers appear to be receiving no more than 25 minutes worth of a refresher.

The police academy, meanwhile, devotes at least four-and-a-half hours to teaching entry-level officers about “policing the emotionally disturbed,” as the NYPD’s student guide calls it.

In an emailed statement, an unnamed police spokesperson said officers already receive “significant training” on interacting with people experiencing mental illness and their involuntary commitment authority. More than 90 percent of patrol, transit and housing officers have been trained regarding voluntary and involuntary transports, according to the department.

“Recruits at the Police Academy are taught about mental illness, how to recognize mental illness, effective communication, and proper tactics,” the spokesperson said in a statement. “Moreover, a significant portion of our members have received crisis intervention training to instruct members on how to effectively respond to critical incidents and enhance 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 spokesperson added.

Since Adams announced the directive Nov. 29, details on its implementation by police officers and frontline mental health workers have been scarce. City Hall has yet to release data on how many people have been involuntarily committed due to the “unable to meet basic needs” criteria. And at least one agency, NYC Health + Hospitals, has indicated it is not tracking that metric — only the total number of involuntary hospitalizations.

The scenarios presented in training sessions provide some insight into the potential situations when police officers might be using their expanded authority. A similar presentation to clinicians, which POLITICO previously obtained, outlined several different scenarios when involuntary commitment might be appropriate.

In the case of the hypothetical Queens woman, the presentation notes someone sleeping on the street during a Code Blue Warning — triggered when temperatures reach 32 degrees or lower — “may be deemed to not care for self, and may be involuntarily taken into custody for psychiatric evaluation at a hospital.”

Another scenario involves a “reasonably 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. Officers called to check on him “MAY NOT involuntarily transport the individual for a psychiatric evaluation” because he is not a threat to himself or others and does not appear unable to take care of himself, the presentation says.

Signs that someone cannot care for themself, as listed in the presentation, include a strong smell of feces or urine, rotting flesh, extreme swelling of the legs or feet, untreated wounds, no shoes, a makeshift crutch or cast, malnourishment and the presence of bugs on the body.

An internal Dec. 6 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 incoherent and on the subway tracks or in the path of oncoming traffic.

Patrick J. Lynch, president of the Police Benevolent Association, which represents rank-and-file NYPD officers, said the union is “constantly asking for more and better-quality training for our members, especially on sensitive and complex topics like mental health response.”

“No matter what other policies the city puts into place, police officers will inevitably remain on the front lines of the mental health crisis,” Lynch said in a statement. “We need the most thorough training possible, and we need our city leaders to support us when we carry out their directives.”

State law explicitly authorizes police and peace officers to involuntarily commit people for the purpose of a psychiatric evaluation. But civil rights groups and criminal justice advocates argue the NYPD is ill-equipped for the responsibility, at least in part because of inadequate training.

“This is not the role of NYPD,” Haroules said. “They should not be trying to navigate these very complicated social problems that implicate health issues.”

Indeed, in instances when 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] on a scene of a clinician making this decision is to support the decision of the clinician, not to argue with the clinician,” the 15-minute presentation says.

Yet clinicians with the authority to involuntarily commit someone, which include psychologists and social workers on mobile crisis teams, are few and far between compared to the NYPD’s tens of thousands of uniformed officers patrolling the city at all hours.

The slides indicate that when a clinician is not present, NYPD officers may decide unilaterally whether 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 on the street dressed inappropriately for the cold weather. (Under former Mayor Bill de Blasio’s administration, some people were taken involuntarily to hospitals during Code Blue Warnings.)

As part of Adams’ directive, NYC Health + Hospitals launched a support hotline that NYPD officers can call for guidance in deciding whether a particular person should be taken to a hospital involuntarily. But a presentation to train Health + Hospitals clinicians staffing the hotline, which NYCLU obtained in a public records request and shared with POLITICO, notes, “NYPD officers makes [sic] the decision.”