Homelessness was declared a public health crisis by the American Public Health Association in 2017, but it remains a difficult, complex issue for cities and counties across the country to aid. Now, as part of new guidance in an effort to address the issue, New York City healthcare workers are receiving updated training to assist with intervening to bring homeless individuals in crisis into medical facilities for treatment.
The updated guidance comes as a result of a February 2022 directive from the city's Mayor Eric Adams to remove and evaluate anyone "who appears to be mentally ill and displays an inability to meet basic living needs, even when no recent dangerous act has been observed."
The new directives have drawn criticism from some, The New York Times reports, arguing that if a person does not pose a threat to others, involving first responders or police to forcibly take them in for care may not be the best approach.
The new training for healthcare workers, which Politico reports it obtained through a public records request, features several example scenarios clinicians could face when providing care for or evaluating a homeless individual who is being given care against their will and undergoing mental health crises.
One example from the training PowerPoint details the success of a case in which a 60-year-old homeless woman was throwing urine and bleach at outreach workers and making threats. Once removed and brought in for care and evaluation, clinicians recognized physical conditions needing treatment, including leg edema and improperly treated wounds. During hospitalization, it is reported that she received needed treatment and became more cooperative in time, leading to her placement in supportive housing after the fact.
However, that is not always the outcome, and many end up back on the streets.
A spokesperson for the health department told Politico that the training is designed for "clinicians who do street and subway outreach" and "is intended to ensure they have the many considerations front of mind in the situations they may encounter."
On average, the CDC reports that "the rate of ED visits among homeless persons was higher than the rate for nonhomeless persons."