Good morning. It’s Thursday. Today we’ll look at a program to treat severely mentally ill people on the streets — and why an audit says the city is not doing enough to see that it is getting results. We will also find out why 16- and 17-year-olds in Newark will not get to vote as soon as they had hoped.
I asked Jan Ransom, who with Amy Julia Harris wrote The Times’s stories on the problems with the system, about the audit as well as their reporting.
The audit showed that the city had been pouring money into this program without checking to see if it was actually working.
Yes. The auditors reviewed a sample of the participants to find out what was happening and found that fewer than a third of those participants regularly took their medications.
One in four never met with a psychiatrist or a psychiatric nurse for treatment.
Brad Lander, the comptroller, said this is a good program, but it’s not working the way the Department of Health and Mental Hygiene is operating it.
Why does it seem to be so hard to check up on whether someone is taking his or her medication?
Many times, the teams lost track of their clients.
The audit found that when they are not being seen, they are not getting their medication.
It’s probably worth noting that the teams cannot force medication on a participant who resists. If a team notices that someone is not doing well, if the person is suicidal or homicidal or acting in a way that is a danger to themselves or others, the team is obligated to do something — which could be getting the person to a hospital for additional treatment.
Wasn’t I.M.T. designed to reduce hospitalization, and also incarceration?
The audit found that the city isn’t regularly checking that metric.
The last study that the city did focused on people enrolled in the program in 2018 and found that incarceration rates for those people dropped 22 percent.
As part of our investigation into the mental health system, we found examples of people who had been looked after by I.M.T. teams for years, had landed back in hospitals frequently and were arrested as often as they had been before they had a treatment team.
We found a homeless man named Dejanay Canteen, who goes by King. He had an I.M.T. team soon after the program started. He struggled with schizoaffective disorder and had cycled in and out of hospitals and in and out of jail.
Once he connected with I.M.T., that was supposed to change.
Did it?
We could see from official records that the cycle continued. He continued to be arrested. He was accused of threatening a street vendor with a knife while trying to steal a pair of sunglasses. The police said he tried to steal the tip jar from a restaurant in a separate incident that also involved a knife. He is now serving seven years in prison for attempted robbery.
What was the department’s response to the audit?
Officials said that this is a population that has been largely resistant to treatment, that the nature of their problems is “complicated” and that it would be unrealistic to set specific care requirements.
They said they would create performance metrics to see how well the program is doing, but they’re not going to do that until 2025. That’s nearly a decade after the program was launched.
Part of the reporting we did looked back at what had happened over the years under different mayors and governors. We found that high-profile incidents — like, most recently, subway shovings by untreated mentally ill people — spurred elected officials to do something. But we found there was little follow-up to see that what they did was actually working.
The current mayor, Eric Adams, has pointed to I.M.T. as a huge piece of his mental health agenda in what he has called a crisis. The audit definitely showed there is a problem with the city doing what it needs to do to see that these initiatives are working the way they were intended to.
Aren’t the city’s public hospitals overwhelmed by nearly 50,000 psychiatric patients a year, while private hospitals have been cutting psychiatric beds?
Absolutely. The idea behind I.M.T. teams was to provide the most severely mentally ill people with care that would meet them where they are. The teams were supposed to step in and fill the void as long-term psychiatric beds in state facilities disappeared.
We’ve seen that the idea behind I.M.T. can and should work, but from the way the city has implemented the program, we do not know if it is working or not.
Weather
It’s gong to be a mostly sunny day in the high 40s, with temperatures dropping to the high 30s during a mostly cloudy evening.
No vote yet for 16- and 17-year-olds in Newark
Last month, the City Council in Newark gave 16- and 17-year-olds the right to vote in school board elections.
Making the arrangements for them to actually cast ballots is easier said than done, it turns out.
Advocates who had pressed for the lower voting age acknowledged this week that state and city officials needed more time to make adjustments to the computerized voting registration system. My colleague Tracey Tully says the goal was to register eligible 16- and 17-year-olds in time for them to vote in the next school board election, scheduled for April 16.
Henal Patel, the law and policy director at the New Jersey Institute for Social Justice, said the timeline for this year’s election cycle, with a March 26 registration deadline for the April election, had always been ambitious. Roughly 7,000 teenagers in Newark are likely to be eligible.
“You want to make sure this stuff is done right,” she said. “We’re much more hopeful for next year.”
The ordinance giving 16- and 17-year-olds the right to vote in the coming school board election was seen as a way to increase civic engagement in a city where only 3.1 percent of the 195,000 registered voters went to the polls in the school board election last April, when eight candidates were on the ballot. Mayor Ras Baraka, a former high school principal, called the measure “a training ground and opportunity to prepare young folks to actually engage in larger elections.”
Gov. Philip Murphy has said that he supports lowering the voting age for school board elections across the state, and a state election official said this week that New Jersey remained committed to doing so. “The state tried to make it happen,” said Ryan Haygood, the president and chief executive of the institute, who was a primary proponent of the lowered voting age. “And it will happen.”
METROPOLITAN diary
Looking spiffy
Dear Diary:
My wife and I recently attended a performance of opera music at Carnegie Hall.
Consistent with custom, I wore my old-school uniform: navy blazer, bow tie, pocket square and French cuffs.
We took the elevator up to our seats, sharing it with another couple. The husband looked somewhat unkempt.
