On Monday, a 49-year-old Queens woman, Pamela Cisneros, used kitchen knives to stab two strangers in Times Square \u2014 killing one, a 32-year-old Bank of America employee and new mother returning to work that day from maternity leave. NYPD officers attempted to subdue the perpetrator with a Taser before shooting her as she ran in their direction and threatened to kill them.<\/p>\n
It has been reported<\/a> that Cisneros had a long history of serious mental illness. She\u2019d also been known to the NYPD, who\u2019d encountered<\/a> her in 2018 and 2019, for belligerent public behaviour and attempting to jump in front of a subway train. She appears to have been stable on medication since then but, in recent months, reportedly didn\u2019t want to rely on medication any longer.<\/p>\n This case is similar to other episodes involving those with untreated serious mental illness. Weng Sor<\/a>, who reportedly went off medication for a serious mental illness drove a truck into Brooklyn traffic back in 2023. In 2018, Saheed Vassell<\/a>, who also went off medication, was fatally shot by police who believed he was brandishing a gun. Then there was Deborah Danner<\/a>, who came at police with a bat in 2016. Police were reportedly at her apartment \u201cpractically once a month\u201d when she wasn\u2019t taking her medication.<\/p>\n When a small number of people with the most serious illnesses \u2014 such as schizophrenia and other psychotic disorders \u2014 aren\u2019t receiving adequate treatment, tragedy can ensue. However, it is possible to stabilise patients before a crisis hits. Treatment, particularly for schizophrenia, can<\/a> decrease<\/a> the risk of violence. That means, if prioritised, serious mental illness need not lead to results like the Times Square incident.<\/p>\n Serious mental illness is not currently a point of focus for NYC\u2019s government. Mayor Zohran Mamdani\u2019s mental health agenda<\/a> remains preoccupied with who answers crises<\/a>, not how the sickest patients are treated. His Department of Community Safety doesn\u2019t mention<\/a> serious mental illness. Yet crisis response teams that Mamdani favours, such as B-HEARD, don\u2019t answer 911 calls where there\u2019s a risk of violence. Only police can do that.<\/p>\n NYPD officers effectively respond<\/a> without further incident to the almost 170,000 annual calls for \u201cemotionally disturbed persons\u201d. Yet they bring<\/a> mentally ill individuals who are a danger to themselves or others to general hospitals for treatment. These hospitals can\u2019t handle<\/a> the load of patients who are unsafe and need specialty psychiatric hospitalisation. New York State, like nearly every other state in the US, has a shortage<\/a> of the necessary beds.<\/p>\n The NYC mayor can\u2019t expand the state psychiatric-hospital system on their own. The state legislature in Albany controls those hospitals. But mayors have leverage. Mamdani has, however, given no impression that he will push for more state hospital beds.<\/p>\n New York also has a successful Assisted Outpatient Treatment (AOT) programme, which is court-mandated for the small number of seriously mentally ill who can remain stable in the community, rather than need a hospital. For those with a history of treatment non-compliance and either two hospitalisations or arrests within 36 months, AOT compels treatment \u2014 and compels the mental health system to prioritise the most in need. Cisneros may not have qualified yet, but the programme is noteworthy because it reduces<\/a> arrests and homelessness by 70%, and repeated hospitalisations by 60%.<\/p>\n Mamdani\u2019s mental health plan makes no mention of AOT, even though the city helps fund and administer the programme. Psych beds and AOT are the most critical interventions for the seriously mentally ill. Mamdani isn\u2019t interested.<\/p>\n The city also pays a hefty price of indifference through its jail system. Around 1,600 inmates have a serious mental illness, while detainees flagged with a mental health issue rose<\/a> from 37% of the jail population in 2014 to 51% in 2023. And more than<\/a> $300 million is spent annually by the city on jail healthcare as a whole.<\/p>\n The figures show a serious issue for public safety. Monday\u2019s attack was one of several like it in New York already this year. In April, a mentally ill man went on a machete slashing spree<\/a> in Grand Central Terminal. He\u2019d been homeless and had multiple arrests to his name. In June, another mentally ill attacker stabbed<\/a> seven near Penn Station. Inpatient treatment access or AOT may have helped them stabilise before the attacks happened.<\/p>\n State hospitals, other specialty psychiatric hospitals, and AOT do what general hospitals, shelters, and voluntary treatment can\u2019t. They stabilise patients who need intensive care and oversight. Most states \u2014 and the federal government \u2014 have long been more concerned with serving the less symptomatic, average person with distress. But the average distressed person isn\u2019t at such risk of public disorder.<\/p>\n