Homelessness and Mental Illness: Medicalizing a Housing Crisis

This paper explores the custody and removal of homeless individuals as well as their rights and ability to defend themselves from unwanted psychiatric assessments and involuntary hospitalization. Involuntary hospitalization, a form of detention, is contextualized in public policy concerning housing and the social determinants of health, individual rights, the city’s shelter system and the right to shelter, and the racism and discrimination inherent in the distribution of homelessness. Involuntary psychiatric care dismisses personal views on psychiatry and medicine. Some adults who are homeless in New York City are at risk due to policies and practices that Mayor Adams suggests were meant to support adults who are experiencing homelessness and “appear” to have severe mental illness. As housing is a social determinant of health, a proper housing system very well may decrease the societal burden of mental illness. Individuals must not be subjected to nonconsensual psychiatric assessments or care due primarily to their lack of housing. Consensual care may be beneficent and its availability ethically appropriate. Beneficence is not an appropriate justification for involuntary hospitalization, so the additional ethical justification of preventing imminent danger is needed.