Billions for government housing is no cure for the mentally ill

In the dubious spirit of “going big,” new Housing and Urban Development Secretary Marcia Fudge has asked for an additional $100 billion — almost twice the agency’s annual budget — so it can house the homeless across the country. The money is necessary, she says, to help the nearly 600,000 HUD estimates to be homeless.

“We need at least another $70 to $100 billion to do those things,” she told Politico. “So yes, I’d like to see a stream of resources to do this.”

There’s no doubt — as anyone who’s been to Grand Central, Penn Station or too many subway platforms lately knows well — there’s a street-homelessness crisis in New York, and it pales in comparison to that of San Francisco, Los Angeles, Portland and Seattle, where tent encampments have taken over downtown areas.

But Fudge gets two fundamental things wrong. This is not a housing crisis; it’s a mental-illness-treatment crisis. And addressing that is not what HUD was established to do.

Notwithstanding sensational stories of down-on-their luck families sleeping in tents or in their cars, a large percentage of the “unsheltered homeless” suffer from untreated mental illness. As Arizona State University’s Marjorie Baldwin, author of “Beyond Schizophrenia,” has written, “there are numerous factors that may lead to homelessness but one of the most important is untreated mental illness.” She cites estimates showing that from a third to fully 70 percent of the street homeless fall into that group.

The crisis has been hijacked, however, by those who would cast it as a problem of physical shelter — housing — in order to advance an agenda promoting government-subsidized residential units broadly. Those who must double-up with extended families are lumped together with street sleepers both to inflate numbers and change the conversation.

Enter HUD, the agency with the word “housing” in its name. HUD, a relic of the 1960s Great Society movement, was never conceived as a vehicle for putting the street homeless into their own subsidized apartments, as if that would guarantee that a schizophrenic’s condition would improve.

Rather, HUD was meant to “rebuild” the inner city, based on the misguided idea that the poor will thrive if they just live in a new public-housing project. In the wake of that failure, HUD’s mission has crept.

Fudge — but more important, every serious mayoral candidate in the city — needs to come to terms with the fact that our urban centers are paying the price for a foolish policy known as deinstitutionalization, which began during the Kennedy administration.

At their peak in the early 1950s, there were more than 500,000 state mental-hospital beds in the United States, including more than 100,000 in New York alone in 1952. A New York State Nurses Association paper last year declaring a “full-blown mental-health crisis in New York” provides a sobering update: 5,419 New York state inpatient beds. California has just 6,000 beds in just five facilities.

We are seeing the results on street corners, in train stations — and on Rikers Island.

Dr. Elinore McCance-Katz, the former head of the federal Substance Abuse and Mental Health Services Administration, says mental-illness treatment “has been relegated to the criminal-justice system.” Often too late, she might add.

One of the main reasons, she argues, “is the lack of a crisis-care safety net in this country. Emergency departments continue to be the primary destination for those with serious mental illness.”

Yet they’re ill-equipped “to address the needs of those in mental-health crisis.” These individuals often get no treatment and are released to the street with no help. “This can lead to infractions of the law resulting in incarceration.”

The answer is not subsidized housing; it’s state-of-the-art psychiatric treatment. It’s not ThriveNYC, with its questionable assertion that almost everyone needs mental-health intervention, but a laser focus on those in our prisons and on our streets suffering from demons and delusions, thanks to misplaced compassion.

No mayoral candidate who gets this wrong — or fails to address the problem as a priority — deserves a vote.

Howard Husock is an adjunct scholar at the American Enterprise Institute and a contributing editor of City Journal.