Involuntary hospitalization of Joyce Brown

Between 1987 and 1988, Brown worked with the New York Civil Liberties Union to challenge her hospitalization in a case which attracted significant media attention.

[1][2][3] The case was one part of a larger trend of deinstitutionalization in the United States, which began in the late 1950s and resulted in the release of hundreds of thousands of people from psychiatric hospitals.

These changes, along with inadequate social programs, housing policies, and broader economic conditions contributed to an increase in homelessness in parts of the United States.

[10] On October 28, 1987, Koch announced a new program for removing homeless people with mental illness from the streets for reasons including self-neglect and future harm, using his new legal interpretation, allocating a 28-bed unit at Bellevue Hospital to take care of newly admissible patients.

Following Koch's announcement, NYCLU volunteers distributed fliers to people living on the street detailing their rights and advising them to contact the organization if they were involuntarily committed.

[10] Brown was taken to Bellevue Hospital on the first day of Koch's program, where she gave false names she had used in the past, including "Ann Smith" and "Billie Boggs".

[10] Levy argued that there was insufficient evidence that Brown was severely mentally ill, and that the behaviors she exhibited may not have been normal or in line with social expectations but did not meet the requirement set by O'Connor v. Donaldson for posing a danger to oneself or others.

He called Robert Gould of New York Medical College to testify that Brown's judgment was limited, but that she was not severely mentally ill.[10] The city's lawyer, supported by four psychiatrists with Project HELP and Bellevue, argued that Brown's mental illness posed a significant risk to herself in that she exhibited suicidal behavior, was antagonistic to the point of provoking violence, and did not wear adequate clothing to survive harsh New York City winters.

[10] Brown testified that she lived on the street because she preferred it to a shelter, that what was characterized as talking to herself was actually singing to herself, and that she gave false names to avoid her sisters.

[10] The Koch administration quickly appealed the decision, and the Appellate Division of the State Supreme Court granted a stay of proceedings, delaying Brown's release.

An independent psychologist, Francine Cournos, testified that Brown had either schizophrenia or manic depression and could benefit from medication, but not if it had to be forced as that may lead her to reject all mental health care.

[16] On January 15, 1988, State Supreme Court Justice Irving Kirshenbaum agreed with Cournos and ruled that New York City could not forcibly medicate Brown.

[10] During the WNYW interview, anchorman John Roland, who lived in the same neighborhood as Brown, became aggressive and challenged her self-characterization, calling her "a mess" and "a disaster".

When US President Ronald Reagan met with Soviet leader Mikhail Gorbachev for the March 1988 Moscow Summit, he brought up Brown's case as an example of American civil rights when criticizing the USSR's detention of political dissidents under the guise of treating mental illness.

[9] The director of the agency that operates her group home and one of Brown's psychiatrists told the Associated Press that the media attention surrounding her case was likely harmful in the long run.

[18] Jeanie Kasindorf of New York compared Brown's case to that of Bernhard Goetz and the 1984 subway shooting in the extent to which it polarized the city.

Some New Yorkers felt the government did not have the right to tell someone they could not live on the street or had to medicate themselves against their will; others argued that someone with severe, untreated mental illness could not be relied upon to make good decisions for themselves and that other residents should not have to contend with the kinds of behaviors Brown exhibited.

[10] Writing in the ABA Journal, Alan Pusey stated that Brown's case sparked national discussion over whether forced hospitalization policies actually help the mentally ill or simply remove them from the eye of the public.

[14] Luis R. Marcos wrote that Brown's case "exemplifies the politics of implementing controversial public mental health policy and the role the news media can play in the process".

[18][19] Adams' policy relies on a similar legal interpretations as Koch's, expanding the circumstances when someone can be forcibly moved to a hospital to when someone appears mentally ill and exhibits "an inability to meet basic living needs, even when no recent dangerous act has been observed".