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No, We Should Not Involuntarily Commit the Homeless During Hurricanes

Only a broken system locks up homeless people to keep them safe.
Residents of a rural migrant-worker town wait for emergency donations following Hurricane Irma in Immokalee, Florida, on September 14th, 2017.

Residents of a rural migrant-worker town wait for emergency donations following Hurricane Irma in Immokalee, Florida, on September 14th, 2017.

As Hurricane Irma bore down on Miami, officials from the Miami-Dade County Homeless Trust fanned out into the city, accompanied by police and mental-health officials. In order to protect homeless individuals from the worst effects of the storm, the Homeless Trust had decided to use the Baker Act, a 1970s-era Florida law allowing for the involuntary commitment of people suspected of mental illness, to lock up any homeless people who wouldn't voluntarily go to shelters. Ron Book, chairman of the Trust, told the Miami Herald: "I'm not going to be the mayor of Houston. I'm not going to tell people to take a Sharpie and write their names on their arm." (It was actually the Mayor of Rockport who told non-evacuees to take this step so that their bodies could be identified.) Instead, Book asserted that anyone who was still on the streets must be mentally ill, and that he intended to "have all of them Baker-Acted." A day later, homeless people were being cuffed and taken away, after psychiatrists working with the Trust stated that the decision to stay outside in the face of a hurricane merited incarceration.

All this might sound like reasonable policy. No one wants homeless people to die for want of shelter. Fred Friedman, however, has questions. Friedman is head organizer of Next Steps, an organization dedicated to ensuring that those with "lived experience of homelessness, mental illness, substance use, or addiction" drive all policy discussions about people with those experiences. Over the phone, he describes himself to me as a person who has experienced both homelessness and "active symptoms of mental illness" at various points in his life.

Friedman is concerned about homeless people in Miami. But he also knows that the risks don't come only from the storm. "It's scary," he says, "when people make decisions that others don't like, they define it as crazy. In this case, they lock them up without any due process." He wonders, now that this precedent has been set, what other moments will justify trawling the streets of Miami to "Baker-Act" homeless residents.

Friedman says that, although protecting life is a good goal, we shouldn't view this implementation of the Baker Act without being troubled by two things: First, it's a sign that all the systems leading up to this point have failed. Second, the Baker Act sets a dangerous precedent for whenever the government next wants to sweep homeless people out of the way. Florida is a state that experiences hurricanes all the time—so why, Friedman wonders, wasn't there a plan that didn't involve involuntary commitment? Friedman points out that Florida officials issued a general evacuation order, and even though some able-bodied people stayed, the state is "not locking those people up." Only homeless people were treated as necessarily mentally ill for choosing not to evacuate. He thinks it's an obvious misuse of the law to deem these people "crazy now and [not] five days ago."

Bethany Lilly, deputy director of policy at the Bazelon Center for Mental Health Law, also wants to understand why this happened and how to prevent it in the future. Over email, she points out that news reports indicated that state psychiatrists already knew many of these men from prior interactions. Lilly writes, "This is an example of how constant and consistent service failures are treated in the mental-health system—by blaming people with mental-health conditions and forcing them into treatment." They need health care and housing at all times, not just in the face of natural disaster, but, as Lilly points out, Florida did not expand Medicaid under the Affordable Care Act and "only 1.4 percent of people receiving services from the Florida public mental-health authority received supported housing in 2016, despite the overwhelming evidence that [housing] is one of the most important mental-health interventions." Is it really surprising, Lilly asks, when the system has failed people time and again, that they might be reluctant to deal with the system?

As pointed out by the mental-health advocacy group National Association for Rights Protection and Advocacy, in a statement on this use of the Baker Act, this is not a new problem. In collaboration with the National Council on Disability, a federally funded advisory body, NARPA released a position paper on the needs of people with psychiatric disabilities after hurricanes Rita and Katrina back in 2006. They found numerous failures and violations of rights of disabled citizens. In other cases, NARPA said, state negligence led to injury and death or premature termination of support operations. Any emergency plan in any hurricane zone should already have drawn from the lessons of Katrina, Rita, and other disasters, in planning to provide support for disabled individuals. Miami's involuntary detention demonstrates a lack of planning.

In the end, officials at the Homeless Trust told me, six people were committed. It's not a huge number, but each of these individuals has rights, and in each case those rights were violated. Those violations could be been prevented with better planning. Advocates worry about the potential for similar misuse of involuntary commitment, especially given that none of the widespread news coverage of the Baker Act reached out to experts like NARPA, Next Steps, or the Bazelon Center.

Meanwhile, as of the time of publication, no one in Miami could tell me whether the people committed under the Baker Act had been released. The storm had knocked out access to email and phones, so the victims of the Baker Act were, at least for now, rendered not just invisible but unreachable.