New Yorkers’ sense that there are more people in obvious mental health crisis on trains and sidewalks is backed by data. A 2025 report from the city comptroller estimates roughly 2,000 people with serious mental illness are cycling between city streets, subways, jails and hospitals at any given time.NYC Comptroller’s Office Studies compiled by Coalition for the Homeless show that the large majority of unsheltered homeless New Yorkers live with serious mental illness or other severe health problems.Coalition For The Homeless
To understand why so many of these New Yorkers are in public spaces instead of treatment, you have to go back to the era of “deinstitutionalization.” Beginning in the 1970s, New York State moved away from large psychiatric institutions and closed or downsized many state hospitals, promising more humane, community-based care. But as the NYC Municipal Archives notes, this shift was “often paired with budget cuts” to public mental health programs in the 1970s and 1980s, so the community services that were supposed to replace institutions were never fully funded or built out.NYC Records & Information Services
This divestment continued in more recent years. A Manhattan Institute analysis found that non-forensic state psychiatric centers in New York City lost about 15% of their adult bed capacity between 2014 and 2018.Manhattan Institute A 2025 update shows that specialized “mental health shelters” in NYC now house more seriously mentally ill people than jails and psychiatric hospitals combined, reflecting how the system has shifted from long-term hospital care to shelters and short-stay crisis beds.
At the same time, the housing and treatment systems that are supposed to catch people before they end up on the street are under intense strain. Long-term supportive housing — apartments paired with on-site services — is widely recognized as one of the most effective tools for people with serious mental illness who are homeless or at risk of homelessness. The city health department describes supportive housing as permanent, affordable housing with built-in supports for people leaving homelessness, hospitalization or jail.nyc.gov Roughly half of NYC’s supportive housing units are reserved for people with serious mental illness.Supportive Housing Network of New York But demand far exceeds supply: an investigation in 2025 found thousands of New Yorkers waiting, sometimes years, for state-funded mental health housing and support programs despite recent funding increases.New York Focus
The broader homelessness crisis makes this worse. Coalition for the Homeless reports that over the course of 2024, the number of longer-term New Yorkers in shelters (not including newly arrived migrants) grew by more than 7,500 people, a 12% increase in a single year.Coalition For The Homeless+1 A statewide report from the state comptroller notes that New York now has the largest homeless population in the nation, even though a relatively small share are unsheltered compared with other states.Office of the New York State Comptroller Those who avoid shelters — often because of safety concerns, rules, or past trauma — are the ones most visible on trains and in public spaces.
Legal tools like Kendra’s Law, which allows courts to order a small subset of people with serious mental illness into assisted outpatient treatment, only reach a fraction of those in need, and research shows people still cycle through hospitals, shelters and the streets.Office of Mental Health+2nyc.gov+2
Taken together, decades of divestment from inpatient psychiatric care, under-built community services, a severe shortage of supportive housing, and rising homelessness have left many New Yorkers with serious mental illness with nowhere stable to go. For them, the subway or a sidewalk is not a choice but the last rung in a long chain of system failures — one that experts across the political spectrum say will require sustained investment in housing, treatment and coordinated care to fix.Coalition For The Homeless
