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Guest Commentary

How will the Next Mayor Address Mental Illness?

Local mental health advocates call on mayoral candidates to address the underlying issue that affects, crime, drugs, homelessness and growth

Guest Commentary

How will the Next Mayor Address Mental Illness?

Local mental health advocates call on mayoral candidates to address the underlying issue that affects, crime, drugs, homelessness and growth

As the Philadelphia mayoral contest gets underway, drugs, gun violence, homelessness and the revival of Center City appear to be emerging as frontline issues. But there is another issue, serious mental illness, which is enmeshed with each of these and needs to be part of the discussion.

While people with serious mental illness, including schizophrenia and bipolar disorder, make up just under 3 percent of the adult population in Philadelphia, they represent an even larger share of the city’s intractable problems. An estimated 40 percent of the city’s homeless population have a serious mental illness, most of whom are chronically homeless and live on the street.

On any given day, there are more than 500 individuals with serious mental illness sitting in a Philadelphia jail. This is in part because half of people with these conditions receive no treatment for their severe psychiatric condition.

While most people with serious mental illness are not violent, having these conditions, especially when untreated, does increase the risk for violent behavior towards oneself or others. In 2020, 167 Philadelphians died by suicide. And you only have to look at the recent shooting of the Bucks County Police Chief to see the potential impact of untreated mental illness and drug misuse on violence in society.

We call on the 2023 Philadelphia mayoral candidates to share their policies on tackling untreated serious mental illness in the city.

As a relative of someone with serious mental illness living in Philadelphia and a national expert in serious mental illness policy, we know these issues intimately well. We call on the 2023 Philadelphia mayoral candidates to share their policies on tackling untreated serious mental illness in the city. We also call on the media and our fellow Philadelphians to ensure these candidates address these issues throughout the mayoral campaign.

The lack of effective and sustainable treatment, as well as long-term, humane housing alternatives for people with serious mental illness, is nothing less than criminal. The dysfunctional “systems” of care for people with these conditions place enormous and undue burdens — emotional, financial and physical — on family members, caregivers and the community at large.

Philadelphia is hardly alone in this, as present treatment systems for people with serious mental illness are fragmented at best. However, there is precedent for mayors to take the lead on system reform. In November 2022, Mayor Adams of New York City announced a plan to help people with untreated mental illness receive more timely treatment. While the rollout of Mayor Adam’s policies has not been without controversy, the intention and direction are positive — people with serious mental illness deserve to live a fulfilling life without the torment of their delusions and hallucinations.

In the case of Mayor Adams, he had the courage to admit the status quo was unacceptable and create a plan to act. Perhaps, Philadelphia, which is in many ways a proven leader in mental health treatment reform and home to the first psychiatric hospital, can still do better. Sound policies and practices can lessen the need for interventions and repeated hospitalizations. They can also markedly reduce homelessness, which is all too often associated with untreated serious mental illnesses.

Present mayoral candidates owe it to the voting public to dive deeply into the issue of untreated serious mental illness in the city of Philadelphia. They must formulate workable approaches and solutions while fully presenting their views to the public in their platforms and campaigns.


Marc Pomper is a retiree with a relative with serious mental illness living in Philadelphia and Elizabeth Sinclair Hancq is the director of research at Treatment Advocacy Center, the only national nonprofit organization dedicated to the elimination of barriers to the timely and effective treatment of severe mental illness.

The Citizen welcomes guest commentary from community members who stipulate to the best of their ability that it is fact-based and non-defamatory.

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