opinion | I’m a New York paramedic. I have never experienced a mental health crisis like this.

We must comb through the embers and see what we can salvage. Then we need to lay a new foundation, put in some beams to support the structure and start building.

What New York, like so many cities in the United States, needs is sustained investment to fund mental health facilities and professionals who provide long-term care. This effort would undoubtedly cost tens of millions of dollars.

I don’t mind taking mentally ill people to the hospital in need – our ambulances do this all the time. But I know it probably won’t solve their problems. Hospitals are overwhelmed, so they sometimes try to move patients to other facilities. Gov. Kathy Hochul has promised 50 extra beds for psychiatric patients in New York City. We need far more to treat those patients who would qualify for involuntary hospitalization on Mr Adams’ vague criteria.

Often a patient is examined by hospital staff, given a sandwich and a place to rest for a few hours, and then discharged. If the person is intoxicated, a nurse may offer a “banana bag” — an IV solution of vitamins and electrolytes — and time to sober up. Chances are that the already overworked staff can’t do much, if anything, about the depression that caused the patient to drink or do drugs in the first place.

Suppose a patient is being treated in the hospital. Mr Adams says under the new policy this patient will not be discharged until a plan is in place to connect the person to ongoing care. But the systems responsible for delivering that care — assisted living, access to outpatient mental health care, social workers, a pathway to reintegration into society — are woefully inadequate. There aren’t enough emergency shelters, there aren’t enough social workers, there aren’t enough outpatient facilities. So people who no longer know how to take care of themselves, who have to hold their hands in a complex process, are alone again on the streets.

A few days ago I was treating a manic-depressive person in her late 30s who was yelling at people on a subway platform in downtown Brooklyn. The man said he went two years without medication because he didn’t know where to get it. He said he didn’t want to go to shelter and I told him I knew where he was from: I was homeless for two years in my early 20s and slept in my car to avoid shelter – one night in the Bedford Atlantic Armory was enough for me.

I persuaded the man to come with me to Brooklyn Hospital Center and made sure he got a prescription. I don’t know if he will remember to take it.