3 September 2026 - 10:00am
On Monday, a 49-year-old Queens woman, Pamela Cisneros, used kitchen knives to stab two strangers in Times Square — killing one, a 32-year-old Bank of America employee and new mother returning to work that day from maternity leave. NYPD officers attempted to subdue the perpetrator with a Taser before shooting her as she ran in their direction and threatened to kill them.
It has been reported that Cisneros had a long history of serious mental illness. She’d also been known to the NYPD, who’d encountered her in 2018 and 2019, for belligerent public behaviour and attempting to jump in front of a subway train. She appears to have been stable on medication since then but, in recent months, reportedly didn’t want to rely on medication any longer.
This case is similar to other episodes involving those with untreated serious mental illness. Weng Sor, who reportedly went off medication for a serious mental illness drove a truck into Brooklyn traffic back in 2023. In 2018, Saheed Vassell, who also went off medication, was fatally shot by police who believed he was brandishing a gun. Then there was Deborah Danner, who came at police with a bat in 2016. Police were reportedly at her apartment “practically once a month” when she wasn’t taking her medication.
When a small number of people with the most serious illnesses — such as schizophrenia and other psychotic disorders — aren’t receiving adequate treatment, tragedy can ensue. However, it is possible to stabilise patients before a crisis hits. Treatment, particularly for schizophrenia, can decrease the risk of violence. That means, if prioritised, serious mental illness need not lead to results like the Times Square incident.
Serious mental illness is not currently a point of focus for NYC’s government. Mayor Zohran Mamdani’s mental health agenda remains preoccupied with who answers crises, not how the sickest patients are treated. His Department of Community Safety doesn’t mention serious mental illness. Yet crisis response teams that Mamdani favours, such as B-HEARD, don’t answer 911 calls where there’s a risk of violence. Only police can do that.
NYPD officers effectively respond without further incident to the almost 170,000 annual calls for “emotionally disturbed persons”. Yet they bring mentally ill individuals who are a danger to themselves or others to general hospitals for treatment. These hospitals can’t handle the load of patients who are unsafe and need specialty psychiatric hospitalisation. New York State, like nearly every other state in the US, has a shortage of the necessary beds.
The NYC mayor can’t expand the state psychiatric-hospital system on their own. The state legislature in Albany controls those hospitals. But mayors have leverage. Mamdani has, however, given no impression that he will push for more state hospital beds.
New York also has a successful Assisted Outpatient Treatment (AOT) programme, which is court-mandated for the small number of seriously mentally ill who can remain stable in the community, rather than need a hospital. For those with a history of treatment non-compliance and either two hospitalisations or arrests within 36 months, AOT compels treatment — and compels the mental health system to prioritise the most in need. Cisneros may not have qualified yet, but the programme is noteworthy because it reduces arrests and homelessness by 70%, and repeated hospitalisations by 60%.
Mamdani’s mental health plan makes no mention of AOT, even though the city helps fund and administer the programme. Psych beds and AOT are the most critical interventions for the seriously mentally ill. Mamdani isn’t interested.
The city also pays a hefty price of indifference through its jail system. Around 1,600 inmates have a serious mental illness, while detainees flagged with a mental health issue rose from 37% of the jail population in 2014 to 51% in 2023. And more than $300 million is spent annually by the city on jail healthcare as a whole.
The figures show a serious issue for public safety. Monday’s attack was one of several like it in New York already this year. In April, a mentally ill man went on a machete slashing spree in Grand Central Terminal. He’d been homeless and had multiple arrests to his name. In June, another mentally ill attacker stabbed seven near Penn Station. Inpatient treatment access or AOT may have helped them stabilise before the attacks happened.
State hospitals, other specialty psychiatric hospitals, and AOT do what general hospitals, shelters, and voluntary treatment can’t. They stabilise patients who need intensive care and oversight. Most states — and the federal government — have long been more concerned with serving the less symptomatic, average person with distress. But the average distressed person isn’t at such risk of public disorder.
Mamdani should prioritise the city’s AOT program and fund it generously. Governor Kathy Hochul, to her credit, has been adding more beds. But state hospital capacity is still far too low after decades of neglect. Hochul will need to do more, even when the high costs make it easier to look away, like Mamdani has done.
