Last week, in Nebraska, Noemi Guzman tried to kidnap a 3-year-old from Walmart. Horrific bodycam footage from the police shows her holding a knife over the boy, slashing him, before cops shot her dead. Two years prior, a judge let Guzman off for a raft of felony charges, including arson and assault, by reason of insanity.
One of the most horrific crimes this decade happened last August, when, on Charlotte North Carolina’s transit system, a mentally ill man named Decarlos Brown allegedly stabbed to death Iryna Zarutska, a complete stranger and Ukrainian refugee. Brown suffers from schizophrenia, yet was let go for previous crimes. His mother said she tried to get him involuntarily committed but was refused.
In blue cities like New York, the culprits who have shoved people on the subway tracks or randomly stabbed someone are almost always known previously for mental health issues. Last week, at the Grand Central subway station, cops shot to death a psychotic man who had slashed three people with a machete. He called himself “Lucifer.”
On the whole, 2025 was a historically great one for public safety. Murders and crime overall dropped nationwide. But in too many cases, ideology, incompetence and unaccountability defined our government’s response to mental illness-related violence in America. And, in the worst cases, made “by reason of insanity” a perverse get-out-of-jail-free card that puts them back on the streets.
Law professors will tell you that a classic verdict of “not guilty for reason of insanity” is rarely used successfully. States put restrictions on that legal maneuver after John Hinckley shot President Reagan in 1981. Hinckley’s lawyers got him off on an insanity plea, provoking widespread outrage.
But other forms of special leniency for mentally ill offenders exist, many developed in the 2010s by progressive ideologues styling themselves “criminal justice reformers.”
The criminal justice reform movement, which is ongoing, defines success in terms of how many people it can get out of jail. Activists will invoke any argument that suggests that an offender facing incarceration should be instead “diverted” into a light touch community program.
With mentally ill offenders, the George Soros crowd asserts that the typical case shouldn’t be seen as bad, and in need of punishment, but rather mad, and in need of treatment.
Diverting mentally ill offenders into treatment can succeed with small-scale programs exercising vigilant supervision. Mass scale diversion will never work, though.
Our mental health system lacks competence to provide sustained and effective treatment to the hardest cases. Mental health system incompetence stems mainly from the unaccountability of non-governmental organizations. Despite holding the purse strings for billions in mental health spending, government asks far too little from publicly-funded nonprofits who, whenever a headline-grabbing tragedy strikes, always seem to have been curiously MIA.
There’s little logic in “diverting” a career criminal back into a mental health system whose failures largely explain why he offended in the first place.
New York’s jail statistics illustrate the limits of diversion. City government classifies about 1,500 inmates as seriously mentally ill, or more than 20% of the total.
Since 2020, New York has seen the number of seriously mentally jail inmates double. The size of that population alone will prevent New York from hitting the absurdly low targets it needs to hit to pull off the “Close Rikers” plan.
Despite being host to likely the best funded and most sophisticated criminal justice reform network in the nation, New York has found jail is indispensable in responding to mental illness-related violence.
To be sure, mentally ill offenders need treatment and deserve to receive it at public expense. But, more basically, many of them need confinement — for the benefit of their communities and themselves. Confinement can happen in jail (where, incidentally, every American has a constitutional right to mental healthcare) or in a psychiatric institution.
Though that latter solution would be best, America faces a dire shortage of psychiatric hospital beds, down more than 90% from the mid-century peak. As the Arlington, Va.-based Treatment Advocacy Center has documented, states across the nation lack adequate psych bed capacity, from blue New York to purple North Carolina to red Nebraska.
Bipartisan failure created the bed shortage. Democrats fear the wrath of disability rights activists who frame even minor investments in inpatient capacity as a slippery slope towards a mass roundup of neurodivergent Americans. And Republicans blanch at the price tag of expanding institutional care, an admittedly expensive but also necessary and humane mode of treatment.
What few state hospital beds we do have are swamped by “forensic” cases: serious offenders found not guilty by reason of insanity and committed to hospitalization, and those charged with a crime but deemed “incompetent to stand trial.” In other words, in the typical scenario, criminal activity functions as the price of admission to a psychiatric hospital.
A better system would provide treatment before tragedy.
More psychiatric inpatient capacity would relieve jails of many of the mentally ill inmates now in their care and allow community based programs to focus on those clients they can truly handle.
President Trump usefully contributed to the debate over mental illness and crime with his July 2025 executive order on “Ending Crime and Disorder on America’s Streets.” However, implementation has been a mixed bag. Substantive mental health reform sits uneasily with Health and Human Services Secretary Robert F. Kennedy Jr.’s MAHA agenda. RFK thinks Americans take too many medications and he’s skeptical of medical experts. But handling psychosis will require more use of meds and deference to psychiatrists’ authority.
More concerning is progressive activists’ ever-fertile imagination. Risky ideas, such as replacing cops with social workers and expanding diversion remain very much in the mix, especially in deep blue places like New York and California.
If broader crime trends hold, perhaps opportunities will emerge to work more intensely on narrower but long-vexing problems such as mental illness-related violence. Alternatively, perhaps government will declare premature victory and allow soft-headed “defund”-like ideologies to regain traction. If the latter, crime won’t stay down for long.
Stephen Eide is a senior fellow at the Manhattan Institute.
This story originally appeared on NYPost
