Denial of Fresh Air to Patients at NYC City-Run Psychiatric Hospitals

In May 2024, DRA and Mental Hygiene Legal Services (MHLS) released a report titled “Denial of Fresh Air Access for Psychiatric Patients: A Report on NYC H+H Hospitals.” This report outlines findings from a months-long investigation into the denial of fresh air and outdoor access to individuals receiving psychiatric treatment in hospitals operated by NYC Health and Hospitals (H+H).

The findings are stark—the majority of H+H hospitals continuously deprive patients of all access to fresh air and the outdoors, regardless of their circumstances or the length of their confinement. The investigation revealed the ongoing hardship and distress experienced by individuals subjected to uninterrupted indoor confinement, often for months at a time, while receiving inpatient mental health care in city-run hospitals.  Read the full report with legal analysis and recommendations for each of the eleven H+H Hospitals.

DRA and MHLS call on H+H and the Adams administration to ensure patients receiving treatment in New York City’s psychiatric units are provided with regular outdoor access—similar to that routinely provided to others confined in city institutions, such as jail inmates. As the report details, some of H+H’s own written policies recognize “the therapeutic and healing benefits of fresh outdoor air,” and the “significant positive impact on the health and wellness of [] patients.” Nonetheless, most H+H hospitals deny patients receiving psychiatric treatment—including both children and adults—any access to the outdoors regardless of their clinical presentation or length of stay.

Patients interviewed by MHLS during the investigation widely reported the profound negative impact of this deprivation on their lives. At Bellevue Hospital, which operates eleven units, including three adolescent units, patients pleaded to go outside. One patient held at Bellevue for over a year, said “I live here in this bed.” A young boy described himself “an outdoors kid” who would want to go outside “as much as I humanly possibly can.” An adult patient reported, “after a while of being here, access [to the outdoors] becomes a need rather than a want.” A forensic patient, when asked about going outside, replied, “you mean like in prison?” From his past incarcerations, he knew that prison inmates are routinely permitted to go outside, even as hospital patients are not.

These patients’ experiences are unfortunately not unique. Bellevue, which provides no outdoor access to any of its adult or adolescent patients receiving psychiatric treatment (as many as 316 patients at any time), is joined by six other H+H hospitals who deny all their adult patients receiving psychiatric treatment access to the outdoors. The wholescale deprivation spans twenty-six separate H+H units, three of which treat adolescents, for a total of nearly 800 licensed beds.