Times Square Killing Renews Questions over New York’s Mental Health System
Author: Christine Savino
September 09, 2026
HRRC believes responses to mental health crises must protect both public safety and the rights and dignity of people with mental illness. Preventing tragedies requires accessible and sustained community-based care, while policies involving involuntary treatment must include strong safeguards against unnecessary coercion and discrimination.
![Times Square, New York City [Image credit: Wikimedia Commons]](https://static.wixstatic.com/media/f05ed1_814a1b599e854c5d9791b4a0c11e81d3~mv2.jpg/v1/fill/w_500,h_333,al_c,q_80,enc_avif,quality_auto/f05ed1_814a1b599e854c5d9791b4a0c11e81d3~mv2.jpg)
On August 31, Pamela Cisneros, 49, allegedly stabbed a 68-year-old man shortly after he exited the subway just before fatally stabbing 32-year-old Erin Piacenti in Times Square, according to police.
Officers confronted Cisneros several minutes later as she held two kitchen knives. After being repeatedly instructed to drop the weapons and with tasers having been deployed without incapacitating her, two officers shot her as she advanced toward them, according to police.
New York Police Department Commissioner Jessica Tisch stated in a press briefing that Cisneros told officers, “I'm not dropping anything. I would rather kill both of you.” She repeated, “I will kill you.”
Cisneros and Piacenti were pronounced dead at Bellevue Hospital, while the other victim survived.
New York Attorney General Letitia James’s Office of Special Investigation opened an investigation into Cisneros’s death, customary when a police or peace officer may have been directly responsible for a person's death. The office cautioned that its account of the shooting contains preliminary facts subject to change.
Cisneros, of Queens, had a “documented mental health history,” including encounters in 2018 and 2019 with the NYPD, but no known arrest history, Police Commissioner Jessica Tisch said. She was also diagnosed with paranoid schizophrenia in 2005 and, according to her brother, bipolar disorder.
Her father, Mario Cisneros, told the New York Times that his daughter had experienced serious mental health problems for decades prior to the attacks in Times Square; he also shared that she had previously attempted suicide during a mental health crisis in 2019. He spoke to having accompanied her to monthly hospital appointments where she received injections that she received as psychiatric treatment. However, that arrangement apparently changed months before the Times Square attack. According to her father, Cisneros declined his offer to accompany her to an April appointment to the Jamaica Hospital Medical Center in Queens, telling him: “No, Dad, don’t worry. I’m good. Don’t worry about me.” He also said she had recently expressed reluctance to continue relying on medication. “She didn’t want to continue them,” he told the New York Times. “She was fighting to not be on the medicine, to not have to depend on it.”
The circumstances echo a decades-old debate in New York over how the state should respond when people with serious mental illness disengage from treatment. The tension came into the spotlight beginning in the 1950s, when an era of deinstitutionalization, or substantial decrease in long-term mental health hospitalization, began.
Supporters argued that those who are mentally-ill should be subject to the least-restrictive means of potential rehabilitation, while opponents countered that the shift displaced the mentally-ill from psychiatric hospitals to jails, prisons, and civilian society without necessary treatment.
In January 1999, 32-year-old journalist and photographer Kendra Webdale was pushed in front of an oncoming subway train at Manhattan’s 23rd Street station by Andrew Goldstein, a man diagnosed with schizophrenia who had a lengthy history of psychiatric hospitalization.The New York Court of Appeals later described Goldstein as having neglected to take his prescribed antipsychotic medication.
Webdale’s killing prompted the state legislature later that year to enact Mental Hygiene Law § 9.60, or Kendra’s Law. The law created Assisted Outpatient Treatment (AOT), under which courts can order certain people with serious mental illness and histories of treatment noncompliance, hospitalization or dangerous behavior to participate in outpatient treatment.
Webdale’s mother, Patricia Webdale, has remained an advocate for the law. “It has helped thousands of people with severe mental illness, just as Kendra would have wanted to help the man who pushed her,” she said while advocating for making the law permanent in 2010.
More than 25 years later, New York is still grappling with mental health crises and the role that institutionalization plays in them.
Glossary
Assisted Outpatient Treatment (AOT) — A procedure, also known in New York as Kendra’s Law, through which qualifying people with serious mental illness can be ordered by a court to participate in an outpatient treatment plan.
Involuntary commitment — A legal process under which a person meeting statutory criteria may be admitted and retained for psychiatric care without voluntarily agreeing to hospitalization.
Kendra’s Law — New York Mental Hygiene Law § 9.60, enacted in 1999 after the killing of Kendra Webdale, which authorizes court-ordered Assisted Outpatient Treatment for people who satisfy statutory criteria.
Mobile Crisis Team — A team of behavioral-health professionals that provides assessment, crisis intervention, counseling and connections to treatment for people experiencing or at risk of a serious behavioral-health crisis.
Serious Mental Illness (SMI) — A term used in New York’s mental-health system for significant mental illness associated with substantial functional impairment and service needs.
References
