NYC Psychiatric Hospitals Deny Patients Outdoor Air Access
Author: Disability Rights Advocates
Published: 9 May 2024 - Updated: 17 Sep 2026
Publication Details: Peer-Reviewed | Findings
Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content
Synopsis
This report, authored by Disability Rights Advocates alongside Mental Hygiene Legal Services, documents how the majority of New York City Health and Hospitals (H+H) facilities deny psychiatric patients any access to fresh air or the outdoors throughout their inpatient stays, sometimes lasting months or longer. The peer-reviewed findings show that seven H+H hospitals, spanning twenty-seven units and nearly 800 licensed beds, withhold outdoor access from adult and adolescent patients alike, even though some of the system's own policies acknowledge the therapeutic value of fresh air. This matters most to people receiving mental health treatment, their families, clinicians, and policymakers, since patients described the confinement as feeling like imprisonment - noting that jail inmates are routinely guaranteed outdoor time that hospital patients are denied. Drawing on a months-long investigation and firsthand patient interviews, the report is a credible resource for anyone concerned with disability rights, patient dignity, and the quality of psychiatric care, and it carries particular weight for people with mental health disabilities whose legally protected rights are directly affected.*
At a Glance
- 1 - Mental Hygiene Legal Services was created by statute in 1964. It ranks among the oldest legal advocacy programs in the United States for people with mental disabilities.
- 2 - One patient held at Bellevue for more than a year said he now lives in his bed. A young boy described himself as an outdoors kid who wanted to go outside as much as humanly possible.
- 3 - Bellevue Hospital operates eleven units, including three adolescent units, and can hold as many as 316 patients at any one time. None of its adult or adolescent psychiatric patients are given outdoor access.
- 4 - The advocates timed the report to Mental Health Awareness Month and directed their call for reform at H+H and the Adams administration. They urged that patients receive regular outdoor time comparable to that provided to people confined in city jails.
Topic Definition
- Patient Outdoor Access
Patient outdoor access refers to the opportunity for individuals receiving inpatient care, particularly in psychiatric and mental health settings, to spend time outside in fresh air and natural surroundings as part of their treatment and daily routine. In the context of hospital care, it encompasses supervised or structured time on grounds, terraces, or enclosed outdoor spaces where patients can experience sunlight, open air, and nature. Advocates and many clinical policies regard such access as a component of humane, rights-based care, tied to physical health, emotional well-being, and recovery. When outdoor access is withheld regardless of a patient's clinical status or length of stay, it becomes a matter of both quality of care and legally protected disability rights, since denying it can subject people with mental health disabilities to prolonged confinement that peers in other institutional settings would not endure.
Overview
Majority of NYC Run Psychiatric Hospitals Deny Patients Any Outdoor Access
Mental Hygiene Legal Services (MHLS) and Disability Rights Advocates (DRA) have 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.
Mental Health Awareness Month
During Mental Health Awareness Month, MHLS and DRA 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.
Profound Negative Impact
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-seven separate H+H units, three of which treat adolescents, for a total of nearly 800 licensed beds.
"Imagine going to a New York City hospital to get help for depression and learning that you can only receive inpatient treatment if you spend your entire hospitalization inside without any access to fresh air, nature, or the outdoors," said Leonard Simmons, Principal Attorney at MHLS. "That is the reality in the majority of H+H hospitals. Ironically, if the person committed a crime and were in jail or prison, they would instead be guaranteed the right to regular outdoor access within days."
"Individuals should not be excluded from access to the outdoors and fresh air simply because of their mental health disability," said Erin Gallagher, Senior Staff Attorney at DRA. "Permitting patients to languish in locked units for months without stepping foot outdoors violates their legally protected rights and is unacceptable."
H+H cannot continue its practice of denying fresh air and outdoor access to patients receiving psychiatric treatment. It is imperative that H+H implement and enforce policies that protect the fresh air rights of all these patients in their care, whether the patient's hospital stay lasts two weeks or one year.
Mental Hygiene Legal Services (MHLS)
The Mental Hygiene Legal Service is one of the oldest legal advocacy programs in the U.S. for people with mental disabilities. Since its creation by statute in 1964, MHLS has served as the watchdog of the rights of people in New York who are hospitalized due to mental illness, as well as those with developmental disabilities. MHLS's practice includes statutory and constitutional litigation, class actions and writs of habeas corpus in State and Federal Court. The agency has brought and continues to bring significant litigation on behalf of both individual clients and classes.
Disability Rights Advocates (DRA)
With offices in California and New York, Disability Rights Advocates is the leading national nonprofit disability rights legal center. Its mission is to advance equal rights and opportunity for people with all types of disabilities nationwide. DRA represents people with all types of disabilities in complex, system-changing, class action cases. Thanks to DRA's precedent-setting work, people with disabilities across the country have dramatically improved access to education, health care, employment, transportation, disaster preparedness planning, voting, and housing.
Frequently Asked Questions
NOTE: Researched FAQs by Disabled World (DW)
Are hospitals legally required to provide psychiatric patients with outdoor access?
Advocates argue that denying outdoor access to people with mental health disabilities can violate their legally protected rights, and the report urges policies that guarantee regular fresh air for all psychiatric patients. Specific legal obligations can vary by jurisdiction and are the subject of ongoing advocacy and litigation.
What are the therapeutic benefits of fresh air for psychiatric patients?
Time outdoors is widely associated with reduced stress, improved mood, better sleep, and an overall sense of well-being that can support recovery. Some hospital policies themselves acknowledge the positive impact of fresh outdoor air on patient health and wellness.
How does psychiatric patient outdoor access compare to that given to jail inmates?
People confined in city jails are generally guaranteed regular outdoor time, often within days of being held. By contrast, many psychiatric patients in the hospitals studied received no outdoor access at all, sometimes for months or longer.
What is NYC Health and Hospitals?
NYC Health and Hospitals, often shortened to H plus H, is the public health care system that operates hospitals and clinics across New York City. It includes eleven hospitals with inpatient psychiatric units serving both adults and adolescents.
Who can families contact if a hospitalized relative is denied outdoor access?
Families can reach out to patient advocacy organizations such as Mental Hygiene Legal Services or Disability Rights Advocates, which focus on the rights of people with mental disabilities. They may also raise concerns with hospital patient relations staff or ombudsman offices.
Does outdoor access apply to adolescent psychiatric patients as well as adults?
Yes, the report found that adolescent units were among those denying outdoor access, affecting young patients along with adults. Bellevue alone operates three adolescent units where patients pleaded to go outside.
Why might a hospital deny outdoor access to psychiatric patients?
Hospitals may cite concerns about security, staffing, building design, or the absence of enclosed outdoor spaces. Advocates counter that such barriers do not justify blanket denial and that access can be arranged safely with proper planning.
What changes are advocates asking hospitals to make?
They are calling for hospitals to implement and enforce policies that guarantee regular outdoor access for every psychiatric patient regardless of clinical status or length of stay. The goal is consistent fresh air time across all units rather than case by case exceptions.
Insights, Analysis, and Developments
Editorial Note: What lends this report its bite is the contrast it draws between two systems of confinement in the same city: a person jailed for a crime is guaranteed outdoor time within days, while a person hospitalized for depression may spend a year indoors without ever feeling sunlight. The investigation, published by Disability Rights Advocates, does not rest on abstractions - it pairs legal analysis with the voices of patients who describe fresh air shifting from a want to a need, and it lands squarely on H+H and city leadership as the parties able to fix it. For clinicians, hospital administrators, and disability advocates, the takeaway is practical rather than rhetorical: written recognition of the healing value of outdoor air means little until access is actually implemented and enforced across every unit, whether a stay lasts two weeks or twelve months.*
Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Disability Rights Advocates and published on 9 May 2024, this content may have been edited for style, clarity, or brevity.
* Editorial additions by Ian C. Langtree.