The seemingly random killings highlight the challenges confronting New York City and other municipalities across the country as they maneuver a delicate balancing act – how to deal with soaring homelessness and mental illness and its perceived – and actual – impact on public safety.

The suspected attacker, 51-year-old Ramon Rivera, is a mentally ill homeless man with eight past arrests in New York City alone.

Despite multiple arrests and a history of mental health problems, Ramon Rivera, accused of killing three strangers in a wild Manhattan stabbing spree, was never sentenced to more than a year in jail.