Street Teams and Clubhouses: A New Plan to Help Mentally Ill New Yorkers
March 2, 2023
In his latest plan to help people with severe mental illness, Mayor Eric Adams says the city will focus on sending more counselors and medical professionals into the streets, not police officers.
“I think the resources are well placed in terms of where the greatest acuity of need is,” Jody Rudin said. “When you look at this plan paired with the governor’s plan, it’s just clear that there’s an unprecedented focus on mental health.”
In an effort to address one of New York City’s greatest challenges as the city recovers from the pandemic, Mayor Eric Adams announced a mental health agenda on Thursday that expands key services for people with severe mental illness.
There are about 100,000 adults in the city with severe mental illness that is untreated, city officials say — people with conditions such as schizophrenia, bipolar disorder and major depression. There are thousands more whose care is slipshod or inconsistent.
The reasons for the gap are many, and include a lack of available psychiatrists, poor coordination between hospitals and other care providers, and the use of jails as de facto (and woefully inadequate) psychiatric facilities.
Mr. Adams’s plan includes:
Adding “mobile treatment” teams — which help people on the streets, and in shelters and jails — to serve 800 more people.
Expanding a program that sends medical professionals rather than police officers to respond to mental-health 911 calls.
Investing in “clubhouses” — centers of community for people with mental illness, who often suffer in isolation, that connect them with education and job opportunities and foster friendships.
“This is the next phase of how we are going to help people in need before they fall into crisis, by ensuring everyone has access to health care, community and a home,” Mr. Adams said at City Hall. “To support people with serious mental illness and their families, we are going to improve access to specialty care and primary care regardless of need.”
The plan — the latest in a series of related measures by the mayor and Gov. Kathy Hochul — comes as the city approaches the third anniversary of the coronavirus pandemic, a period when many New Yorkers have struggled psychologically, and overdose deaths and homelessness have surged.
Mr. Adams, a Democrat who ran for office on a public safety message, announced a plan last fall to move homeless people with severe mental illness who pose a threat to themselves or to others off the streets and into hospitals, against their will if necessary. Mr. Adams has received both praise and fierce pushback to his sweeps of homeless encampments, his deployment of officers in the subway and the involuntary removal policy.
In January, Ms. Hochul, also a Democrat, said she would compel hospitals to reopen hundreds of psychiatric beds they closed during the pandemic, require hospitals to keep psychiatric patients until they are stable and coordinate discharge planning with community providers, and create mobile treatment teams to serve more than 2,000 people in New York City.
The mayor’s new plan is short on details of implementation and cost. Mostly, it lays out a vision, a set of priorities; the city will need to cobble together funding for most of them.
It is a companion to the policy that the mayor announced in the fall, which concentrated on how the city would deal with people who had completely unraveled in public. That plan was criticized in some quarters as being heavy-handed and coercive, though it attracted plenty of support. The new plan, which focuses entirely on treatment that people can access voluntarily, aims to prevent them from falling apart in the first place.
Doing that, said Ashwin Vasan, the city’s health commissioner, requires “prevention of the drivers of crisis: isolation, unstable housing, unstable clinical care.”
The plan to tackle severe mental illness is part of a broader behavioral health policy the mayor laid out on Thursday that includes tackling addiction and the mental health needs of children. The city set a goal of reducing overdose deaths by 15 percent by 2025, in part by opening public vending machines that dispense the overdose reverser naloxone. Drug deaths jumped by nearly 80 percent from 2019 to 2021.
The plan also takes aim at racial inequities: Black and Hispanic New Yorkers with severe mental illness are disproportionately likely to receive inadequate or no treatment.
One frequent critic of the mayor’s homelessness policies said that the plan did not amount to a meaningful shift.
Craig Hughes, a social worker at the Bronx office of Mobilization for Justice, a nonprofit law firm that represents many mentally ill, low-income New Yorkers said that “help will elude thousands of people who want and need it” as long as the mayor continues to use the police to respond to homeless people and leaves supportive housing vacancies unfilled.
The city’s plan includes building six new community behavioral health centers, with federal funding, for people with low incomes. It calls for $7 million in city money to expand clubhouses, which are widely regarded as a cost-effective way to help people with severe mental illness stay connected to supports.
The plan also calls for creating 15 more mobile treatment teams that will serve over 800 people, including five teams dedicated to the most challenging patients who move often between shelters, jails, streets and hospitals.
Those teams, called Intensive Mobile Treatment teams or I.M.T., include social workers, peer counselors and psychiatric professionals. They have a broad purview to offer clients help wherever and whenever they need it, whether that means helping them find housing, connecting them to benefits, or solving day-to-day problems.
Jody Rudin, president of the Institute for Community Living, which operates six I.M.T. teams under contract with the city, applauded the plan.
“I think the resources are well placed in terms of where the greatest acuity of need is,” she said. “When you look at this plan paired with the governor’s plan, it’s just clear that there’s an unprecedented focus on mental health.”
Brandon Jackson, 32, a client of one of the institute’s I.M.T. teams whose history includes jail for a violent robbery and hospitalization for creating disturbances at a shelter, said that over the past year, the team had helped get him on a track toward stability.
“With medical, with schooling, anything community-wise I need,” he said. “If I need food, if I need clothes, if I need to find a safe haven to go at, they support all around.”
On Tuesday, Mr. Jackson moved into what he hopes would be a long-term home: a shared apartment in supportive housing, which offers on-site social services.
Read via The New York Times.