Behavioral Health

Address the needs of those living with serious and persistent mental illness

Sometimes the best policy is not something new and flashy, but rather to double down on programs with proven track records. We know, for instance, that the Fountain House model of care—which creates structured therapeutic social settings for members—helps people living with serious and persistent mental illness transition from therapeutic to non-therapeutic settings. Individuals who use Fountain House for residential rehabilitation services are consistently less likely to be admitted to the hospital or to use the emergency department. So we will expand this program citywide.

Put substance abuse services where they are needed. The city has scores of free or low-costs drug and alcohol abuse clinics and treatment centers, but many are not located in areas where they are most needed, and they tend to be clustered around places like 125th Street in Harlem. I will launch a citywide program to evaluate the location of substance abuse clinics and make sure they are adequately spread out to support people in all parts of New York City.

I would eliminate ThriveNYC and integrate its intent/reallocate its funding to mental health resources in underserved communities and the school system.      

The pandemic has forced healthcare providers to shift much of their psychiatric care to telehealth platforms to ensure their work with homeless and formerly homeless New Yorkers undergoing psychiatric care could continue to be safely cared for. This allowed them to reach more people, in more places, in a more flexible way. Virtual visits helped them maintain better continuity of care for patients.  

We should embrace this trend and strive to use it to help as many struggling New Yorkers as possible, We have the resources to get them care and get them housed, we need it is only a matter of managing, delegating, and making it happen.    

New York City’s mentally ill need better care and greater supervision. I plan to provide that by strengthening outpatient commitment through the highly successful Kendra's Law program and rebuilding New York’s inpatient capacity at general hospitals and state-run psychiatric centers. Inpatient psychiatric beds, which were already in short supply pre-Covid have been cut down, that needs to change.    

With limited training, we ask our police to do the work of psychologists, social workers, and psychiatrists. They are asked to clean up for society’s lack of investment in mental health, education, and economic opportunity. This needs to change. Continuing to ask them to handle overdoses, mental health crises, or homelessness is unreasonable and unfeasible. That is why I am in favor of re-allocation at least $1.3 billion away from the NYPD budget towards community-based Mental Health crisis response and restorative justice.  

• 10,000 new beds for homeless mentally ill, in partnership with CBOs and non-profits 
• Unarmed Rapid Response Teams to address mental health crises
• More mental health and guidance counselors in schools, ideally no fewer than 1 per 250 students 

Tackle the growing mental health crisis

Prior to the pandemic, our city was already grappling with a growing mental health crisis, with the number of mental-health-related 911 calls increasing by 23% from 2015 to 2018 and nearly one in ten New Yorkers reporting having depression... In order to ensure that New Yorkers are getting the help they need in moments of crisis, we must move mental health response entirely into the domain of public health and away from law enforcement, and adjust City resources accordingly.

In order to carry out a comprehensive and aggressive response to this crisis, the Donovan administration will create a mental health interagency council, led by commissioners of key agencies such as the Department of Health and Mental Hygiene, the Department of Education, the Administration for Children’s Services, and the Deputy Mayor for Health and Human Services. Our three-step approach will focus on identifying and preventing mental illness, strengthening treatment, and improving crisis interventions.

Address the growing mental health crisis with compassion and urgency

• Embed mental health resources in schools to provide social-emotional support and connect students to the care they need. More than 4,000 students have lost a parent to COVID-19. Mental health will be one of the most important areas of focus to ensure students with interrupted education can get back on track to succeed.
• There is no one size fits all approach for mental health. We will expand and invest in proven community-based approaches to help New Yorkers living with serious mental illness, including Assertive Community Treatment (ACT) teams, intensive outpatient approaches and Kendra’s Law / Assisted Outpatient Treatment (AOT).
• Intervene in mental health crises before they require police involvement. Reduce response times for mobile crisis teams to provide stabilization when it is most needed, and connect teams to options beyond 911 when follow-up is needed.
• Embed qualified professionals focused on mental health alongside police officers who are responding to 911 calls to help address non-violent situations.
   
• Open Overdose Prevention Centers to expand on the City’s harm reduction approach, prevent overdose deaths, and reduce public drug use

Create "Emergency Social Services," a citywide network of 24/7 emergency response units for mental health, homelessness, and substance misuse calls 

There is no reason New York City cannot deploy social services at the same speed we currently deploy police. Yet the city’s mental health crisis response service is designed for response times as long as two hours even when it operates at peak efficiency. That delay is unacceptable to someone in the midst of a mental health crisis, an overdose, or any New Yorker concerned enough to place that 911 call in the first place. And in too many cases it means that a police officer is called to the scene instead.

To address this, Ray will create a citywide system of Emergency Social Services (ESS) operating 24 hours a day who will respond to all 911 calls that relate to mental health or substance misuse issues. This will also provide a non-police response to calls regarding people experiencing homelessness. Ray will also fund local support centers around the city to assess and refer individuals that can be stabilized without a trip to the emergency room.

Similar units have shown promising results in other U.S. cities even when utilized in a limited capacity. Ray will ensure ESS units are operating in every precinct in the five boroughs by 2023. Initial estimates suggest a 24/7 behavioral health emergency response program could be fully funded for $150 million annually.

In addition to Emergency Social Service teams, Ray will invest in mental health, homelessness and youth services specialists embedded at the precinct level in every community to proactively engage with at-risk community members. These individuals will operate in tandem with the police to facilitate cooperation, referrals and follow up. In addition, Ray will ensure that all police officers receive crisis intervention training, so that they can more effectively diffuse sensitive situations and help New Yorkers in crisis.

Mental health is the “invisible” crisis behind the pandemic. It was a crisis before March 2020, and COVID has only deepened the problem. No recovery for the city will be complete without taking mental health into serious consideration, especially the mental health of our youth. Accessing mental health resources can be an incredible challenge, particularly for low-income New Yorkers who may not have the resources to afford life-saving therapy or psychological services. As Mayor, I commit to making care more accessible. One of the primary ways that I will do this is by reallocating money that has historically gone to upholding structures of policing, and instead allocate that money to social services, including by building upon ThriveNYC. I will ensure all schools have social workers employed so students can access care quickly and easily. Outside of schools, we must expand the availability of individual, group, and peer-led mental health supports and increase local community access by providing these services in the city’s integrated community health clinics, which predominantly serve working class communities of color.  

Confront our unprecedented mental health and substance use crises

Scott will dismantle the ineffective ThriveNYC structure and build a true, worldclass program that can support the mental health needs of all New Yorkers; invest more in programs for those struggling with serious mental illness; expand access to mental health care by redesigning the Mental Health Services Corp; expand early prevention and intervention programs for mental health, including through investment in school-based mental health services across the city; reduce barriers to entry for New Yorkers who need behavioral health supportive housing, in collaboration with the state; and fight the opioid epidemic by investing in the Healing NYC overdose death prevention program. 

• Revitalize the Mental Health Service Corps (MHSC) program
• Expand availability of telemental health services in the H+H system
• Provide mental health services through the H+H system for all frontline healthcare workers and other essential workers
• Expand the licensed behavioral health peer workforce within H+H
• Refocus on serious mental illness (SMI)
• Address the social and emotional health needs of students with real, on-theground professionals in every school
• Transform our mental health crisis response system
• Expand behavioral health supportive housing
• • Fight the opioid epidemic

Covid has had a devastating mental health impact on residents of New York City. Death, economic hardship, loss of experience, survivors’ guilt and uncertainty are commonplace for so many New Yorkers....we must take a holistic approach to our City’s recovery that includes investing in mental health services, with a focus on the needs of young people and improving our City’s crisis response system.

Expand the number of social workers, mental health providers and school-based mental health centers in New York City schools
We must dramatically expand the number of social workers and mental health providers who provide services in schools. School-based health centers (SBHCs) are proven to provide much-needed healthcare for young people, including mental health care. A Yang administration will expand SBHCs so all young people receive the critical care they need.

Create 21st century mental health rapid response service
A Yang administration will dramatically expand non-police responses to those in distress by expanding HOME-STAT, investing in community safety efforts at the local level, and empowering neighborhood networks of rapid response providers to get people in distress the care that they need.

Expand number of psychiatric beds
While we continue to deliver excellent outpatient psychiatric services to New Yorkers, a Yang Administration will work with H+H to expand the number of psychiatric beds by 20%.