Gotham Gazette https://www.gothamgazette.com/component/tags/tag/104 Wed, 20 Nov 2019 11:58:57 +0000 Joomla! - Open Source Content Management en-gb webmaster@gothamgazette.com (Webmaster) Looking Back at Mayor David Dinkins, 30 Years After His Historic 1989 Win https://www.gothamgazette.com/city/8757-looking-back-at-mayor-david-dinkins-30-years-after-his-historic-1989-win https://www.gothamgazette.com/city/8757-looking-back-at-mayor-david-dinkins-30-years-after-his-historic-1989-win 32392339708 d8626a56ce z

Former Mayor David Dinkins (photo: Ed Reed/Mayor's Office)


 On the night of November 7, 1989, then-Manhattan Borough President David Dinkins made history. With election night returns coming in, it became clear that Dinkins had narrowly defeated then-U.S. Attorney Rudy Giuliani and would become the first black mayor of New York City. It was the culmination of an arduous election cycle for Dinkins, having beaten incumbent Mayor Ed Koch in the Democratic primary two months earlier.

Now, with the 30th anniversary of that momentous election, the Max & Murphy podcast decided to look back on Dinkins’ victory, tenure, and defeat by Giuliani in 1993. Gotham Gazette’s Ben Max and City Limits’ Jarrett Murphy spoke with Dinkins, now 92 years old, in his office at Columbia University to hear his thoughts on his career and life.

The show also featured legendary journalist Tom Robbins, who covered Dinkins’ elections and one term as mayor from his perches at the Village Voice and New York Daily News, with his reflections on Dinkins’ rise and fall, and how he should be remembered.

David Dinkins on His Mayoralty and Legacy
As with nearly any politician, David Dinkins is best remembered for the highest office he held: that of New York City mayor, from 1990 through 1993. But to hear Dinkins tell it, he never had his sights set on Gracie Mansion. Instead, becoming Manhattan Borough President, a seat he first won in 1985, was all he ever really wanted.

“From my perspective,” Dinkins said, “I had achieved what I wanted. I’m borough president of Manhattan, this is as good as it gets. I never ever said, gee, I want to be mayor of New York City. That didn’t cross my mind.”

Borough President was an office that Dinkins had worked hard to reach, only succeeding on his third attempt. He quipped, “People used to say to me, ‘What do you do?’ I said, ‘I run for borough president.’” But, although he liked his then-powerful job (the role of borough president has since been weakened significantly through changes to the city charter), he conceded that “We needed somebody to defeat the mayor, Ed Koch.”

At the time, Koch was serving his third term, which was beset with a slew of corruption scandals across several city agencies and ensnaring several allies of the mayor, though he himself was never accused of criminal wrongdoing. He had also become increasingly unpopular among black New Yorkers, paving the way for Dinkins’ victory.

“After having worked so hard to become borough president,” he continued, “to run for mayor was not automatic in my mind. In a sense I was drafted. My supporters insisted that I run, I said OK, and as luck would have it we prevailed.”

Once he took office as mayor, Dinkins faced an immediate set of challenges, most prominently high crime rates, but also growing homelessness, budget deficits, and more. “You didn’t need to be a genius to see that this [crime] was an area that you had to attack,” Dinkins said. “And we did. Largely, by going to Albany and persuading the Legislature that they should give us the resources…To get the money, we had to go to Albany, hat-in-hand.”

Dinkins oversaw new programs such as “Safe Streets, Safe City,” which added thousands of new cops to the police force. He also created the current all-civilian structure of the Civilian Complaint Review Board – a quasi-independent city agency that monitors and investigates complaints of police officer misconduct – and significantly strengthened its powers to combat abuses of power by the police. Though his tenure saw New York City’s highest-ever murder rate in 1990, it fell every successive year of his term, and overall major crime dropped throughout Dinkins’ final three years.

“We had to do what we did, that was what was required, irrespective of what my own political fate was gonna be down the line,” Dinkins insisted. “I mean, the city needed it. We needed more police officers…People were dying. It was tough.”

When asked about his top priorities while in office, Dinkins centered children and families. “I’m a nut for kids,” he said. “Little ones, middle-sized ones, big ones, I’m very fond of children and young people. So that was very important to me that we be as responsive as was possible to the needs of young people.”

“Sometimes people ask me what I want to be remembered for,” he said later. “And I always say, I want to be remembered as somebody who cared about people, especially children.”

Dinkins’ tenure had its fair share of difficulties, perhaps most infamously the Crown Heights riots of 1991, but he credits his team with getting him and the city through those years.

“We had the deficits to face and all, but we left in far better shape than when we started. But the key is the people,” he reminisced. “It really is. And I don’t say this out of modesty or something, it really honest to God is the people. If you’ve got good folks, you can do almost anything. And we had good people. Women and men, young and old, and they were terrific. And we believed in each other. They had faith in me, and I had faith in them.”

In his office, Dinkins was surrounded by pictures and memories of those people he credits with lifting him up. Photos of strategist Bill Lynch, whom he and many others most credit for his 1989 victory; singer Harry Belafonte; Manhattan Borough President Percy Sutton; Judge Fritz Alexander; labor leader Victor Gotbaum; tennis star Arthur Ashe; South African President Nelson Mandela, whom Dinkins famously hosted in New York City in 1990; and President Barack Obama all lined Dinkins’ walls.

Asked if he had any regrets, Dinkins simply said, “No.”

It’s now been more than 25 years since Dinkins last ran for office, but he continues to be active in the world of New York politics, lending his endorsement to Governor Andrew Cuomo and other New York political figures as recently as 2018. His legacy will also live on in the David N. Dinkins Municipal Building at 1 Centre Street, renamed for him in 2015 by Mayor Bill de Blasio, who worked for Dinkins at City Hall, and home to the offices of the Manhattan Borough President, the Public Advocate, the city Comptroller, and many others.

“Gosh, I’d have been happy with a lamppost!” he gushed. “But this is terrific, so I’m very pleased about that.”

For his successor in the mayor’s office, Dinkins did not mince words. “I was never very fond of him [Giuliani] anyway,” he said. “So from time to time, these days, things happen, and people complain about him, and I say, ‘See, I told you!’”

But Dinkins is far more pleased with de Blasio, who began his political career as a Dinkins campaign volunteer and later served as a staffer in his administration. “I have great pride in what he’s able to do,” Dinkins said when asked about de Blasio and whether he sees de Blasio’s mayoralty as something of an extension of his, “but I don’t say it’s because of our administration or anything like that.”

In 2013, de Blasio was the first person elected mayor of New York City as a Democrat since Dinkins.

Dinkins also had weighed in on the potential field of candidates for the approaching 2021 mayoral election, though he didn’t go into specifics. “I just hope that we have somebody who really cares about the same kinds of things that I care about,” he said. “I don’t know who the candidates are gonna be, but whoever it is, I hope they recognize what a magnificent city this is.”

[LISTEN to the full interview with former Mayor David Dinkins]

Tom Robbins on Dinkins
Robbins, a veteran New York political reporter who frequently covered Dinkins, offered his perspective on Dinkins’ 1989 win, years as mayor, and 1993 loss. For Robbins, Dinkins was a mayor who did many of the right things, but didn’t have the political instincts necessary for greater success in the job.

“I think [Bill Lynch] recognized in Dinkins somebody whose essential decency and non-threatening demeanor could play well into the time,” Robbins said. “In retrospect, what could have been, there were other people from that ilk that Dinkins represented who probably would have been much better at the job of mayor,” he said, pointing to Manhattan Borough President Percy Sutton, former state Senator Basil Paterson (father of former Governor David Paterson and once a deputy mayor under Koch), and longtime U.S. Representative Charlie Rangel as three examples, all of whom were Dinkins allies.

“I think any one of those guys had a bigger understanding of politics,” he said. “They understood what it meant, and how to hold the reins of power. And Dinkins had trouble with that. We saw that almost as soon as he came into office.”

Before Dinkins could be elected, however, he first had to defeat the incumbent, Ed Koch. The previously unbeatable Koch was mired in a wide-ranging corruption scandal in his third term.

“Koch was just reeling,” as Robbins characterized it. “I mean, you could see him during the press conferences. He just was staggered by some of the things that were coming to light, that he clearly had had no idea about.”

“That segment of white voters were disenchanted because of the corruption issue,” he continued, “and there was widespread antipathy against him because of the racial unrest that he had seemed to have a tin ear to. So yeah, he was vulnerable, and David Dinkins decided he was gonna run against him.”

After Dinkins got past Koch in the primary and Giuliani in the general election, “he knew that he was gonna have to scramble, and that there were gonna be layoffs, and that he was gonna have difficulty doing new contracts with the unions,” Robbins said. “This guy had, I think, a lot of strikes against him that made it much harder, and he needed a political understanding of that.”

In spite of these criticisms, however, Robbins had praise for several aspects of Dinkins’ administration.

“Some of the people that he brought into city government in that first wave were some of the best civil servants that I think we’ve ever seen in this city,” Robbins said, echoing Dinkins’ effusive praise for his team.

Robbins also brought up Dinkins’ changes to the CCRB, his Safe Streets, Safe City program, and his targeting of squeegee men as examples of his successes. As Robbins noted, many of the gains the city made and since credited to Rudy Giuliani actually began under Dinkins. “He never really got credit for that,” Robbins argued about the reductions in crime and disorder. “A more savvy political operative, I think, would have figured out how to use that to your advantage.”

Robbins wrote many stories for the New York Daily News on Dinkins, including one he brought up during the interview on Max & Murphy: a lengthy piece on Dinkins’ daily schedule that was often cited as evidence that Dinkins was not the most attentive, hard-working mayor he could be.

“Dinkins was never as comfortable with the press,” Robbins said. “He never really was able to establish himself in a good relationship. There were lots of things to pick at. And I did some of the picking.”

“They had a perspective from the [Daily News editorial] desk, which was, this guy’s really not doing any heavy lifting here,” Robbins recalled. “Dinkins, for his sanity, needed to play tennis in the morning, so that’s what he did. And he did it in time to get to work at 9, the same time most people get to work. But so the story also showed that, about 5 o’clock everyday, he would put on the tux [for evening events]. And we would take these famous photographs that were unmistakable.”

Robbins said that this coverage led to a broader perception that Dinkins was too soft. “You want someone who’s gonna be a tiger, right? You want a mayor who’s so into the job that he can really be a [former Mayor Fiorello] La Guardia, rushing around to fires, that’s what New Yorkers want. And he wasn’t that.”

However, looking back on the administrations that came before and after Dinkins, Robbins was resolute: “David Dinkins remains my favorite mayor.”

“I think that’s shown through his policies,” he elaborated, “his attitude on the homeless, his attitude about creating low-income housing back then. Look, he didn’t just hire new cops. He decided he was going to keep high schools open every night so that kids could have someplace to go. He created Beacon Schools, which still exist. He created the Civilian Complaint Review Board...He created almost two dozen health clinics as a way to channel people away from the ERs in hospitals, another way to deal with practical medicine needs. I thought it was a great chapter in the city.”

“It was only four years and mistakes were made,” Robbins said, “but I think that during that time New York began to be the kind of city it could be.”

[LISTEN to the full conversations with David Dinkins and Tom Robbins]

***
by Joey Fox, Gotham Gazette

Read more by this writer.

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Looking Back at Mayor David Dinkins, 30 Years After His Historic 1989 Win Sun, 25 Aug 2019 22:46:37 +0000
De Blasio’s Promised ‘Comprehensive Strategy’ for City Response to People in Mental Health Crisis is Well Behind Schedule https://www.gothamgazette.com/city/8754-de-blasio-s-promised-comprehensive-strategy-for-city-response-to-people-in-mental-health-crisis-is-well-behind-schedule https://www.gothamgazette.com/city/8754-de-blasio-s-promised-comprehensive-strategy-for-city-response-to-people-in-mental-health-crisis-is-well-behind-schedule ca nyc mental

Community Access members rally at City Hall (photo: @ca_nyc)


A task force empaneled by Mayor Bill de Blasio to recommend how city government, particularly the police department, can better respond to emotionally disturbed people in crisis has yet to release its report, about 10 months after its work was to be concluded.

Calls from community leaders and activists have grown, but the “NYC Crisis Prevention and Response Task Force” remains largely silent, leading advocates and elected officials to wonder why the issue isn’t a higher priority for a city that has seen 14 mentally ill people killed by police officers in “EDP” calls since Crisis Intervention Training began in 2015.

It was created on April 19, 2018 by the mayor and First Lady Chirlane McCray, who leads the administration’s mental health programming, in order to look at how New York City cares for emotionally disturbed people, who are often people diagnosed with serious mental illnesses such as bipolar disorder or schizophrenia, when they are experiencing a crisis moment like exhibiting violent or erratic behavior.

The release said it would be “a 180 day effort.” If true that would have landed its conclusion at mid-October of last year. With a couple months for internal consideration and publication of next steps, advocates, elected officials, and service-providers expected something from City Hall at the start of this year. As September approaches, there have been no signs of the task force’s final recommendations or a plan from the de Blasio administration.

“At the end of 180 days, the City will announce a citywide strategy to improve NYC’s mental health crisis system,” the press release said.

In that April 2018 press release announcing the task force, there were four stated goals: “prevent mental health crises before they happen”; “enhance coordination between the city’s safety and health systems”; “enhance ongoing support to reduce mental health crises over the long-term”; and “share data across systems to refine approach over time.”

“As a City, we have completely overhauled how we address mental health to shatter stigma and increase access to care,” de Blasio said in the release. “Now, we must do the same for when a New Yorker is at risk of experiencing a mental health crisis. I’ve charged this Task Force with developing a comprehensive strategy to prevent these situations from escalating and enhance the City’s crisis response system. These recommendations will keep our neighborhoods and our most vulnerable New Yorkers safe.”

The task force was to be chaired by top City Hall officials, with McCray as an “honorary co-chair,” and the work led by the Police Department and Department of Health and Mental Hygiene, with involvement from a variety of other city agencies and offices.

The working groups of the task force, which included around 75-80 people from a broad swath of organizations that have some involvement with people’s mental illness and/or policing, submitted recommendations to the task force’s advisory group in January. The advisory group included city leaders like NYPD Commissioner James O’Neill, now executive director of ThriveNYC Susan Herman, various deputy mayors, and others.

Crisis Intervention Training (CIT) was designed to give police officers better tools to de-escalate situations involving emotionally disturbed people. Over the past ten years, police officers have been forced to handle these situations more and more. According to a report by THE CITY, EDP calls to 911 have risen dramatically since 2009, from 97,000 to nearly 180,000 in 2018.

When someone calls 911 about a person in emotional or psychological crisis, the current NYPD response consists of sending police officers and Emergency Medical Services, but critics say this protocol falls well short in ensuring safety and care, as evidenced by the 14 deaths over the last four-plus years. Currently, the city focuses more on preventing crisis than what to do during a crisis, which is in part what this task force was created to address.

"The Task Force was very much centered on prevention, as well as ensuring that, post-crisis, people are connected to care and their life stabilizes in such a way that they are less likely to be in an emergency situation in the future," Herman, now of ThriveNYC and formerly of the NYPD, told Gotham Gazette. During the August 6 interview, Herman said the task force's report is expected within about a month but did not provide any specifics. 

ThriveNYC, McCray’s mental health “roadmap” programming, utilizes two major options to prevent a mentally ill person from reaching a crisis point. First, Thrive funds about six co-response teams a day. The co-response teams are a proactive intervention for people who neighbors, bystanders, local service providers, or police believe may be demonstrating escalating tendencies towards violence. The co-response teams -- consisting of two police officers and a medical clinician -- can find that person and connect them to care and appear successful: 82% of the people co-response teams attempt to engage are successfully connected or re-connected to care or another stabilizing support such as housing or family.

Second, the city operates Health Engagement and Assessment Teams (HEAT) teams which are a health help-only response in that they don’t involve police officers. HEAT teams are called by police, or local agencies such as the Department of Homeless Services. Thrive also operates various ACT teams, which provide mobile outpatient care to those with mental illness but are not designed to respond to crises.

One recommendation by mental health advocates would make the co-response teams a 911 response. For example, when someone calls 911 regarding a mentally ill person in the midst of a crisis, 911 operators could send a clinician with a police officer to handle the situation.

"When someone is thought to be mentally ill,” said Herman, “and has already demonstrated escalating levels of violence, co-response Teams of police and clinicians can provide an important intervention. Currently, co-response teams do not respond directly to 911 calls. These teams are a proactive intervention when homeless services, police, probation, or a local clinic or social services provider has said someone is mentally ill and they worry they are getting increasingly violent. This is an intervention to avert a crisis, not to end an emergency.”

CIT training has been slow to wind its way through the NYPD. According to that same report by The CITY, as of this past March, 11,970 of the NYPD’s nearly 36,753 officers have received Crisis Intervention Training.

However, some advocates like Carla Rabinowitz, advocacy coordinator of the nonprofit Community Access, don’t think training every NYPD officer is enough: they don’t want police officers involved in EDP calls at all.

“One of our main concerns,” she told Gotham Gazette, “is that we don’t want the police responding anymore, there have just been too many incidents. We don’t feel it’s right for the police, not fair to them, it’s not fair to the families to only be able to call the police. It’s scary for families, they don’t want to call the police. They want an alternative. They want someone to come who is going to take care of their health care, not who is going to force them to the ground.”

“It’s like sending in a mechanic to do what a heart surgeon should do. You want people who know how to de-escalate, who are very familiar with mental health…you don’t want militarized force. It’s not the response.”

Another change Community Access is calling for is a non-911 number to call for people in crisis. That number could effectively take police out of the equation altogether. ThriveNYC currently operates NYC Well, a mental health tele-helpline that people with any type of mental health issue can call to talk to somebody or get connected to care. NYC Well currently has the ability to dispatch mobile crisis teams, or police with Emergency Medical Services.

No matter what the task force recommends, Rabinowitz of Community Access, which was part of the working groups, doesn’t think enough mental health “peers” were involved in the process.

“There were a lot of people on this task force, and we credit the mayor for creating this task force, the problem is…we still haven’t seen the recommendations yet,” said Rabinowitz. “And the thing we’re concerned about is on the task force there weren’t that many people with lived experience, what we call ‘peers.’ And the task force was trying to help people who were encountering the police who were mental health recipients.”

Herman disputed the criticism: "Peers played a critical role in the Task Force, as did community advocates. We have had several separate meetings with community advocates as well. There was also a Task Force subcommittee on community engagement."

Public Advocate Jumaane Williams has been an outspoken critic of the city’s response to EDP calls. In a rally hosted by Community Access on the steps of City Hall in April of this year to mourn the one-year anniversary of both the creation of the task force that had not yet produced results and the death of Saheed Vassell, a 34-year-old mentally ill man killed by police officers, which sparked the creation of the task force, Williams said, “When it comes to issues of policing, transparency, accountability, when it comes to how emotionally disturbed persons are dealt with in this city, from the beginning to when police are called to try to fix all the problems, it is this mayor and this administration that has the accountability and the successes, and unfortunately mostly failures. He has to be held accountable.”

“When loved ones call for assistance, their loved ones need not be killed by officers who are improperly trained and do not have the tools and are not equipped to deal with medical emergencies. We are failing everyone in this system and I blame it now in totality on this administration.”

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by Truman Stephens, Gotham Gazette

Read more by this writer.

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De Blasio’s Promised ‘Comprehensive Strategy’ for City Response to People in Mental Health Crisis is Well Behind Schedule Thu, 22 Aug 2019 04:00:00 +0000
‘Nobody Should Enter the Criminal Justice System for Something Related to Mental Illness’ https://www.gothamgazette.com/state/8705-new-york-criminal-justice-system-mental-illness-thrive-nyc https://www.gothamgazette.com/state/8705-new-york-criminal-justice-system-mental-illness-thrive-nyc first lady chirl mcc first

Chirlane McCray on Rikers Island (photo: Michael Appleton/Mayor's Office)


A rising number of 911 calls to report emotionally disturbed persons, several fatal encounters between police officers and people with serious mental illness, and an increasing percentage of seriously mentally ill people among those detained in city jails have all raised questions about how New York City and State provide care for those suffering from the most serious mental illnesses.

These questions and concerns don’t have easy answers. The city’s public hospital system, NYC Health + Hospitals; the mayor’s mental health care roadmap, ThriveNYC; services from the city’s Department of Health and Mental Hygiene; treatment within the city Department of Correction; private clinics; mental health shelters; and more combine to create a complex and stratified framework for treating those with a serious mental illness (SMI).

For some, much of what is at times called a crisis of treatment for those with serious mental illnesses like schizophrenia can be traced to the trend whereby the state closed down psychiatric hospitals with many thousands of inpatient beds while requisite treatment systems were not put into place to help people who would no longer be institutionalized, many of them cycling through the criminal justice system and inappropriately receiving their best mental health care while in jail.

There is insufficient use of mandatory outpatient treatment, some critics of the city and state say, with significant recent criticism also aimed at Mayor Bill de Blasio and First Lady Chirlane McCray over how resources have been allocated in their signature ThriveNYC program. Meanwhile, others have focused on questioning that police officers with guns are often first responders to people experiencing a serious mental health crisis, and those critics have been successful to some extent in getting protocols changed, though they say there is clearly more to do.

Dr. Mitchell Katz, president and CEO of NYC Health + Hospitals, says he’s troubled by the gaps in treatment and looking for new answers that would require the city and state to work together.

“The problem with the current mental health system, from my point of view, is for people with serious mental illness, the people we most worry about, the people we sometimes see on the subway or sitting on the bench, that right now there is nothing in between acute hospitalization and traditional outpatient care,” he said in April during an appearance hosted by the Citizens Budget Commission (CBC), a nonprofit think tank.

During an interview after the CBC event on the What’s The [Data] Point? podcast from CBC and Gotham Gazette, Katz was asked for more on his view about how to fill that gap.

He said H+H is working with the state on fixing a system that “drops off too precipitously.” Katz said he was in discussions to create programming to increase services for those who don’t qualify or don’t want to be admitted for inpatient care at a hospital but don’t receive enough treatment or care in the current outpatient system.

“We know in New York City there is a group of people with very serious mental health and addiction problems who rotate between the acute hospital, the shelter, and the jail,” he said on the podcast. “They don’t need to be locked up but let’s provide them a positive residential program that they want to stay at because it’s better than shelter and it’s better than the jail when we know that there are people who get arrested in order to be taken care of in jail.”

Over the course of months since Katz’s April comments, Gotham Gazette reached out multiple times to New York City Health + Hospitals and the Mayor’s Office but didn’t receive any further details on Katz’s vision for the program or whether there are ongoing discussions to make it a reality. State law and the state Office of Mental Health (OMH) have near full authority over the types of mental health treatment options allowed throughout the state, and are essential to the discussion, as Katz indicated.

In a statement to Gotham Gazette, a spokesperson for the New York State Office of Mental Health said, “as New York State continues to transform its mental health system to serve more individuals in the least-restrictive setting possible, we are expanding our reach through community-based services. These treatment models allow people to stay in the communities where they are best supported.”

Serious mental illnesses are not the types of mental illnesses and mental health issues that plague a little under 50 million Americans; according to the National Institute of Mental Health, about 4.5% of American adults have a serious mental illness -- meaning roughly 239,000 New Yorkers based on population statistics.

The three most common SMIs are schizophrenia, bipolar disorder, and major depression – less severe depression and anxiety are not categorized as serious mental illnesses although both the National Institute of Mental Health and the Substance Abuse and Mental Health Services Administration (SAMHSA) agree there is some ambiguity in the cut-off line for what’s considered a “serious” mental illness. It’s also important to note that there are complications with the term “serious mental illness”; it is not a diagnosis itself, but a level of disability or a threshold for having a particularly significant and debilitating mental illness.

In asking how New York treats those estimated 239,000 New Yorkers, there are the unavoidable questions of where they can and should be treated, as Katz indicated. Back in the early 20th century, many people with SMIs were admitted into state psychiatric centers, more commonly known as “insane asylums”; however, over the past 80 years there has been a major shift in placing those with serious mentally illness into inpatient treatment.

In the 1950s, New York began deinstitutionalization – a shift from inpatient care (a patient admitted into a hospital full-time) to community-based outpatient care. According to a 2018 report by Manhattan Institute senior fellow Stephen Eide, the process of deinstitutionalization continues to this day but may have gone too far. According to the report, the city’s public hospital and health care system, NYC Health + Hospitals, is the leading provider of inpatient psychiatric care in the city with only 1,218 beds dedicated to adult inpatient psychiatric care, representing 48% of adult inpatient beds in the city. State psychiatric centers in the city account for 1,058 adult inpatient beds.

ThriveNYC, led by McCray, has come under fire on multiple fronts, including general money mismanagement and lack of clear outcome-tracking, but also for how it helps -- or doesn’t help -- those with serious mental illnesses. During a City Council budget and oversight hearing on March 26, McCray was pressed on the issue several times, including pointed questions about how much of the ThriveNYC budget is dedicated toward treatment for those with SMIs.

At one point she said, “All of Thrive is really focused on the seriously mentally ill,” but she and others who testified about the program eventually offered more clarity.

Thrive, which is called a “roadmap” and spends around $200 million per year on programming and coordination, does include services solely focused on those with serious mental illness, but its main objective is to plug gaps of already existing services run by H+H and the city Department of Health and Mental Hygiene (DOHMH), while reorienting health care to always include mental health care and extend awareness and treatment into all of the city’s communities.

“Thrive is dedicated to prevention when possible, early prevention, treating people in crisis, and making sure people are stabilized when they do reach a crisis point,” McCray said. In arguing that all of Thrive is aimed at serious mental illness, she argued that untreated lower-level mental health issues can spiral.

Thrive, in the context of treating those with SMIs, is criticized for focusing more on mental health rather than mental illness; most of its 54 initiatives are focused on combating stigma, the negative factors that can lead to mental illness, and encouraging people to spot mental health issues in others and themselves, and to seek help.

In a May op-ed in the New York Post, DJ Jaffe, the executive director of Mental Illness Policy Org, and Eide of the Manhattan Institute called for the reallocation of ThriveNYC’s entire budget to focus on those with serious mental illness. They offered specific ways in which to redirect funding into different programs, such as enhancing existing crisis intervention teams, creating an office to exclusively manage the use of Kendra’s Law in New York CIty, and promoting supportive housing for homeless people with serious mental illnesses.

“The most serious cases are the ones most likely to become homeless, arrested, incarcerated, hospitalized and violent if they go untreated,” they wrote. “Yet Thrive virtually ignores this group in favor of people with less severe illnesses.”

Susan Herman, the recently-appointed executive director of ThriveNYC, said during the March testimony, “we are filling strategic gaps and piloting innovative programs for the seriously mentally ill to be able to work with people so they can stay in community by connecting them to services, by helping them connect or reconnect to treatment. We’re helping people both before crisis and after crisis.”

For example, McCray said in an op-ed in New York Daily News that Thrive adds $30 million of funding (about 15% of its budget) to the $300 million the Department of Health and Mental Hygiene already spends directly to help people with SMIs.

“Thrive-supported programs are designed to enhance and complement these existing services, not compete with or replace them,” she wrote.

For someone who voluntarily requests care, they can go to a public hospital for informal short-term hospital care as well as traditional outpatient care. The average stay for someone hospitalized for mental illness is 11 days, according to the New York City Department of Health and Mental Hygiene.

Outpatient care -- preferred by many for its community-based nature -- consists of things like meeting with a therapist or a psychiatrist and getting medication prescribed. Influential 1999 Supreme Court case Olmstead v. L.C. ruled public entities must provide community-based services to those with mental illness whenever possible.

“Lots of people have schizophrenia,” says Dr. Gary Belkin, Executive Deputy Commissioner for Health and Mental Hygiene in the city's Health Department and Chief of Policy and Strategy of ThriveNYC, in a phone interview. “The vast majority don’t end up on the street untreated and that’s because there are things that happen earlier, things that Thrive is working on – getting better care connections, having many points of contact, opportunities for family/friends to bring them mobile help."

Thrive has Assertive Community Treatment (ACT) teams dispatched around the city, often in mental health shelters, to treat people with serious mental illness. There are at least 50 ACT teams in New York with the capacity to serve 3,500 people at any time, according to Herman’s March 26 testimony. Thrive also created intensive mobile treatment teams that mostly go to shelters and provide treatment for homeless people. These outreach efforts mostly help people with outpatient care, but can lead to more intensive intervention, though it is very rare for judges to order people into inpatient hospitalization in New York.

Some of these efforts will now be part of ThriveNYC’s recently-announced outcome-tracking procedures, announced in late June.

The key questions, it seems, are whether Thrive’s efforts and the increased emphasis on outpatient programs on the state level -- perhaps including what Katz of H+H said he’d like to see -- can successfully fill gaps left by deinstitutionalization, while creating a more humane care system, and reduce threats posed by those with serious mental illness to themselves and others.

Deinstitutionalization in New York has been drastic. According to Eide’s report, as of November 2018, the average daily number of people in New York state adult psychiatric centers was 2,267. In 1955, there were over 93,000. Even in just the last four years, the number of state inpatient psychiatric beds -- in other words, the capacity for inpatient care -- has dropped by 19% statewide, from 2,866 in 2014 to 2,335 in 2018.

The drop in average daily patients and inpatient beds has coincided with an increase in the number of seriously mentally ill homeless people in New York and the proportion of inmates with a serious mental illness diagnosis in city jails.

According to Eide’s findings, there are more psychiatric beds in New York City mental health shelters than the number of psychiatric beds in state psychiatric centers and Health + Hospitals facilities combined.

Supportive housing, which provides housing and social services for those with serious mental illness, is also seen as a key tool. There are currently 52,000 units of supportive housing statewide, half of which are funded by the state Office of Mental Health (the other half don’t necessarily serve those with mental illness). Supportive housing, which is built and funded by both the city and state, sometimes in conjunction, is typically run by nonprofit providers who provide onsite mental health care, medication delivery systems, and more.

According to testimony given in a May City Council hearing by the Supportive Housing Network of New York, there are around 33,000 units of supportive housing in New York City. Amid calls for more units, both Mayor de Blasio and Governor Andrew Cuomo have made pledges to develop more supportive housing.

In his NYC 15/15 Supportive Housing Initiative announced in November 2015, de Blasio said the city would develop 15,000 additional units of supportive housing over 15 years. Two months later, Governor Cuomo announced his plan to build 20,000 units over the same 15-year timespan. These announcements came after the two were unable to come to an agreement on what have been known for decades as “New York-New York” supportive housing deals whereby the city and state work together to develop thousands of units.

The New York State Senate and Assembly Democratic majorities see a need for more programming aimed at mental health care and housing, too. Earlier this year, the two bodies unanimously passed a bill creating a temporary commission to study what is seen as chronic underfunding for these housing programs. The commission would “provide policy guidance and recommendations relating to the adequacy of funding levels and need for sufficient staffing in all supportive housing under the auspices of the Office of Mental Health.”

According to a June 25 press release from supportive housing provider Bring It Home, “[t]he bill would prompt a study of current funding and staffing levels across the state and investigate ways the state can begin to remedy its years-long failure to adequately fund mental health housing programs.” Advocates are urging Cuomo to sign the bill so the commission can issue its report in time for the next state budget season.

Another discussion that has played out over many years, at the state level especially, is over how to treat individuals who are too sick to seek help.

Per New York State Law, the criteria to involuntarily admit someone due to mental health is fairly strict – the person can’t understand the need for care or presents a substantial harm to self and/or others, among other standards.

According to a 2015 New York City Department of Health and Mental Hygiene report, 40% of adult New Yorkers with serious mental illness didn’t receive medical treatment in the prior year.

Courts can and do order people to outpatient care: assisted outpatient treatment (AOT) is also known in New York as Kendra’s Law. Originally passed in 1999 in New York State (the first law of its kind and emulated in many other states since), Kendra’s Law allows select people close to a mentally ill person to petition the court to mandate a treatment plan for that person. According to OMH’s website, as of Monday (July 29) there were 3,109 people under active court order via Kendra’s Law, 1,377 of them in New York City.

Jaffe of Mental Health Policy Org, a staunch supporter of Kendra’s Law, estimates around 4,000 people should be in mandated treatment under the law. Critics of Kendra’s Law typically accept the principle but say it’s overly strict, such as the need to show an instance of seriously violent behavior in the last four years. Once a petition to mandate care is successfully filed, the chances of the courts granting the petition are extremely high: 90% of Kendra’s Law petitions were granted statewide from July 29, 2018 through Sunday (July 28, 2019), according to OMH’s website.

Kendra’s Law affects a very small population but has shown signs of working: the state Office of Mental Health says for someone who went through an assisted outpatient treatment program, psychiatric hospitalization was reduced by 64% after AOT, incarceration by 72%, and homelessness was reduced by 61%. Jaffe and Eide in their op-ed call for the creation (and funding) of a Kendra’s Law Office to deal solely with helping the city expand its efforts to get more people into Kendra’s Law.

Meanwhile, ThriveNYC offers NYC Well, a mental health helpline that has the ability to dispatch mobile crisis intervention teams to someone experiencing a mental health crisis. The phone line is something that de Blasio and McCray often cite in their public remarks about Thrive and the city’s efforts to improve mental health care.

Another big piece of the current picture of care for those with serious mental illnesses is correctional health services, which have been needed more and more. Although the daily inmate and detainee population in city jails is decreasing, the percentage of those diagnosed with a serious mental illness has gone from 10.2% in city fiscal year 2014 to 14.3% in fiscal year 2018, according to the Mayor’s Management Report.

Dr. Katz  said on What’s the [DATA] Point? that “In the case of correctional health…we know in New York City there is a group of people with very serious mental health and addiction problems who rotate between the acute hospital, the shelter, and the jail.”

One goal of ThriveNYC is to limit the number of people going to jail due to serious mental illness. The city will open two health diversion centers later this year. Announced in late 2018, the diversion centers will provide somewhere for police officers to take someone who has committed a low-level, non-violent crime but they believe is exhibiting behavioral problems due to mental health. The centers will offer mental health treatment and have overnight beds but stays will be capped at five days.

Skeptics of the idea point out that there will only be two diversion centers, one in the Bronx and one in East Harlem, and each center will only serve its specific community. Plus, the centers will have a “no-refusal” policy that could edge out those with serious mental illness if the centers are at capacity. According to Herman at the March City Council hearing, Thrive plans to evaluate the success of the two programs and possibly create more centers next year.

“We want to catch [people] before entry into the criminal justice system,” said Dr. Belkin. “Nobody should enter the criminal justice system for something related to mental illness. We should be able to reach those people so that doesn’t happen, where they can be treated and managed in a health context before they get ensnared in the criminal justice system. I think everyone wants to avoid that path."

Critics argue, as alluded to by Katz and recently brought up during a Council hearing on recidivism of those with mental illness, that mental health services outside of the criminal justice system are less robust than those offered in city jails. According to Katz, “the fact that we make it necessary for some people to commit shoplifting in order to ensure they’re in a safe place, get their meds, get their food, get their house, when we could do that so much less expensively elsewhere is really a condemnation on us.”

Another option, proposed by Jaffe and Eide, is the expansion of mental health courts, which allows judges to divert those with serious mental illness and charged with crimes to treatment instead of jail. They say current mental health courts cannot offer housing to these people, which weakens its effectiveness.

City Council Speaker Corey Johnson is attempting to prevent those with mental illness from going to jail and to ensure they get better treatment instead. In a speech on criminal justice reform on May 16 at John Jay College, he announced the Council will create a program to house 100 people with SMI caught in the criminal justice system and emphasized the 100 beds are a start, but the program will need further investment and focus to add more beds.

Johnson also pointed out how targeting the legal system can keep people with SMI out of jail; he announced the Council will fund a program to connect social workers with defense attorneys to find alternatives to prison. He also previewed the Get Well & Get Out Act, which would require correctional services staff to keep attorneys informed of their clients’ mental health.

The bill was introduced on June 13 by Council Member Margaret Chin of Manhattan and six other Council sponsors, including Speaker Johnson. The Council quickly held a hearing on the bill that was combined with an oversight hearing on recidivism rates for those with mental illness. The bill has not yet received a committee vote.

How the city handles crisis situations including people with serious mental illness has come under increased scrutiny over the last few years. According to the NYPD and an investigation from THE CITY, calls to 911 involving EDP’s, or emotionally disturbed persons, have risen from around 97,000 in 2009 to 180,000 last year. Fourteen people who appeared to be suffering from acute mental illness have been killed by police officers in the past three years.

The extent to which the city’s roughly 37,000-member police force has been trained in crisis prevention is an ongoing issue. THE CITY estimated that only about 11,970 uniformed officers had undergone crisis prevention training at the time of its March reporting.

In April 2018, de Blasio and McCray launched the NYC Crisis Prevention and Response Task Force to create a strategy to better deal with mental health crises in the city. That report was due in January and has not been publicly released. The Task Force consists of leaders from the Department of Health and Mental Hygiene, ThriveNYC, and the NYPD, among others.

McCray in her Daily News op-ed said serious mental illness and EDP calls aren’t as related as they appear.

“Unfortunately, too many people think of serious mental illness as ‘crazy people in the subway,’ or 911 calls involving emotionally disturbed persons. But not everyone sleeping in the subway or on the streets has an illness,” she wrote. “And emotional disturbance describes erratic behavior at a given time — not a chronic disease.”

In an attempt to treat EDPs, Thrive created what it calls co-response teams that proactively send a police officer with a clinician to people who have shown violent tendencies or behavioral problems in the past. The forensic ACT teams, the mobile intervention teams, and the co-response teams are all a part of Thrive’s NYC Safe program.

It’s possible that the program Dr. Katz spoke about in April -- creating a residential program for the seriously mentally ill to fill in the gaps of treatment between outpatient care, inpatient care, and prison -- is what’s called “Intensive Outpatient Treatment,” or IOT, which offers a much higher intensity of services but still in the patient’s community. Patients under IOT would visit a psychiatrist more often and for longer than traditional outpatient programs.

Already existing outpatient programs must apply for a waiver to the state Office of Mental Health for permission to offer an intensive outpatient treatment program. OMH has approved waivers for 35 clinics beginning in August 2017, according to OMH’s website (they are required by state law to publicly release waiver requests and decisions).

Otherwise, the most intensive treatment with the most consistent care can be found in hospitals, prisons, or homeless shelters.

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by Truman Stephens, Gotham Gazette

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‘Nobody Should Enter the Criminal Justice System for Something Related to Mental Illness’ Mon, 29 Jul 2019 04:00:00 +0000
ThriveNYC to Implement New Performance Tracking System Focused on Outcomes https://www.gothamgazette.com/city/8645-thrivenyc-to-implement-new-performance-tracking-system https://www.gothamgazette.com/city/8645-thrivenyc-to-implement-new-performance-tracking-system first lady chirlane mcray deputy mayors comm

Chirlane McCray (photo: Michael Appleton/Mayor's Office)


Following repeated criticism about spending hundreds of millions of dollars with unclear outcomes, ThriveNYC, First Lady Chirlane McCray’s signature mental health initiative, is now publishing nearly 100 metrics to track the performance of dozens of programs that have been launched in the last three years.

The metrics, provided to Gotham Gazette just before their public launch, will show outcomes of programs, not just their reach or the city’s investment into them as has been the case since the inception of ThriveNYC.

Over the last few months, ThriveNYC partnered with the CUNY Institute for State and Local Governance and various city agencies to create 94 performance indicators across the board, and will begin to publish that data on its website starting this fall, with varying timelines depending on individual initiatives.

ThriveNYC will publicly post a detailed description of each initiative, the agency handling the program, and the indicators associated with it. For instance, for NYC Well, the mental health phone helpline run by the Department of Health and Mental Hygiene, ThriveNYC will measure the percentage of callers who say they are satisfied by its services. To measure the Mental Health First Aid training program, the office will look at the percentage of people that say they shared or used the training they received. 

“Now that the programs are implemented and even the ones that are about to launch, we’re putting up the metrics that we’re going to be looking at to see what kind of effect they’re having,” said Susan Herman, ThriveNYC’s director since February, in a phone interview on Thursday. 

Inaugurated in 2015, ThriveNYC was meant as a paradigm shift in how the city handles mental health issues, seeking to tear down stigma around getting mental health care, targeting services at New Yorkers who cannot afford the cost of care or have been long underserved, and ensuring that people of all backgrounds are more attuned to their own mental health needs, as well as those of their friends, family, and colleagues.

With $850 million pledged over four years, the overarching initiative, called a mental health “roadmap,” sought to bring together a range of services, with more than 50 programs (including some that were already running) across a dozen-odd city agencies. McCray has been the face of the program, touting its gospel across the city and in appearances, both with and without Mayor Bill de Blasio, across the country.

But while many have praised the program’s goals, the accountability involved has been vague. In April 2018, McCray said in an interview on the Max & Murphy podcast from Gotham Gazette and City Limits that Thrive would begin a “resetting” phase, including by bringing on its first executive director and tracking more metrics for the various programs. Gotham Gazette reported soon after that many of the ThriveNYC goals were difficult to track and that the budget was opaque.

By February of this year, a second reset began. ThriveNYC became a standalone office housed under the mayor’s office and Susan Herman, a former NYPD deputy commissioner, was named its director and senior advisor to the mayor, with the task of better organizing the effort and ensuring that it had the right structures in place. But several news reports, first in Politico New York and then The New York Times, further pointed out that ThriveNYC was struggling to track and show results despite having spent nearly $600 million.

In March, the New York City Council convened an oversight hearing where they tried to hold McCray and Herman’s feet to the fire, demanding to know if the city was getting the bang for its buck. 

Those answers are now forthcoming, the city says. 

Herman’s first task when she took over ThriveNYC, she said in the interview, was to clarify to the public the scope of ThriveNYC and the services provided under its umbrella. She denied that the metrics were created in response to the criticism the program faced, saying that they couldn’t be established earlier since there was no data to assess and that the various initiatives had to first be up and running.

“First of all we’re measuring the right things at the right time. This is when you start measuring outcomes, when you are fully implemented,” she said. “And I think most researchers would tell you, ‘Yeah this is just exactly when you should be doing exactly what you’re doing.’ And secondly, it’s very important to know that we are also engaged in formal evaluations, many of which are up and running and have been up and running, some of them for over a year, some of them two years, some of them just launched, some of them still to come but we have worked with outside researchers for years to do formal evaluations of Thrive programs and we’ll continue to do that.” 

Michael Jacobson, executive director of the CUNY Institute for State and Local Governance, echoed Herman in a separate interview. “In this kind of work there are generally two kinds of measures for programs and program success: there’s outputs and outcomes,” he said. “Outputs tend to be process-y, like how many meetings did you do, how many contacts, and those are really useful for management. In the end, whether you’re the government or general public, it’s the outcomes that matter. And they’re both more important and usually the trickier thing to measure.”

While McCray and de Blasio have talked extensively about the importance and impact of ThriveNYC, the measures have almost all been outputs, as Jacobson put it, with McCray admitting at the recent Council oversight hearing that limited systems were in place to even try, difficult as it may be, to track outcomes for individuals serviced by Thrive programs.

With the next fiscal year, FY 2020, beginning on Monday, ThriveNYC will also launch new programs, with plans to spend nearly $243 million overall through the course of the year. These programs are expected to have metrics attached, with reports issued quarterly, semi-annually, and annually, depending on the data gathered.

Some are already evident and showing impact. For instance, according to ThriveNYC, 48% of young children receiving mental health treatment for early childhood trauma at seven clinics run by the Department of Health and Mental Hygiene have shown signs of improvement. At 25 Department for the Aging senior centers with on-site mental health clinicians, 56% of seniors receiving treatment have shown improvement in depression symptoms and 65% have shown improvement in anxiety symptoms.

Even the host of new metrics are an “interim” phase, Herman said, which will eventually be followed by broader evaluations of programmatic effects on specific populations -- school students, for example -- and then a holistic review of ThriveNYC’s effect on the entire city. 

Herman couldn’t explain why the city had failed to measure the impact of many of the programs involved that had existed before ThriveNYC, though she said these had not been repackaged but instead enhanced under the de Blasio administration.

“Some of these programs, could some of them have had outcome measures earlier? Perhaps,” she said, “but this is a way of looking at Thrive in total...It’s an important distinction. Because really what people are asking is what’s the impact of Thrive? And at this point what we should be looking at is the impact of each of the initiatives. It’s only later still that we can look at the impact of Thrive on larger populations and eventually on New York as a whole.” 

Jacobson said, “You can start to think about this for any program but you can’t do it until you get some historical data...It couldn’t have been on day one.” 

Part of the failure to show qualitative and quantitative results, Herman said, is because of the nature of ThriveNYC. Akin to other long-term public health programs, it’s hard to gauge in the span of a mayoralty.

“It’s comparable frankly to universal pre-K where you can see the immediate result, you can see that kids are in school, families are happier but, like Headstart, you won’t know the impact on those children’s lives for many years to come,” she said. “And then you see it and it’s very clear. Just like smoking bans, just like trans fats bans, just like universal pre-k. You’re gonna have an impact that you won’t see for years.”

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by Samar Khurshid, senior reporter, Gotham Gazette
     

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ThriveNYC to Implement New Performance Tracking System Focused on Outcomes Fri, 28 Jun 2019 04:00:00 +0000
Charter Revision Commission Urged to Consider Tighter Donation Rules for City-Affiliated Nonprofits https://www.gothamgazette.com/city/7654-charter-revision-commission-urged-to-consider-tighter-donation-rules-for-city-affiliated-nonprofits https://www.gothamgazette.com/city/7654-charter-revision-commission-urged-to-consider-tighter-donation-rules-for-city-affiliated-nonprofits m bdb first lady chirlane

Mayor de Blasio & the Mayor's Fund (photo: Edwin J. Torres/Mayoral Photo Office)


A government reform group is urging Mayor Bill de Blasio’s Charter Revision Commission to explore stronger restrictions on donations to nonprofits affiliated with city agencies, building on a raft of laws passed through the New York City Council and signed by the mayor in 2016, which are set to go into effect next year.

Reinvent Albany, an organization focused on government transparency and accountability, is advocating for greater disclosure requirements and lower limits for donations made to city-affiliated nonprofits by entities and individuals who have contracts and other business with the city and appear on its “doing business” database. One of the most prominent examples of a city nonprofit is the Mayor’s Fund to Advance New York City, which carries out programming through public-private partnerships and raises millions in private funding to do so every year, and is currently chaired by de Blasio’s wife, First Lady Chirlane McCray.

Reinvent Albany will present its recommendations at a public hearing of the mayor’s Charter Revision Commission in Queens on Thursday.

The recommendations are an outgrowth of controversy involving several top elected officials and organizations, most recently in de Blasio’s first term, when he formed a nonprofit called the Campaign for One New York to help promote his political agenda, particularly his push for universal pre-kindergarten and a tax increase to fund it. The group accepted large donations from many wealthy donors and special interests, including labor unions and real estate developers, many of whom had business with the city and had also been backers of the mayor’s electoral campaign. At the time, electoral campaigns were far more restricted in donations they could accept from entities with city business -- no such limits applied to elected official-affiliated nonprofits.

Though it wasn’t required, the mayor disclosed the group’s donors voluntarily every six months. But, the entire scheme invited criticism, and its efforts helped trigger a federal investigation of the mayor and his associates. The investigation eventually closed without charges being filed, but de Blasio and his team were criticized by federal prosecutors as well as the city’s Campaign Finance Board.

In response, the City Council passed a bill to rein in donations to nonprofits affiliated with elected officials, bringing “doing business” donation limits in line with those that apply to electoral campaigns -- just $400 for mayoral candidates -- and putting those nonprofits under the jurisdiction of the Conflicts of Interest Board. In 2019, the COIB will start to issue detailed reports of such nonprofits, including their donors and how much they contributed. The bill, spearheaded by then-Council Speaker Melissa Mark-Viverito, was signed by de Blasio, who called it the right thing to do despite claiming he had done nothing illegal or unethical with the Campaign for One New York.

But the new rules do not cover nonprofits affiliated with city agencies, which, Reinvent Albany points out, number in the hundreds and currently have no “doing business” restrictions.

“We’re increasingly concerned about nonprofits that have existed for years affiliated with city agencies, and donors giving to these nonprofits and having business with those same city agencies,” said Alex Camarda, Reinvent Albany’s senior policy advisor, in a phone interview. The lack of regulation could create the “perception of undue influence, if not actual conflict,” he said. With the mayor having formed a Charter Revision Commission with the express mandate to look at campaign finance reform, the issue appears to be right up the commission’s alley, if not necessarily something de Blasio had in mind.

To close several holes, Reinvent Albany recommends that all donations to nonprofits affiliated with elected officials be capped. The law currently only applies the $400 doing-business cap to those nonprofits that spend more than 10 percent of their budget on public-facing communications featuring the elected official. Camarda said the limit could be higher, though he did not suggest a specific amount.

Further, as Camarda mentioned, the group is calling for expanding donation restrictions to all city agencies, public benefit corporations, public authorities, and local development corporations. “A company that does business with the city could give millions” toward a city agency under the current law, Camarda said. “That’s where we feel the [Council’s law] doesn’t go far enough.

The COIB requires that agencies report any private donations above $5,000 made either to the agency or to an affiliated nonprofit. Those donations are reported in broad ranges that obscure how much an agency has received. For instance, The Fund for Public Schools, a nonprofit tied to the Department of Education, reported more than $4 million in donations from May through September 2017, per the latest disclosures available, including exact donations though it was not required. Reinvent Albany is also pushing for disclosure of all donations in their exact amounts, and on the city’s Open Data portal to allow for easy data analysis.

Finally, the group is calling for the city’s ethics laws to apply to volunteers who are involved in major policy work and senior appointments and that are also fundraising for nonprofits affiliated with electeds. Though their testimony does not say so, the recommendation clearly alludes to First Lady McCray, who has played an increasingly prominent role in de Blasio’s administration, appearing with the mayor at major personnel announcements and continuing to roll out aspects of her main policy and program initiatives. In late 2016, amid investigations into the mayor’s administration, Politico New York reported that the Mayor’s Fund to Advance New York City was more thoroughly vetting donors to avoid potential conflicts. McCray recently told Gotham Gazette and City Limits that she does not worry much about conflicts given that lawyers handle those issues. The Fund provides assistance for programs at 30 city agencies and has played a prominent role in the administration’s ThriveNYC mental health initiative, which was spearheaded by McCray.

“We do not oppose per diem or unpaid volunteers serving on city boards, task forces and commissions, much like the members of this commission,” the Reinvent Albany testimony reads. “But they should not also be fundraising simultaneously for nonprofits affiliated with elected officials.”

The group acknowledged that there were nonetheless nonprofit organizations that may not be covered by any changes they recommend, such as organizations that receive large sums in city funding and whose board members are donors to city elected officials.

“Many of these nonprofits do important work that helps the city,” Camarda said. “We don’t want them to become avenues for companies and wealthy donors to circumvent the campaign finance system.”

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by Samar Khurshid, senior reporter, Gotham Gazette
     

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Charter Revision Commission Urged to Consider Tighter Donation Rules for City-Affiliated Nonprofits Thu, 03 May 2018 04:00:00 +0000
Now ‘Resetting,’ Chirlane McCray’s $850 Million Mental Health Program Has A Lot Riding On It https://www.gothamgazette.com/city/7630-now-resetting-chirlane-mccray-s-850-million-mental-health-program-has-a-lot-riding-on-it https://www.gothamgazette.com/city/7630-now-resetting-chirlane-mccray-s-850-million-mental-health-program-has-a-lot-riding-on-it Chirlane McCray Bill de Blasio

Chirlane McCray, with Bill de Blasio looking on (photo: Benjamin Kanter/Mayor's Office)


On a sunny Wednesday morning in November 2015, more than 30 of New York City’s top public officials gathered together in East Harlem. They stood shoulder-to-shoulder and tiered in three rows on the ground floor of the City University of New York’s school of social work. An audience of hospital administrators, business leaders, mental health advocates and journalists watched from folded seats.

Chirlane McCray, wife of New York City Mayor Bill de Blasio, took the lectern. With a sing-song cadence and emphatic smile, she announced what would become her signature initiative:

“It is my great pleasure to announce the release of ThriveNYC: A mental health roadmap for all,” McCray said. The surrounding group, that included de Blasio and their children, Dante and Chiara, applauded. The plan, she said, is one of action. “It includes an investment of $850 million over four years.”

ThriveNYC is not an organization. Led by McCray, who cannot hold a paid position in the administration due to nepotism laws, Thrive is a “mental health roadmap.” It encompasses 54 mental health-related projects that are being housed across 20-plus city agencies. Richard Buery, former deputy mayor for strategic policy initiatives and Mary Bassett, the commissioner for the Department of Health, have helped spearhead many of the broad-ranging projects.  

With each of the projects, 31 of which previously existed before McCray’s 2015 announcement, the aim has been to address the stigma-laced culture around mental health as well as general barriers in accessing mental health care across the city’s five boroughs. In the two-plus years since McCray announced Thrive, her political profile has boomed and the city has published dozens of metrics meant to indicate the initiatives’ successes.

As even McCray and de Blasio admit, the city still has significant mental-health related issues and a long way to go. The Kaiser Family Foundation, a leading non-profit research organization, found that just 42 percent of the city’s mental health needs were being met as of December 2017.

Recently, a host of high-profile incidents between New Yorkers with mental health disorders and city employees, especially police officers, have topped headlines. In the first week of April, NYPD officers shot and killed a black man with bipolar disorder who was standing on a street corner in Brooklyn’s Crown Heights neighborhood. The man was holding a metal pipe as if it were a gun. The incident, one in a series of similar deadly encounters between police officers and New Yorkers suffering from serious mental illness, sparked protests and questions around city officials’ mental health training.

McCray recently said of two such incidents, including the killing of Saheed Vassell in Crown Heights, “neither one of those tragedies had to be,” according to Observer, and pointed to ThriveNYC as the plan to fill a long-standing void and prevent such tragedies.

Meanwhile, weeks before the most recent incident and an announcement of a new “crisis prevention and response task force,” in mid-March, the mayor’s office circulated a press release that the sweeping mental health initiative that is ThriveNYC had hired an executive director: Alexis Confer. Confer, who had been working on the initiative under Buery, is the first person to occupy a full-time administrative role under Thrive. The hire, McCray said in an interview in the following days, is part of Thrive moving into a second, “resetting” phase.

“The resetting is really necessary because the first two years we were really focused on getting everything off the ground, every program didn’t launch at the same time,” McCray said during a recent appearance on the Max & Murphy podcast from Gotham Gazette and City Limits. Now that nearly all of the 54 projects are up and running, the goal is to use the administration’s remaining years in office to ensure each project will reach its goals and live beyond the ticking political timeline. Tracking metrics and success, McCray said, are critical in accomplishing these goals.

“We know we have 3 years and 9 months,” the first lady said. “I want to make sure that all of these programs last beyond this administration, which means that we have to do careful analysis of how well they’re doing, and we have to actually embed them in the agencies.”

Yet as Thrive moves forward, questions linger around its structure, impact, and McCray’s role -- especially since the first lady has recently been toying with the idea of running for political office in the next city election cycle.

With speculation swirling around McCray’s future and a city muddled in what some experts have labeled a mental health crisis, much is at stake. In leading Thrive, McCray took on what she called “ambitious” goals. The result has largely been positive, it appears, in terms of reorienting how city government addresses mental health and the breadth of the services available. People working under Thrive-backed programs sing praise for McCray’s dedication and work ethic. Many people in the city’s mental health sector also commend efforts to address one of the city’s most pervasive issues.

According to McCray, there are about 400 metrics that indicate the various programs’ successes and, in some cases, shortcomings. While city officials working under Thrive are already applauding its impact, some of the metrics that have been published don’t seem to point to concrete improvements or to all of the programs’ being on track to meet their marks.

*****

Before de Blasio took office in 2014, the office of New York City First Lady was vacant for close to 15 years, whereby mayoral partners were not active in politics. During his mayoral campaign and into his transition into office, de Blasio and McCray had made clear that New Yorkers were getting something along the lines of ‘two for one.’ De Blasio regularly called his wife his number one advisor. She did, after all, bring her own political background to the table. The city’s mayoral duo met working under Mayor David Dinkins, the city’s first and only black mayor and last Democrat elected before de Blasio.

Under Dinkins, McCray primarily worked on the speech-writing team. She then worked on-and-off for elected officials and held a brief post at the foreign press service with the work always centered around writing. When de Blasio was first elected, McCray helped appoint top city officials, as she had done before during his political career as public advocate and a member of the City Council, they said.

Unlike some first ladies at various levels of government, McCray has used the role to bring publicity to topics and spearhead initiatives with real money behind them. De Blasio appointed her chair of the nonprofit Mayor’s Fund to Advance New York City, which raises tens of millions of dollars for public-private partnerships, and, of course, she helped develop and oversee the city’s sweeping mental health program.

On the day of the announcement for Thrive, McCray introduced a handful of the 23 new initiatives. For example, a 24/7 hotline would be launched to connect people seeking mental health services with treatment options. Primary care providers would be trained to prescribe buprenorphine, a medication that prevents withdrawal symptoms, to people recovering from opioid addictions.

McCray listed off a number of goals: train 250,000 people in mental health first aid; implement social-emotional learning in all the city’s 1,850 Pre-K for All programs; create a mental health corps that will clock 400,000 hours of outpatient care each year.

The 15-minute introduction the first lady delivered on that brisk 2015  day was the culmination of a handful of meetings, spread out over the course of the previous months, with the commissioners of more than a dozen city agencies. Traveling across the boroughs, McCray asked agency heads—from the Department for the Aging to the Administration for Children’s Services—about mental health services available to the populations they serve. All of the agencies already had some mental health initiatives in place and McCray wanted to know what was working and what wasn’t. Commissioners from at least two departments were impressed by McCray’s commitment and insightful questions early on.

“To me, the first lady has been incredibly active—way more active than I really expected or anticipated,” said Lorelei Vargas, a deputy commissioner for the Administration for Children’s Services who attended the early meetings.

In that first speech, McCray didn’t mention the planning behind Thrive. Instead, the veteran speech writer invoked the personal. She touched upon her family’s own struggles with mental health, from her daughter’s public struggle with addiction to her parents’ depression. She recited statistics about the prevalence of mental health problems in New York City— 8 percent of high schoolers tried to commit suicide, 26 percent of CUNY students reported having anxiety, and 13 percent of elders in care facilities suffered from depression.

McCray called Thrive’s goals ambitious and emphasized the collaborative demands of this type of work. The smile on de Blasio’s face grew as the mayor looked on and clapped with warm approval. The city, in trend with the state and country, was facing a shortage of mental health professionals. Thrive aimed to respond to this by equipping people already working in city agencies and interacting with residents with the ability to screen for mental health issues, and then direct them to adequate services. To accomplish this, McCray said reducing stigma was a necessity.  

“If we work together we can make it as easy to talk about anxiety as it is to talk about allergies,” McCray concluded.

*****

McCray speechTwo-and-a-half years later, nearly all of the 54 initiatives are underway. Hundreds of people have been hired to work on initiatives, old and new, and tens of thousands trained in mental health first aid. More than $818 million has been allocated across more than a dozen agencies’ budgets through fiscal year 2019. Two-thirds of the sum comes from city dollars. A combination of federal grants and private donations fund the $24 million Connections to Care program, also under Thrive, and Medicaid reimbursements back the shelter-based treatment for people who are homeless.

But getting a grasp of how the initiatives that span more than 20 city agencies fare requires looking beyond the official year-two update report that representatives of the mayor’s press office direct inquiries to. Tracking the funds alone demands examining each of the agencies’ budgets that are slated to receive Thrive-related funds. A team at New York City’s Independent Budget Office (IBO) spent months reviewing the budgets and compiled a report on Thrive.

The metrics measuring the programs’ success are similarly spread out. McCray mentioned that there are about 400 metrics being used across the initiatives to track their success. Some are being maintained by the city agencies operating the initiatives, others by the mayor’s and first lady’s offices, and at least one is being monitored and evaluated by the Rand Corporation. During her appearance on the Max & Murphy podcast, McCray said that she reads up on all of them every week.

“You know, we’re watching, we’re watching very carefully,” McCray said. “Every other week, we have a roster, or an implementation chart to show   how we’re making our bench-lines, how our timeline is moving, whether we’re on target, or off target, it's very thorough. We’ve got 400 metrics to measure our programs, and we’re very much focused on making sure that we’re doing a very thorough evaluation and assessment of  how we’re doing.”

Yet, following multiple requests and conversations with the mayor's and first lady’s offices, as well as requests over the course of weeks with 11 agencies working under the auspices of Thrive, metrics have trickled in slowly and sparingly. Spokespeople from the mayor and first lady’s offices have responded to multiple requests for the 400 metrics by sending along the "ThriveNYC Year Two Update" report, which lists 55 projects and associated metrics through October 2017 . Some of the initiatives have exceeded their goals, others underperformed. Some have few metrics, if any, by which to gauge progress.

People have critiqued Thrive overall for not specifically targeting programs toward New York City residents who suffer from more severe psychiatric disorders. The nine-hour mental health first aid trainings, for example, don’t necessarily equip city employees with the necessary skills to assist someone suffering from a severe psychiatric disorder or in the throes of an episode. Employees from three city agencies dismissed those claims, asserting that the varied programs address people across the spectrum.

“It’s simply not true. Thrive addresses the full span,” McCray said. She added that many of the programs are focused on early intervention and prevention because many people suffering from severe psychiatric disorders later in life often have had mental illness go untreated in the past. “This is why you see so many people on the street. That is the result of untreated mental illness, and not just a year or two, this is years and years and years in the making. If we act early, we could actually prevent, or certainly intervene,” she said.

De Blasio himself recently dismissed the criticism, pointing to both NYC Safe and the reasonable use of Kendra's Law, which necessitates a judge mandating treatment for individuals in need.

Yet in response to increasing attention on this subsect of the population, de Blasio and McCray announced the formation of the new task force on Thursday that will focus on some of these concerns.

The task force brings together city officials, mental health researchers and individuals with mental illness over the next 180 days who will identify ways to increase interventions, according to a press release. The group is also slated to address means to improve coordination between public health and safety agencies within the city. McCray along with the leading names on Thrive, including Confer and Bassett, are set to manage the task force. Thrive initiatives, meanwhile, continue onward.

One of the initiatives that’s among the most referenced during press events around Thrive is NYC Well, the hotline for people seeking mental health services. De Blasio and McCray recite the number -- 1-888-NYC-Well -- at public and private events on a regular basis, often asking their audiences to repeat it back or say it with them. Judged by the number of people who have utilized NYC Well, the initiative has been deemed a success.

More than 250,000 people have reached out to the hotline through phone calls, texts or online chats, according to Thrive’s two-year update report. This exceeded initial projections by about 25 percent. Prior to NYC Well, many city agencies, like the Department of Health and Mental Hygiene, ran independent hotlines where people tended to call for mental health services. NYC Well consolidated these numbers into one, where people on the receiving end of the calls would be better equipped to navigate the city’s mental health providers and other services.

The first lady and others involved in thrive said the numbers are a testament to advertising campaigns around the city. Nearly $15 million of Thrive’s overall funds through 2019 are dedicated toward media campaigns. However, some have questioned whether basing the program’s success on the number of people who reach out is most telling as to whether people are actually being connected to the care they are seeking.

Commissioners for the Department for the Aging said they were excited about the impact that Thrive’s funding has already had on the two projects the agency runs in partnership with Thrive. The Friendly Visiting program, which launched July 2017, trains and connects volunteers with homebound elders. In the program’s first four months, Thrive’s year-two update reported, 645 seniors were served. Thrive has also backed initiatives to provide additional mental health services in senior centers.

Some have expressed concern that programs that existed prior to Thrive are being lumped into the umbrella program without much benefit. But representatives from the Department for the Aging disagreed.

“It’s a more the merrier situation. We absolutely need more services than we can provide in our point in time,” said Jackie Berman, the director of research at the department who is closely involved in the administrative-side of the two Thrive initiatives. “Thrive opens up the door, but there’s even still a great need—it’s the tip of the iceberg.”

While initiatives like Friendly Visiting and NYC Well have hit their goals, others have faltered. City officials remain adamant that these initiatives are still on track to meet the targets that were recited in 2015 and echoed in appearances since.

For example, there are seemingly underwhelming metrics about the number of people who have received mental health first aid training. Thrive’s two-year update report, which collected data from 2016 through October 2017, indicated hat nearly 37,000 people had been trained in mental health first aid, which means taking a free nine-hour course offered throughout the city. The course is meant to teach participants how to screen people for possible mental health issues and educate them on the steps to take when concerned about another’s mental health. With the city experiencing a mental health professional shortage, the idea is to give residents the tools to fill some of the gaps left by the shortage.

For Thrive to meet its goal of training 250,000 city residents in mental health first aid by 2020—there would have to be significant growth in the number of people enrolling in mental health first aid programs. At least double the number of people will have to be trained in 2018 and 2019 that were trained in 2016 and in 2017 combined.

Confer, hired to be Thrive’s executive director as of mid-March, did not provide concrete ways that the city would scale up the number of people receiving mental health first aid trainings. She did, however, stress the importance of meeting the goals. The metrics, she said, not only promote benchmarks critical to the programs’ success, but also act as “a magnifying glass on ourselves.”

Yet, some metrics are difficult to ascertain. Though the city outlined a number of benchmarks for 34 initiatives in the year-two update, there are missing links between how lump sums in budgets trace to each of these metrics. For example, NYC Safe, which is run by the Department of Health and Mental Hygiene, is geared toward supporting people with mental illness who are more likely to exhibit violent behavior. The program has $22 million earmarked toward its development.

According to the year-two update, NYC Safe was responsible for adding  40 substance-abuse-disorder specialists to treatment teams across the city. In January 2016, three intensive mobile treatment teams launched and a fourth was added the following year. Overall, Thrive’s year-two update said that 405 New Yorkers were engaged in the NYC Safe program through October 2017. The link between how the $22 million is being employed and how money links to each of these metrics is not available.

Jane Meyer, a spokesperson for the mayor’s office, said that some data was simply not readily available. Some metrics were only available in quarterly update reports, for example. Meyer said the city was working on the weeks-long request for the most up-to-date information on each of the 54 initiatives. However, she said, consolidating all of the 400 metrics that the first lady said she keeps up-to-date with was proving a time-consuming task.

Confer said she’ll be spending 100 percent of her time on Thrive in the new post. Without a specific office or even the semblance of being an organization, Thrive doesn’t publically appear to have full-time staff other than Confer. She said she planned to spend the first few weeks taking stock of the initiatives that she has helped oversee from the deputy mayor’s office since Thrive’s launch. She also plans to touch base with the hundreds of people working on the projects that have been labeled as Thrive-based initiatives.

“The goal is to save lives, and to make sure people have the resources they need—that is the ultimate metric of success,” Confer said.

*****

Before Confer stepped into the executive director role, no single person was tasked with maintaining and organizing the initiatives under Thrive. McCray was as close as it got. She also spends her time heading the Mayor’s Fund.

The Fund, a non-profit organization, facilitates partnerships between the city and private stakeholders to implement programs advantageous to New Yorkers and, at times, experiment with initiatives that could become part of what city government does. McCray’s role has drawn criticism from some concerned that the appointment creates an expectation from private donors that the mayor will treat them with favor. McCray has waved those off.

“It’s not an overriding concern,” McCray said on the Max & Murphy podcast, saying that people donate to the fund because they are devoted to philanthropy, not because they expect political favors. “But we do have lawyers,” she said. “And lawyers are important to sift out the who does what and when, and that’s important.”

Tax filings for the fund between 2014 and 2016 list McCray working one hour a week. A spokesperson for the mayor’s office, responding to an inquiry about this filing, said McCray spends about 10 percent of her time working on the Mayor’s Fund and that the public schedules aren’t reflective of all her time. Thrive, meanwhile, appears to occupy much more time, and there is some crossover.

The most prominent is Connections to Care. The Mayor’s Fund contracts the McSilver Institute for Poverty Policy and Research, part of New York University, to train non-governmental organizations and nonprofits in screening for mental health issues. Connections to Care is based on the premise that very few people go out of their way to seek mental health care. Having city employees recognize mental illnesses when they do interact with the city’s population would provide more entryways to care.

“I would say it’s been a fantastic experience,” said Andrew Cleek, the institute’s chief program officer.

For McCray, the experience may be the first of many more politically-minded work in the future.

In mid-March, McCray packed her bags and boarded a flight to Puerto Rico to travel the region and assess the mental health climate in the territory following hurricane Irma. In the weeks leading up to her trip, McCray was showing up more frequently at public events. The mayor featured her at press conferences, where she often invokes Thrive.

Rumors began to spread that McCray was prepping to expand her future political aspirations. She didn’t dismiss the idea. McCray actually said it was on a list of things she’s considering. But, in order to get there, she said she needs to focus on the work that currently has her name on it—the most prominent being Thrive.

“I’m too focused on doing a really good job, of what I’m doing now—because my future depends on it,” McCray said when asked about whether she was beginning to plan out steps for her own run for office. “It really does.”

***
by Maya Miller for Gotham Gazette
@GothamGazette
The author is a freelance journalist currently earning an M.A. in health and science journalism at Columbia's Graduate School of Journalism.

This article has been corrected to reflect the number of NYC Well is a 1-888 number, not 1-800

This article has also been updated to remove an inaccurate mention of a discrepancy in reported numbers of people given mental health first aid training.

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Now ‘Resetting,’ Chirlane McCray’s $850 Million Mental Health Program Has A Lot Riding On It Sun, 22 Apr 2018 04:00:00 +0000
Max & Murphy Podcast: First Lady Chirlane McCray https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray mxm logo

Ben Max, left, of Gotham Gazette, and Jarrett Murphy, right, of City Limits


March 26, 2018 - Max & Murphy Podcast: New York City First Lady Chirlane McCray

Chirlane McCray

New York City First Lady Chirlane McCray is leading the city's ThriveNYC mental health care plan and its many component programs, serving as Chair of the Mayor's Fund to Advance New York City, and providing guidance as her husband's top advisor. McCray joined the podcast to discuss the various components of her work, where she sees the de Blasio administration at this point in its tenure, the administration's struggles with getting its message out, her political future, and more.

Listen to the full conversation and let us know what you think -- we're on Twitter @TweetBenMax and @JarrettMurphy and guest @Chirlane McCray (@NYCFirstLady). You can listen to the episode through the embedded audio below or download the episode wherever you get your podcasts.

***
by Ben Max, Gotham Gazette
     

Read more by this writer.

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Max & Murphy Podcast: First Lady Chirlane McCray Mon, 26 Mar 2018 04:00:00 +0000
Part of ThriveNYC, NYCHA Trains Staff in Mental Health First Aid https://www.gothamgazette.com/city/7049-part-of-thrivenyc-nycha-trains-staff-in-mental-health-first-aid https://www.gothamgazette.com/city/7049-part-of-thrivenyc-nycha-trains-staff-in-mental-health-first-aid 5716575756 06b18d2c43 z

NYCHA community gathering at Queensbridge (Pete Mikoleski/NYCHA flickr) 


At a recent training session, just over 35 New York City Housing Authority staff members assembled at the authority’s downtown offices last Thursday. The course, which included eight topics, was part of the city’s ThriveNYC mental health care plan, one piece of which is 2,000 NYCHA employees receiving mental health care training so that they can more carefully and helpfully interact with public housing residents who may be experiencing mental health challenges.

The eight session subjects included first aid, substance abuse, suicide, and eating disorders. Participants told personal stories of dealing with mental illness, discussed circumstances they had encountered in the past in serving NYCHA residents, and asked questions about how best to approach hypothetical scenarios they suspected may occur.

When suffering from mental illness, “people often turn to people they know or agencies they trust, or people they see in their communities,” said Dr. Gary Belkin, executive deputy commissioner of mental hygiene for the city, who visited the training. Belkin explained that mental illness and mental health challenges are more prevalent among NYCHA’s residents, who number around 500,000, than the population at large.

ThriveNYC was launched by New York City First Lady Chirlane McCray, who was motivated by seeing many around her benefit from receiving aid for mental health ailments. “I heard many stories of triumph that reminded me of a fundamental truth: Mental illness is treatable. When people have access to the resources they need, they can live their lives to the fullest,” McCray wrote in a roadmap for ThriveNYC. The $850 million program aims to make mental health care more available and changing norms around the general issue to make receiving care more appealing to New Yorkers, many of whom are unaware of their options or are unwilling to seek assistance.

According to a 2015 report from the city Department of Health, one in five New Yorkers suffers from mental illness, including challenges ranging from acute depression to schizophrenia. Forty-one percent of those with mental illness said they did not receive or were delayed in getting treatment in the past year, according to the ThriveNYC website. One major ThriveNYC goal is training 250,00 New Yorkers in mental health first aid, thus working to combat the larger problem by making New York City communities more aware of both the signs that an individual may be in need of assistance and the resources available to those with mental health challenges.

On the side of the room in which the NYCHA training session was held last week stood signs with contact information for mental health hotlines both nationally and in New York City, for use in connecting residents to care providers.

NYCHA is a particularly important organization in the city’s battle against mental illness, Dr. Belkin told the staff members gathered for the training. Just before the lunch break, he spoke to trainees about how their close relationships with New Yorkers are essential to providing help to those suffering with mental health issues.

Dr. Belkin said that NYCHA workers, who forge bonds and establish trust with NYCHA residents, are well-positioned to assist in achieving key ThriveNYC goals. NCYHA employees have a “kind of a familiarity and a closeness” with low-income New Yorkers that others, such as doctors and nurses, don’t, Belkin said in an interview with Gotham Gazette following his remarks to the NYCHA staff. “It’s a real opportunity to be credible to the people we’re trying to reach,” he said. “It seems like a natural fit.”

NYCHA residents are a particularly important cohort to reach, too, Dr. Belkin explained. “It's not just the proximity and credibility with residents that NYCHA has but also this is a group of New Yorkers we need to reach,” he said. “People residing in NYCHA housing or rental assisted housing, or either, are two to three times more likely to have what we call ‘serious psychological distress,’” said Dr. Belkin, referencing an umbrella term used in health department community surveys that includes a range of illnesses. NYCHA tenants are a “population we need to make sure is connected and feels like they have a point of entry to mental health that's more familiar and not as stigmatized,” Belkin said.

Marina Oteiza, Borough Administrator for Family Partnerships in Manhattan at NYCHA, echoed Dr. Belkin’s optimism in regards to non-medical professionals ability to help people on this front. “A lot of lay people can do this,” she said of efforts to identify mental illness and direct those in need of assistance to the right place. “You don't necessarily need a social worker,” she said of NYCHA employees making connections to services for residents. “If you’re meeting with them, you're comfortable talking to them, you have a rapport with them. You can facilitate that a lot quicker than a social worker,” she said. “It does not need to be with a trained mental health professional,” she continued. “It can be with someone who cares and has an empathetic ear.” Good bedside manner, coupled with formal training would create an effective force towards the goal of improving NYCHA residents’ health and safety with regard to widespread mental health issues, she argued.

During the session, the instructor placed strong emphasis on destigmatizing mental illness, and making sure employees adopted a sympathetic, non-judgmental posture towards those with acute and chronic mental health issues. These ailments are medically treatable conditions and should be seen as such. The session leaders emphasized that mental health issues come about from no fault of the victim’s and did not result from an individual’s actions or character nor from weakness. Nobody should be ashamed or embarrassed for requesting medical attention, they stressed.

Helen Reinstein, certified mental health instructor and senior management trainer with the Learning and Development Unit of Human Resources at NYCHA, was in attendance at Thursday’s training in NYCHA offices at 250 Broadway. “You wouldn't hesitate to talk to someone with a broken arm about getting their arm set and getting the follow up care they need,” Reinstein said of the need to normalize mental health care. “We want people to feel the same way about mental health issues.”

Trainees were introduced to frameworks for types of circumstances they may have to handle in the field and were provided with scripted lines to use should these situations arise. The NYCHA staffers -- employees who help run and maintain NYCHA buildings, properties, and programs -- were also instructed on warning signs of mental illness and techniques to reach people that do not make a concerted effort to alert others of their struggles. Look at “body language,” said Tajhma Carroll, assistant director of Brooklyn Leased Housing, a NYCHA division. She then listed a few frequent indicators they were informed often suggest someone may be in need of treatment. “Sweats, they mentioned, hands or legs shaking. Those are telltale signs,” she said. “It's not only in what they say,” Carroll added.

People “isolated and alone in their house” or who engage in hoarding, wherein individuals store an excessive amount of things in their homes, leading to cramped, unhygienic living environments, are also causes for concern, Oteiza said. “If they’re not letting you into the apartment, that’s going to be a red flag for us,” she said.

If signs aren’t identified and those suffering from mental health problems are unaware of options available to them or unwilling to access medical attention, people may turn to other means to relieve their pain, Reinstein noticed. “A lot of times, people are using illegal substance in order to try to get to a place of feeling normal and using it as self-medication rather than seeking the care and intervention they really need,” she said.

As part of their education, NYCHA workers were instructed to ask some of the toughest questions when evidence warrants them, such as “have you ever considered suicide?” and “do you have a plan to kill yourself?” Those involved acknowledged how hard it can be to ask those questions or to inform someone their condition can only be properly alleviated by receiving a medical evaluation. During the training sessions, NYCHA staff constantly grappled with the challenge of ensuring people are getting the assistance they need, while also lending them enough personal space. “I do think there is a natural reticence to be intrusive, which is a good thing,” said Sherman.

Most trainees appeared to buy into the strategy of being active and quick to inquire if they detect signals that something may be amiss for a NYCHA resident. “So far people have been very receptive,” Reinstein said. “We’re excited about this training,” said Sherman. “I think that we’re really creating a culture where our staff really has the confidence to be able to interact with people, to de-escalate where it’s appropriate, to connect people with resources.”

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Part of ThriveNYC, NYCHA Trains Staff in Mental Health First Aid Wed, 05 Jul 2017 04:00:00 +0000
The Max & Murphy Podcast https://www.gothamgazette.com/podcasts/max-murphy-on-politics https://www.gothamgazette.com/podcasts/max-murphy-on-politics mxm logo

Ben Max, left, of Gotham Gazette, and Jarrett Murphy, right, of City Limits


"Max & Murphy" is a podcast hosted by Ben Max of Gotham Gazette and Jarrett Murphy of City Limits that began in 2016 as a brief discussion on the latest in housing policy but quickly expanded to lengthier discussions of a wide variety of political and policy issues, including interviews with candidates for office, elected and appointed government officials, advocates and other experts. In 2017 the show was an important stop for candidates for top city offices and in 2018 for candidates for state offices. Also in 2018, the podcast was picked up by WBAI radio, where the show initially airs on Wednesdays from 5 to 6 p.m. Portions or full episodes of the show are then posted to the podcast streams, and to the Gotham Gazette and City Limits websites. 

Find episodes through the links below, or find "Max & Murphy" wherever you get your podcasts: iTunes, Google Play, Stitcher, etc. Find it and subscribe!

Have feedback? Find us on Twitter @TweetBenMax and @jarrettmurphy.

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Gov Andrew Cuomo 2019 agenda 100 days Should Andrew Cuomo Run for President? — January 02, 2019
 
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mxm logo 400px Top Stories of 2018 & What to Watch in 2019 — Decemeber 26, 2019
 
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wbai 12 19 scott stringer 400 Comptroller Scott Stringer — Decemeber 19, 2018
 
Gustavo Rivera and Bill Hammond Will Single-Payer Health Care Come to New York? — Decemeber 12, 2018
 
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Max & Murphy Podcast: Congestion Pricing & the MTA in 2019 Congestion Pricing & the MTA in 2019 — November 21, 2018
 
latrice walker wbai 400 Bail Reform with Assemblymember Latrice Walker — November 14, 2018
 
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Analyzing 2018 Election Results & Looking Ahead to 2019, with Alyssa Katz of The Daily News Analyzing 2018 Election Results & Looking Ahead to 2019, with Alyssa Katz of The Daily News — November 7, 2018
 
Election Day Live Show with Special Guests including Jumaane Williams & Errol Louis Election Day Live Show with Special Guests including Jumaane Williams & Errol Louis — November 6, 2018
 
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Cuomo-Molinaro Debate Analysis Cuomo-Molinaro Debate Analysis — October 23, 2018
 
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keith wofford wbai 400 2 Republican Attorney General Nominee Keith Wofford — October 10, 2018
 
tom dinapoli 400 Comptroller Tom DiNapoli — October 3, 2018
 
john trichter 130 Jonathan Trichter, Republican nominee for Comptroller — October 3, 2018
 
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Howie Hawkins, Green Party Nominee for Governor Howie Hawkins, Green Party Nominee for Governor — September 26, 2018
 
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rosenthal holtzman pod 400 The Long Fight for New City Sexual Harassment Laws — June 25, 2018
 
gelinas 477 A New Era at The MTA? with Nicole Gelinas — June 21, 2018
 
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Jumaane Williams Lieutenant Governor Candidate Jumaane Williams — February 23, 2018
 
feb14 podcast Analyzing De Blasio's State of the City Address — February 14, 2018
 
Deconstructing De Blasio's Visit to Albany Deconstructing De Blasio's Visit to Albany — January 30, 2018
 
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alex matthiessen move ny 400 Congestion Pricing with Alex Matthiessen of Move New York — January 22, 2018
 
ritchie torres 400px City Council Member Ritchie Torres on The New Council & His New Role — January 17, 2018
 
rivera brannan 400x167 New City Council Members Justin Brannan & Carlina Rivera — January 10, 2018
 
bdb400px Big Political News to Start 2018 — January 3, 2018
 
melissa mark viverito alatriste podium400 City Council Speaker Melissa Mark-Viverito — December 15, 2017
 
eric koch 400 Eric Koch, former City Council communications director — December 15, 2017
 
Shola Olayote NYCHA CEO Shola Olatoye — December 7, 2017
 
liz crowley podcast 400 City Council Member Elizabeth Crowley — December 5, 2017
 
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bdb voting sign in 400 Analyzing the 2017 Election Results — November 9, 2017
 
mayor bdb 400 10 Things to Think About on Election Day — November 7, 2017
 
mayoral candidates 400 Resetting the Mayoral Race after the Final Debate — November 3, 2017
 
3 mayors stream Akeem Browder, Aaron Commey & Mike Tolkin are Running for Mayor — October 23, 2017
 
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debate stage400 Analyzing the First General Election Mayoral Debate — October 11, 2017
 
tish james400 Public Advocate Letitia James — October 2, 2017
 
Michel faulkner Comptroller candidate Michel Faulkner — September 29, 2017
 
jcpolanco 400 Public Advocate Candidate JC Polanco — September 18, 2017
 
gifford miller city council 400px Gifford Miller, former Speaker of the City Council and mayoral candidate — September 11, 2017
 
brigid bergin and ben max400px Brigid Bergin of WNYC radio — September 5, 2017
 
Joseph Viteritti De Blasio Author Joseph Viteritti — August 30, 2017
 
Public advocate Candidate David Eisenbach Public advocate Candidate David Eisenbach — August 28, 2017
 
azi paybarah tv 400px167px Azi Paybarah — August 17, 2017
 
Dr. Christina Greer and Alexis Grenell Representative vs. Substantive Representation, with Dr. Christina Greer and Alexis Grenell — August 15, 2017
 
max murphy katz fullington res The Mayoral Race with Top Political Strategists — July 31, 2017
 
bo dietl Mayoral Candidate Bo Dietl — July 24, 2017
 
nicole malliotakis Republican Mayoral Candidate Nicole Malliotaki — July 13, 2017
 
eric phillips Eric Phillips, press secretary to Mayor Bill de Blasio — July 5, 2017
 
sal albanese Democratic Mayoral Candidate Sal Albanese — June 26, 2017
 
paul massey 

Republican Mayoral Candidate Paul Massey — June 19, 2017 (note: Paul Massey dropped out of the mayoral race on June 28, though the episode is still worth listening to)

 
bob gangi Democratic Mayoral Candidate Bob Gangi — June 12, 2017
 
mxm logo 400px Election Season is Here! — June 1, 2017
 


A variety of earlier episodes of the Max & Murphy Podcast, through the archive, often focused on New York housing policy and politics — see all episodes from the start February 12, 2016 to May 25, 2017

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The Max & Murphy Podcast Sun, 25 Jun 2017 04:00:00 +0000
'New York Values' in Historical Perspective https://www.gothamgazette.com/130-opinion/6173-new-york-values-in-historical-perspective https://www.gothamgazette.com/130-opinion/6173-new-york-values-in-historical-perspective ted cruz

Ted Cruz (photo: @SenTedCruz)


Stereotyping New York in political debate
In a Republican presidential debate in January, Senator Ted Cruz tried to score points, saying of Donald Trump, "Donald comes from New York and he represents New York values." Cruz went on to say that "everyone in the country knows exactly what New York values are and I've got to say they're not Iowa values or New Hampshire values." New Yorkers are "socially liberal and pro-abortion and pro-gay marriage and focus on money and the media," he said.

Cruz repeated the message, with variations, in his campaigns in Iowa and New Hampshire.

Senator Cruz was using an old political gambit, playing on stereotypes of New York (particularly New York City) as excessively liberal, corrupt, money-grubbing, and out of step with the rest of America.
New Yorkers get their backs up when their city or state is stigmatized or attacked.

After the January debate, Governor Andrew Cuomo retorted that Senator Cruz "doesn't know what New York values are because New York is in many ways the epitome of what formed this nation and what keeps it strong....We do believe in E Pluribus Unum, out of many come one, and his rhetoric is the exact opposite." Several other prominent New Yorkers weighed in, including Donald Trump, who suggested that New York's heroic response to 9/11 revealed its deepest values.

Cruz's comments provoked many other New Yorkers to express their opinions (mostly positive) about their city. The New York Times asked a cross-section of city residents their opinion on what constituted "New York values" a few days after Cruz's attack. Their responses: New Yorkers are diverse, friendly, ambitious, curious, tolerant, competitive, impatient, hustling and determined -- "we keep our heads high, no matter what."

A New York Daily News front page on January 15 put it more directly with a headline of "DROP DEAD, TED."

New Yorkers have seen it before
Cruz is certainly not the first politician to try to cast New York as a place of wanton ways with values at odds with those of the rest of the nation.

Republican attacks on New York Governor Al Smith when he ran unsuccessfully for president in 1928 focused on his Catholic religion, opposition to prohibition, and subservience to the New York City Democratic organization Tammany Hall, all allegedly emblematic of his hometown, New York City. Smith's campaign theme song, "The Sidewalks of New York," and his "New York accent" in campaign speeches confirmed how ingrained New York City's culture and folkways were.

In 1960, conservative Republican Senator Barry Goldwater expressed a wish that "we could tell New York to kiss our [expletive] and we could really start a conservative party." In 1963, he suggested the nation would be better off if the east coast could be sawed off and floated out to sea. But everyone understood that New York, with its liberal politics, cultural influence and economic power, was his main bugaboo.

The next year, Goldwater won the Republican presidential nomination over New York Governor Nelson Rockefeller, whom Goldwater labeled a liberal New York spendthrift. His supporters sniped that Rockefeller was immoral for having divorced his first wife and remarried, something they vaguely insinuated had to do with loose New York morals.

Historical views of "New York values"
Fending off attacks is easier than defining precisely what New York's values are. That's no surprise, given New York's long history, complexity, and our proclivity for vigorous debate among ourselves.

In 1939, Mayor Fiorello LaGuardia assailed critics who asserted that his city was "a money mart...a synonym for Wall Street...New Yorkers are impolite." New York is "a warm-hearted and generous community," he insisted. But with a touch of that New York pride bordering on arrogance that can irritate outsiders, the mayor added that his city was so far superior to others that "we could afford to stop for the next twenty years and we would still be slightly ahead of the procession."

Historian Milton Klein wrote in 1978 that New Yorkers could be thought of as "cosmopolitan Americans: energetic...materialistic and brash but also convivial, humane, tolerant and idealistic. That one state alone should be able to encompass in itself so many of the virtues and limitations of the American people is a measure of New York's unique role in the nation's history."

Mayor Michael Bloomberg, in a statement to the 9/11 Commission in 2003, eloquently described his city's cosmopolitan pre-eminence:

To people around the world, New York City embodies what makes this nation great. That's a function of our status as the world's financial capital, driven not only by Wall Street but [also] our international prominence in such fields as broadcasting, the arts, entertainment and medicine. Such is New York's importance that to a great extent, as goes its economy, so goes the country's. If Wall Street is destroyed, Main Street will suffer. Beyond that, New York embraces the intellectual and religious freedom and cultural diversity that makes us truly the world's second home. We are a magnet for the talented and ambitious from every corner of the globe. In short, we embody the strengths of America's freedom.

Governor Mario Cuomo (1983-1995) saw enlightened, progressive public policies as New York's defining trait. He defined "the New York Idea" as "government using its resources to help create private sector growth, then requiring those who benefit from that growth to share some part of it so that hope and opportunity are extended to those who have not been as fortunate."

Andrew Cuomo, the current governor, emphasizes that New Yorkers are exceptionally energetic, innovative, determined, and resilient. "At every difficult moment in our nation's history, New York has emerged as...the progressive leader in the nation," he explained in his inaugural address in 2011. "In New York, we may have big problems, but we confront them with big solutions," he said in his State-of-the State message the next year. He often includes in his speeches a quotation from essayist E.B. White: "New York is to the nation what the white church spire is to the village, the visible symbol of aspiration and faith, the white plume saying the way is up."

Two sets of "New York values" seem to stand out
Of course, historians may differ on what New York's most important values are. But looking back over our history, two sets of values seem to stand out.

One is openness, inclusion, and tolerance. Since colonial times when the Dutch controlled the city, the emphasis has been on diversity, valuing individual differences, letting people alone, and providing opportunity for work, advancement, and getting ahead.

New York has been open, welcoming, accommodating, and supportive of newcomers. Over time, more immigrants have come in through New York than any other city. Our city and state have been at the forefront of social justice campaigns and civil rights reforms. For instance, the NAACP was founded in New York City in 1909 and New York passed the nation's first state civil rights law, in 1945. New York City probably has the most diverse population of any major city in the world.

A second is optimism and resilience. New Yorkers are undeterred by setbacks, springing back from adversity and continuing forward progress. It dates back at least to the origins of the state. The Revolutionary New York provincial congress were rebels-on the run, moving from New York City to White Plains to Fishkill to Kingston ahead of advancing British troops. They finished hastily drafting New York's first state constitution in April 1777.

When the British threatened Kingston, the new government became a government-on-the run, simply dispersing, reassembling later at Poughkeepsie, and keeping the fledgling state intact. The first governor, George Clinton, calmly took the oath of office in August 1777 and then hurried off to lead a battle against the enemy where he barely escaped capture.

New Yorkers keep going and are known for against-the-odds triumphs. For instance, mockery and stonewalling by the power structure inspired New York's great women's rights advocate Elizabeth Cady Stanton on to more tenacious campaigning. Denied the right to vote, she defiantly ran for Congress from New York City in 1868, losing but making a point about women's political stature. Jackie Robinson was undeterred by racist taunts and threats and became the first black man to play professional baseball, with the Brooklyn Dodgers in 1947, and later an inspirational civil rights leader.

The New York City Fire Department mourned its dead after 9/11 and then got right back to work, creatively revising its mission, policies, and training to meet the new threat of terrorism.

New York City not only survived the attacks but came back more resilient and stronger than ever.

The debate over "New York values" is likely to continue
New York mirrors the nation in its complexity and resists tidy categorization. Its values are hard to pin down but its history is rightly a source of inspiration and pride, with tolerance and resilience at the core.

Activist, writer, and New York City First Lady, Chirlane McCray, refuted Ted Cruz by citing the city's steadfastness in challenging times."That fighting spirit, that gut instinct to join together in times of hardship, that refusal to leave behind the most vulnerable among us -- these are the values that have defined New Yorkers from the very beginning."

As the presidential campaign moves along, we can expect to hear more about "New York values." When we do, we need to keep historical insights and perspectives in mind.

***
Dr. Bruce W. Dearstyne lives in Guilderland, New York. He is the author of The Spirit of New York: Defining Events in the Empire State's History, published in 2015 by SUNY Press.

***
Have an op-ed idea or submission for Gotham Gazette? Email opinion@gothamgazette.com

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'New York Values' in Historical Perspective Tue, 16 Feb 2016 01:24:03 +0000