Gotham Gazette Gotham Gazette is an online publication covering New York policy and politics as well as news on public safety, transportation, education, finance and more. https://www.gothamgazette.com/component/tags/tag/mental-health-care 2019-06-25T02:26:38+00:00 Webmaster webmaster@gothamgazette.com City Council Looks at Reducing Recidivism for People with Mental Illness 2019-06-18T04:00:00+00:00 2019-06-18T04:00:00+00:00 https://www.gothamgazette.com/city/8608-city-council-examines-how-to-reduce-recidivism-for-people-with-mental-illness Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2019/council-comm-cj.jpg" alt="council comm cj" width="600" height="400" /></p> <p>Elizabeth Ford of Health + Hospitals, left, &amp; Becky Scott of DOC (photo: John McCarten/City Council)</p> <hr /> <p>City Council members on Monday held an oversight hearing to examine how New York prevents formerly incarcerated mentally ill persons from returning to jail. The hearing made clear that the de Blasio administration, Health + Hospitals public hospital system, and City Council members all want to reduce the number of mentally ill persons who rely on the jail system for their mental health care and keep those with serious mental illness out of jail altogether.</p> <p>But, it was evident at the hearing that there is much more emphasis on services for the imprisoned mentally ill than on keeping those with serious mental illness out of jail, whether for the first time or in all-too-common recidivism.</p> <p>The psychiatric services offered in city jails -- like nurse and doctor staff, therapeutic groups, and medicine -- are robust but someone with a serious mental illness often loses the best care upon leaving jail. This then contributes to high recidivism rates.</p> <p>The hearing centered several key data points: roughly 43% of those held in city jails are suffering from mental illness (14% have serious mental illness); the recidivism rate in New York City is 20%, but for those with mental illness it’s 47%.</p> <p>Held by the Council’s Committee on Justice System, Committee on Criminal Justice, and Committee on Mental Health, Disabilities and Addiction, the hearing looked at the different ways the city Department of Correction and Correctional Health Services, a part of New York’s public health care system, New York City Health + Hospitals, provide care for the mentally ill in prison and once they leave. Two pieces of legislation dealing with notifying defense attorneys of their detained clients’ mental health and returning unused commissary money to recently released inmates were also discussed with various stakeholders who testified.</p> <p>As the overall jail population has declined significantly, the proportion of New Yorkers with mental illness in city jails has risen in recent years: the overall average daily population of city jails decreased from around 11,500 in 2014 to around 8,900 in 2018, and the percentage of people with mental illness increased from 38% to 43%.</p> <p>The percentage of those with a serious mental illness, defined by Correctional Health Services as anyone with schizophrenia, bipolar disorder, major depressive disorder, or post-traumatic stress disorder, has increased from 10.2% to 14.3% in that same time frame.</p> <p>Council Member Keith Powers, a Manhattan Democrat and chair of the Committee on Criminal Justice, asserted that the City Council and the different city agencies in attendance all agree that jail is not the place to help seriously mentally ill people. However, jail is often where people with serious mental illness wind up, and jails often offer medical services – city jails have many psychiatric services located in one place (in fact, Rikers Island is the third-biggest provider of psychiatric care in the United States behind jails in Los Angeles and Chicago).</p> <p>Currently, city jails put inmates diagnosed with mental illness in “mental observation houses” (MOs), where there are advanced levels of service and psychiatric nurses available, or the more intensive option, PACE (Program to Accelerate Clinical Effectiveness) units where there’s 24/7 embedded staff and more therapeutic groups, according to Dr. Elizabeth Ford, who testified for Correctional Health Services.</p> <p>However, through questioning from Powers, Ford admitted right now there are people who qualify for PACE but due to spacing issues are only in MOs. <a href="https://thecity.nyc/2019/04/new-special-jail-units-for-mentally-ill-are-off-pace.html" target="_blank" rel="noopener">THE CITY reported in April</a> that the de Blasio administration is well behind on its planned 12 PACE units by 2020 (currently there are six).</p> <p>Council member questions made clear that there are many mental health services available in prison, but the key organizing question of the hearing was: what happens when an inmate/patient is released? Ford said CHS gives inmates seven days of their medicine so they don’t drop off too preciptiously after leaving jail, a 30-day prescription which can be fulfilled at a pharmacy of their convenience, and many referrals to outpatient treatment programs.</p> <p>Outpatient treatment is the primary way people with mental illness are treated in New York, most of which are run by New York City Health + Hospitals. Outpatient care requires patients to appear at appointments, as opposed to inpatient care or state institutionalization – mental health care nationwide over the past 60 years has transitioned away from state-run facilities once known as “insane asylums” or “psychiatric hospitals” and towards outpatient care.</p> <p>When asked how CHS can make sure recently-released inmates follow through on getting care, Ford mentioned they are hiring more social workers and focusing on making sure existing services, like existing mobile care teams, work well rather than accepting “new mandates.”</p> <p>In terms of keeping mentally ill people out of prison in the first place, Ford brought up the new plan from the administration of Mayor Bill de Blasio of helping mentally ill people go to the Health + Hospitals system, instead of prison.</p> <p>Furthermore, two diversion centers -- in East Harlem and South Bronx -- will offer police officers a place to bring emotionally disturbed people who exhibit signs of mental illness instead of arresting them. They’re not open yet, but are supposed to open later this year.</p> <p>Ford hopes the community-based aspect of the diversion centers will be especially useful as the centers will be located to existing outpatient care.</p> <p>Supportive housing is another way to prevent recidivism, according to Ford. Supportive housing offers mental health services to people struggling to find housing. The de Blasio administration plans to build 15,000 supportive housing units over 15 years.</p> <p>If the roughly 1,200 city jail detainees diagnosed with serious mental illness were to be released tomorrow, the relatively minor supportive housing options and short-term diversion centers combined with New York’s disinclination towards inpatient care throw doubt on how the seriously mentally ill would be treated without jail-based services.</p> <p>The city has created what they call Community Re-Entry Assistance Network (CRAN) teams, which are six-month transitional teams to help those with serious mental illness re-enter the community after release.</p> <p>On the two pieces of proposed legislation being considered at the hearing, the lead sponsor of the defense attorney notification bill is Manhattan Council Member Margaret Chin, while Queens Council Member Donavan Richards is the lead sponsor of the commissary bill.</p> <p>Chin’s bill, Intro. 1590, would require the Department of Health and Mental Hygiene to notify the defense attorney of a person who is in the custody of the Department of Correction and who has been diagnosed with a serious mental illness.</p> <p>The bill, co-sponsored by City Council Speaker Corey Johnson and six other Council members, is not supported by Correctional Health Services in its current language. Although Dr. Ford chose to keep some reservations of Correctional Health Services private, she did mention that the agency has a newly-created court liaison program intended to act as a go-between for defense attorneys and medical officers.</p> <p>The current process for notifying the defense attorney of a seriously mentally ill person who is accused of a crime is the patient must give consent to Correctional Health Services and CHS gives information relevant to the mental illness diagnosis to the defense attorney.</p> <p>The bill “attempts to break the cycle of imprisonment,” said Chin, as ideally more cases could take mental illness into account.</p> <p>The most intense exchanges of the hearing occurred in regard to the other piece of legislation discussed Monday. Intro. 0903, Council Member Richards’ bill, would require the Department of Correction to notify all recently-released former inmates if there is money in their individual jail commissary account as well as return that money within 60 days of release.&nbsp;&nbsp;</p> <p>A commissary account, which can be deposited into by an inmate’s family, is essentially a bank account that the inmate can use to purchase snacks or personal products while in jail. Currently, the Department of Correction is holding $3.7 million from as far back as 2012 in unclaimed commissary money for the over 140,000 individuals who have not claimed it.</p> <p>Richards, indignant, heavily implied DOC wasn’t making any effort to return the money, while DOC testifiers stated multiple times they don’t use the unclaimed money for their own purposes.</p> <p>According to those who testified for the Department of Correction, the only outreach done by the DOC has been to put posters -- only in English -- in the jails. DOC representatives said the often unpredictable nature of inmates’ release schedules as well as the general difficulty in remaining in contact with released inmates makes returning the money difficult. DOC does not support the bill, citing difficult logistics.</p> <p>In a fitting summary of the hearing, Council Member Diana Ayala of Harlem and the Bronx said if the Department of Correction cannot find people leaving prison to give them their money back, how can they ensure the mentally ill leaving prison get the mental services they need?</p> <p>

***
by Truman Stephens, Gotham Gazette

Read more by this writer.

</p>
<p><img src="https://www.gothamgazette.com/images/graphics/2019/council-comm-cj.jpg" alt="council comm cj" width="600" height="400" /></p> <p>Elizabeth Ford of Health + Hospitals, left, &amp; Becky Scott of DOC (photo: John McCarten/City Council)</p> <hr /> <p>City Council members on Monday held an oversight hearing to examine how New York prevents formerly incarcerated mentally ill persons from returning to jail. The hearing made clear that the de Blasio administration, Health + Hospitals public hospital system, and City Council members all want to reduce the number of mentally ill persons who rely on the jail system for their mental health care and keep those with serious mental illness out of jail altogether.</p> <p>But, it was evident at the hearing that there is much more emphasis on services for the imprisoned mentally ill than on keeping those with serious mental illness out of jail, whether for the first time or in all-too-common recidivism.</p> <p>The psychiatric services offered in city jails -- like nurse and doctor staff, therapeutic groups, and medicine -- are robust but someone with a serious mental illness often loses the best care upon leaving jail. This then contributes to high recidivism rates.</p> <p>The hearing centered several key data points: roughly 43% of those held in city jails are suffering from mental illness (14% have serious mental illness); the recidivism rate in New York City is 20%, but for those with mental illness it’s 47%.</p> <p>Held by the Council’s Committee on Justice System, Committee on Criminal Justice, and Committee on Mental Health, Disabilities and Addiction, the hearing looked at the different ways the city Department of Correction and Correctional Health Services, a part of New York’s public health care system, New York City Health + Hospitals, provide care for the mentally ill in prison and once they leave. Two pieces of legislation dealing with notifying defense attorneys of their detained clients’ mental health and returning unused commissary money to recently released inmates were also discussed with various stakeholders who testified.</p> <p>As the overall jail population has declined significantly, the proportion of New Yorkers with mental illness in city jails has risen in recent years: the overall average daily population of city jails decreased from around 11,500 in 2014 to around 8,900 in 2018, and the percentage of people with mental illness increased from 38% to 43%.</p> <p>The percentage of those with a serious mental illness, defined by Correctional Health Services as anyone with schizophrenia, bipolar disorder, major depressive disorder, or post-traumatic stress disorder, has increased from 10.2% to 14.3% in that same time frame.</p> <p>Council Member Keith Powers, a Manhattan Democrat and chair of the Committee on Criminal Justice, asserted that the City Council and the different city agencies in attendance all agree that jail is not the place to help seriously mentally ill people. However, jail is often where people with serious mental illness wind up, and jails often offer medical services – city jails have many psychiatric services located in one place (in fact, Rikers Island is the third-biggest provider of psychiatric care in the United States behind jails in Los Angeles and Chicago).</p> <p>Currently, city jails put inmates diagnosed with mental illness in “mental observation houses” (MOs), where there are advanced levels of service and psychiatric nurses available, or the more intensive option, PACE (Program to Accelerate Clinical Effectiveness) units where there’s 24/7 embedded staff and more therapeutic groups, according to Dr. Elizabeth Ford, who testified for Correctional Health Services.</p> <p>However, through questioning from Powers, Ford admitted right now there are people who qualify for PACE but due to spacing issues are only in MOs. <a href="https://thecity.nyc/2019/04/new-special-jail-units-for-mentally-ill-are-off-pace.html" target="_blank" rel="noopener">THE CITY reported in April</a> that the de Blasio administration is well behind on its planned 12 PACE units by 2020 (currently there are six).</p> <p>Council member questions made clear that there are many mental health services available in prison, but the key organizing question of the hearing was: what happens when an inmate/patient is released? Ford said CHS gives inmates seven days of their medicine so they don’t drop off too preciptiously after leaving jail, a 30-day prescription which can be fulfilled at a pharmacy of their convenience, and many referrals to outpatient treatment programs.</p> <p>Outpatient treatment is the primary way people with mental illness are treated in New York, most of which are run by New York City Health + Hospitals. Outpatient care requires patients to appear at appointments, as opposed to inpatient care or state institutionalization – mental health care nationwide over the past 60 years has transitioned away from state-run facilities once known as “insane asylums” or “psychiatric hospitals” and towards outpatient care.</p> <p>When asked how CHS can make sure recently-released inmates follow through on getting care, Ford mentioned they are hiring more social workers and focusing on making sure existing services, like existing mobile care teams, work well rather than accepting “new mandates.”</p> <p>In terms of keeping mentally ill people out of prison in the first place, Ford brought up the new plan from the administration of Mayor Bill de Blasio of helping mentally ill people go to the Health + Hospitals system, instead of prison.</p> <p>Furthermore, two diversion centers -- in East Harlem and South Bronx -- will offer police officers a place to bring emotionally disturbed people who exhibit signs of mental illness instead of arresting them. They’re not open yet, but are supposed to open later this year.</p> <p>Ford hopes the community-based aspect of the diversion centers will be especially useful as the centers will be located to existing outpatient care.</p> <p>Supportive housing is another way to prevent recidivism, according to Ford. Supportive housing offers mental health services to people struggling to find housing. The de Blasio administration plans to build 15,000 supportive housing units over 15 years.</p> <p>If the roughly 1,200 city jail detainees diagnosed with serious mental illness were to be released tomorrow, the relatively minor supportive housing options and short-term diversion centers combined with New York’s disinclination towards inpatient care throw doubt on how the seriously mentally ill would be treated without jail-based services.</p> <p>The city has created what they call Community Re-Entry Assistance Network (CRAN) teams, which are six-month transitional teams to help those with serious mental illness re-enter the community after release.</p> <p>On the two pieces of proposed legislation being considered at the hearing, the lead sponsor of the defense attorney notification bill is Manhattan Council Member Margaret Chin, while Queens Council Member Donavan Richards is the lead sponsor of the commissary bill.</p> <p>Chin’s bill, Intro. 1590, would require the Department of Health and Mental Hygiene to notify the defense attorney of a person who is in the custody of the Department of Correction and who has been diagnosed with a serious mental illness.</p> <p>The bill, co-sponsored by City Council Speaker Corey Johnson and six other Council members, is not supported by Correctional Health Services in its current language. Although Dr. Ford chose to keep some reservations of Correctional Health Services private, she did mention that the agency has a newly-created court liaison program intended to act as a go-between for defense attorneys and medical officers.</p> <p>The current process for notifying the defense attorney of a seriously mentally ill person who is accused of a crime is the patient must give consent to Correctional Health Services and CHS gives information relevant to the mental illness diagnosis to the defense attorney.</p> <p>The bill “attempts to break the cycle of imprisonment,” said Chin, as ideally more cases could take mental illness into account.</p> <p>The most intense exchanges of the hearing occurred in regard to the other piece of legislation discussed Monday. Intro. 0903, Council Member Richards’ bill, would require the Department of Correction to notify all recently-released former inmates if there is money in their individual jail commissary account as well as return that money within 60 days of release.&nbsp;&nbsp;</p> <p>A commissary account, which can be deposited into by an inmate’s family, is essentially a bank account that the inmate can use to purchase snacks or personal products while in jail. Currently, the Department of Correction is holding $3.7 million from as far back as 2012 in unclaimed commissary money for the over 140,000 individuals who have not claimed it.</p> <p>Richards, indignant, heavily implied DOC wasn’t making any effort to return the money, while DOC testifiers stated multiple times they don’t use the unclaimed money for their own purposes.</p> <p>According to those who testified for the Department of Correction, the only outreach done by the DOC has been to put posters -- only in English -- in the jails. DOC representatives said the often unpredictable nature of inmates’ release schedules as well as the general difficulty in remaining in contact with released inmates makes returning the money difficult. DOC does not support the bill, citing difficult logistics.</p> <p>In a fitting summary of the hearing, Council Member Diana Ayala of Harlem and the Bronx said if the Department of Correction cannot find people leaving prison to give them their money back, how can they ensure the mentally ill leaving prison get the mental services they need?</p> <p>

***
by Truman Stephens, Gotham Gazette

Read more by this writer.

</p>
Where We Work, ThriveNYC is Helping Families and Getting Homeless Children to School 2019-05-06T04:00:00+00:00 2019-05-06T04:00:00+00:00 https://www.gothamgazette.com/130-opinion/8472-where-we-work-thrivenyc-is-helping-families-and-getting-homeless-children-to-school Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2019/thrivenyc-dayofaction.jpg" alt="thrivenyc dayofaction" width="600" height="401" /></p> <p>Chirlane McCray (photo: Michael Appleton/Mayoral Photography Office)</p> <hr /> <p>Questions have been raised recently about the cost and achievements of the ThriveNYC mental health initiative. This is no surprise: big, high-profile, efforts like ThriveNYC have always been susceptible to such criticisms.</p> <p>But ThriveNYC is just the unifying umbrella of more than 40 different pilot programs attempting to deliver innovative mental health interventions across multiple city agencies. Organizing these disparate efforts into one initiative helped get resources for many long-needed mental health services unlikely to be funded on their own.</p> <p>However, bundling these relatively small, experimental programs together into one big initiative makes them all a target in the event that just two or three of the interventions turn out to be ineffective, or take too long to get off the ground.</p> <p>This is unfortunate, because in our experience, ThriveNYC provides critical new funding for skilled staff positions essential to our efforts to improve the quality of services to homeless families.</p> <p>For example, we have long known that homeless children struggle to attend school regularly. Just 34% of homeless children have “good” attendance (90% of school days or better), while over 73% of their housed counterparts meet this threshold. Low school attendance is one of the most damaging outcomes of family homelessness, with often-lifelong negative consequences for children who fall behind in their educational progress.&nbsp;</p> <p>Gateway Housing and its partners are reducing chronic absenteeism among homeless children through our Improving School Attendance for Homeless Children (ISAHC) initiative. Piloted at three city shelters operated by nonprofit providers BronxWorks, Win, and HELP USA, the ISAHC initiative uses data, training, and coordination to identify and assist families struggling to get their kids to school.</p> <p>In just its first four months, the ISAHC program has already achieved measurable improvements: one-third of homeless students who were chronically absent or worse have now improved to good attendance under ISAHC, and we believe further progress is likely.</p> <p>The ISAHC initiative could not have achieved these positive outcomes without staff funded by ThriveNYC.</p> <p>Better coordination and a laser focus on attendance identifies kids who aren’t getting to school. But every day, we come across children with poor attendance whose families are experiencing severe mental health issues. &nbsp;We refer these families to new specialists employed by DHS’ nonprofit shelter providers, called Client Care Coordinators. Over 300 Client Care Coordinator positions in nonprofit-run family shelters have been created with ThriveNYC funding.</p> <p>Before ThriveNYC, we would have had very little to offer the children of homeless families facing the most complex challenges. With ThriveNYC, we now have a chance to help them and their families with professional interventions not available before the initiative existed.</p> <p>Service providers are seeing similar benefits of ThriveNYC-funded initiatives that expand access to Naloxone, provide mental health services in youth shelters, and offer Assertive Community Treatment mental health teams, to name three more ThriveNYC programs that are demonstrating real results for the most vulnerable New Yorkers.&nbsp;</p> <p>Measuring the performance of new interventions is important – no one wants to spend taxpayer dollars on ineffective programs. That’s why Gateway Housing has independent researchers tracking ISAHC to see if it works, and whether it can be replicated at other shelters.</p> <p>But implementing effective social services takes time and experimentation. While the jury may be out on some of ThriveNYC’s more ambitious initiatives, we have clear evidence that at least some of its resources are making a measurable difference for homeless children, today and for the rest of their lives.</p> <p>Mental health needs are all too often overlooked and underfunded. &nbsp;We should preserve ThriveNYC funding to continue the good work already achieved by its most effective programs, and to give its more daring, experimental efforts a chance to demonstrate success. &nbsp;</p> <p>***<br />Ted Houghton and Brendan Cheney are President and Associate Director of Gateway Housing, a nonprofit organization that works to improve the homeless shelter system. On Twitter <a href="https://twitter.com/Gateway_Housing" target="_self">@Gateway_Housing</a>.</p> <p>

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

</p>
<p><img src="https://www.gothamgazette.com/images/graphics/2019/thrivenyc-dayofaction.jpg" alt="thrivenyc dayofaction" width="600" height="401" /></p> <p>Chirlane McCray (photo: Michael Appleton/Mayoral Photography Office)</p> <hr /> <p>Questions have been raised recently about the cost and achievements of the ThriveNYC mental health initiative. This is no surprise: big, high-profile, efforts like ThriveNYC have always been susceptible to such criticisms.</p> <p>But ThriveNYC is just the unifying umbrella of more than 40 different pilot programs attempting to deliver innovative mental health interventions across multiple city agencies. Organizing these disparate efforts into one initiative helped get resources for many long-needed mental health services unlikely to be funded on their own.</p> <p>However, bundling these relatively small, experimental programs together into one big initiative makes them all a target in the event that just two or three of the interventions turn out to be ineffective, or take too long to get off the ground.</p> <p>This is unfortunate, because in our experience, ThriveNYC provides critical new funding for skilled staff positions essential to our efforts to improve the quality of services to homeless families.</p> <p>For example, we have long known that homeless children struggle to attend school regularly. Just 34% of homeless children have “good” attendance (90% of school days or better), while over 73% of their housed counterparts meet this threshold. Low school attendance is one of the most damaging outcomes of family homelessness, with often-lifelong negative consequences for children who fall behind in their educational progress.&nbsp;</p> <p>Gateway Housing and its partners are reducing chronic absenteeism among homeless children through our Improving School Attendance for Homeless Children (ISAHC) initiative. Piloted at three city shelters operated by nonprofit providers BronxWorks, Win, and HELP USA, the ISAHC initiative uses data, training, and coordination to identify and assist families struggling to get their kids to school.</p> <p>In just its first four months, the ISAHC program has already achieved measurable improvements: one-third of homeless students who were chronically absent or worse have now improved to good attendance under ISAHC, and we believe further progress is likely.</p> <p>The ISAHC initiative could not have achieved these positive outcomes without staff funded by ThriveNYC.</p> <p>Better coordination and a laser focus on attendance identifies kids who aren’t getting to school. But every day, we come across children with poor attendance whose families are experiencing severe mental health issues. &nbsp;We refer these families to new specialists employed by DHS’ nonprofit shelter providers, called Client Care Coordinators. Over 300 Client Care Coordinator positions in nonprofit-run family shelters have been created with ThriveNYC funding.</p> <p>Before ThriveNYC, we would have had very little to offer the children of homeless families facing the most complex challenges. With ThriveNYC, we now have a chance to help them and their families with professional interventions not available before the initiative existed.</p> <p>Service providers are seeing similar benefits of ThriveNYC-funded initiatives that expand access to Naloxone, provide mental health services in youth shelters, and offer Assertive Community Treatment mental health teams, to name three more ThriveNYC programs that are demonstrating real results for the most vulnerable New Yorkers.&nbsp;</p> <p>Measuring the performance of new interventions is important – no one wants to spend taxpayer dollars on ineffective programs. That’s why Gateway Housing has independent researchers tracking ISAHC to see if it works, and whether it can be replicated at other shelters.</p> <p>But implementing effective social services takes time and experimentation. While the jury may be out on some of ThriveNYC’s more ambitious initiatives, we have clear evidence that at least some of its resources are making a measurable difference for homeless children, today and for the rest of their lives.</p> <p>Mental health needs are all too often overlooked and underfunded. &nbsp;We should preserve ThriveNYC funding to continue the good work already achieved by its most effective programs, and to give its more daring, experimental efforts a chance to demonstrate success. &nbsp;</p> <p>***<br />Ted Houghton and Brendan Cheney are President and Associate Director of Gateway Housing, a nonprofit organization that works to improve the homeless shelter system. On Twitter <a href="https://twitter.com/Gateway_Housing" target="_self">@Gateway_Housing</a>.</p> <p>

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

</p>
What's The [Data] Point? 1,112,975, with Dr. Mitchell Katz, President of NYC Health + Hospitals 2019-04-04T04:00:00+00:00 2019-04-04T04:00:00+00:00 https://www.gothamgazette.com/city/8430-what-s-the-data-point-1-112-975-with-dr-mitchell-katz Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 71</strong><strong> -- 1,112,975, with Dr. Mitchell Katz, president of NYC Health + Hospitals [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/artworks-000515225592-2py301-t500x500.jpg" alt="artworks 000515225592 2py301 t500x500" width="150" height="150" style="margin: 10px; float: left;" />Dr. Mitchell Katz is in charge of the city's public hospital system, which includes 11 hospitals and dozens of other facilities and clinics. Katz came to New York City Health + Hospitals to help turn around the struggling system, especially in terms of its finances, but also in its delivery of care. He recently spoke at Citizens Budget Commission breakfast, after which he joined the podcast to take a few questions -- this episode consists of that Q&amp;A followed by Katz's remarks at the breakfast about what he's doing to change H+H, what progress has been made and what challenges persist.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/601060620&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="185" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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</p>
<p><img src="https://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 71</strong><strong> -- 1,112,975, with Dr. Mitchell Katz, president of NYC Health + Hospitals [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/artworks-000515225592-2py301-t500x500.jpg" alt="artworks 000515225592 2py301 t500x500" width="150" height="150" style="margin: 10px; float: left;" />Dr. Mitchell Katz is in charge of the city's public hospital system, which includes 11 hospitals and dozens of other facilities and clinics. Katz came to New York City Health + Hospitals to help turn around the struggling system, especially in terms of its finances, but also in its delivery of care. He recently spoke at Citizens Budget Commission breakfast, after which he joined the podcast to take a few questions -- this episode consists of that Q&amp;A followed by Katz's remarks at the breakfast about what he's doing to change H+H, what progress has been made and what challenges persist.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/601060620&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="185" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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What's The [Data] Point? 2,268, 'Deinstitutionalization' in New York 2018-12-13T05:00:00+00:00 2018-12-13T05:00:00+00:00 https://www.gothamgazette.com/city/8140-what-s-the-data-point-2-268-deinstitutionalization-in-new-york Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 61</strong><strong> - 2,268, 'Deinstitutionalization' in New York, with Stephen Eide of the Manhattan Institute [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/wtdp-stephen-eide.jpg" alt="wtdp stephen eide" width="277" height="184" style="margin: 10px; float: left;" /></p> <p>Stephen Eide, a senior fellow at the Manhattan Institute for Policy Research, is the author of <a href="https://www.manhattan-institute.org/sites/default/files/R-SE-1118.pdf" target="_blank" rel="noopener">a new report</a>&nbsp;about New York’s inpatient mental healthcare system, the state push toward deinstitutionalization, and what it has meant for people with serious mental illness and New York City. "Cuts to state psychiatric hospital beds has coincided, in recent years, with increasing mental illness-related pressures on the city’s homeless services and criminal justice systems," Eide argues.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/544477803&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="180" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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<p><img src="https://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 61</strong><strong> - 2,268, 'Deinstitutionalization' in New York, with Stephen Eide of the Manhattan Institute [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/wtdp-stephen-eide.jpg" alt="wtdp stephen eide" width="277" height="184" style="margin: 10px; float: left;" /></p> <p>Stephen Eide, a senior fellow at the Manhattan Institute for Policy Research, is the author of <a href="https://www.manhattan-institute.org/sites/default/files/R-SE-1118.pdf" target="_blank" rel="noopener">a new report</a>&nbsp;about New York’s inpatient mental healthcare system, the state push toward deinstitutionalization, and what it has meant for people with serious mental illness and New York City. "Cuts to state psychiatric hospital beds has coincided, in recent years, with increasing mental illness-related pressures on the city’s homeless services and criminal justice systems," Eide argues.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/544477803&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="180" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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The Invisible Toll of Hurricane Maria 2018-11-18T05:00:00+00:00 2018-11-18T05:00:00+00:00 https://www.gothamgazette.com/130-opinion/8087-the-invisible-toll-of-hurricane-maria Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2018/govcuomo-pr.jpg" alt="govcuomo pr" width="600" height="400" /></p> <p>Puerto Rico (photo via the governor's office)</p> <hr /> <p>The physical damage caused by Hurricane Maria on the island of Puerto Rico was undoubtedly devastating. Fortunately, homes and buildings can, have been, and will be rebuilt, but it’s often trauma from these natural disasters that leaves the most lasting and destructive mark on a community.</p> <p>The psychological impact of months without electricity, access to food and clean water, and unexpectedly losing loved ones – experienced on an island-wide scale – cannot be overstated. This kind of stress and instability is shocking, and that’s why so many professionals in the mental health community have prioritized working with victims of Hurricane Katrina in New Orleans, Superstorm Sandy in the northeast, and other natural disasters over the years.</p> <p>It's not unusual for storm victims to have feelings of fear, anxiety, sadness, or shock in the immediate aftermath of these destructive events. It becomes a problem when these feelings continue for weeks, months, or years after such disasters. Mental health professionals know that if communities are not given the proper help and support to cope with trauma from a horrific storm, they may never truly recover.</p> <p>Earlier this month, political and community leaders from New York City gathered in Puerto Rico to assist with recovery, and work together to help chart a path forward. At the core of the discussion was mental health and health care – in fact, New York Mayor Bill de Blasio made it the signature announcement of his trip. He and First Lady Chirlane McCray <a href="http://www.nydailynews.com/news/politics/ny-pol-deblasio-mccracy-puerto-rico-mental-health-20181109-story.html" target="_blank" rel="noopener">announced</a> a $200,000 commitment to help a nonprofit health care provider hire additional psychiatrists for some of the neediest communities – including one dedicated to children.</p> <p>This help could not come soon enough. While on the island myself two weeks ago, I helped deliver supplies to a Federally Qualified Health Center, which is trying to do as much as it can with the little it has. Equipment as basic as medical gloves is frequently needed, and doctors are forced to meet with patients – some even struggling with drug and alcohol addiction as well – in rooms the size of large closets. All the while, quality primary and specialty care for these communities is needed more than ever before, with thousands of doctors fleeing the island in the years leading up to Maria and during its aftermath.</p> <p>For too long, mental health has been an afterthought of medical care, especially in Latino communities. In a recent citywide study we conducted of New York’s Latino patients – <a href="https://stateoflatinohealth.com/" target="_blank" rel="noopener">Invisible: The State of Latino Health</a> – we found that only one-third of Latinos think that behavioral or mental health services are easily accessible. This lack of access to care can have severe consequences, as untreated trauma can push the most vulnerable to substance abuse and addiction. The New York City Department of Health and Mental Hygiene <a href="https://www1.nyc.gov/assets/doh/downloads/pdf/episrv/2017-latino-health.pdf" target="_blank" rel="noopener">reports</a> that almost two-thirds of New York City Latinos who die from drug overdose are, in fact, Puerto Rican.</p> <p>We know another Hurricane Maria will hit – it’s just a matter of when. Until then, we need governments, public leaders, and community groups to ensure Puerto Rico has the right support systems in place to help families rebuild their spirits and psyches, not just their homes. While the financial costs of these disasters may make the biggest headline splash, it’s the often unseen damage that may demand our greatest attention and action.</p> <p style="text-align: center;">[Read: <a href="https://www.gothamgazette.com/opinion/7988-state-of-latino-health-dismal-and-invisible" target="_blank" rel="noopener">State of Latino Health: Dismal, and Invisible</a>]</p> <p>***<br />Ricardo is the Chief Business Development Office for SOMOS Community Care, and the former executive director of Medicaid in Puerto Rico.</p> <p>

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<p><img src="https://www.gothamgazette.com/images/graphics/2018/govcuomo-pr.jpg" alt="govcuomo pr" width="600" height="400" /></p> <p>Puerto Rico (photo via the governor's office)</p> <hr /> <p>The physical damage caused by Hurricane Maria on the island of Puerto Rico was undoubtedly devastating. Fortunately, homes and buildings can, have been, and will be rebuilt, but it’s often trauma from these natural disasters that leaves the most lasting and destructive mark on a community.</p> <p>The psychological impact of months without electricity, access to food and clean water, and unexpectedly losing loved ones – experienced on an island-wide scale – cannot be overstated. This kind of stress and instability is shocking, and that’s why so many professionals in the mental health community have prioritized working with victims of Hurricane Katrina in New Orleans, Superstorm Sandy in the northeast, and other natural disasters over the years.</p> <p>It's not unusual for storm victims to have feelings of fear, anxiety, sadness, or shock in the immediate aftermath of these destructive events. It becomes a problem when these feelings continue for weeks, months, or years after such disasters. Mental health professionals know that if communities are not given the proper help and support to cope with trauma from a horrific storm, they may never truly recover.</p> <p>Earlier this month, political and community leaders from New York City gathered in Puerto Rico to assist with recovery, and work together to help chart a path forward. At the core of the discussion was mental health and health care – in fact, New York Mayor Bill de Blasio made it the signature announcement of his trip. He and First Lady Chirlane McCray <a href="http://www.nydailynews.com/news/politics/ny-pol-deblasio-mccracy-puerto-rico-mental-health-20181109-story.html" target="_blank" rel="noopener">announced</a> a $200,000 commitment to help a nonprofit health care provider hire additional psychiatrists for some of the neediest communities – including one dedicated to children.</p> <p>This help could not come soon enough. While on the island myself two weeks ago, I helped deliver supplies to a Federally Qualified Health Center, which is trying to do as much as it can with the little it has. Equipment as basic as medical gloves is frequently needed, and doctors are forced to meet with patients – some even struggling with drug and alcohol addiction as well – in rooms the size of large closets. All the while, quality primary and specialty care for these communities is needed more than ever before, with thousands of doctors fleeing the island in the years leading up to Maria and during its aftermath.</p> <p>For too long, mental health has been an afterthought of medical care, especially in Latino communities. In a recent citywide study we conducted of New York’s Latino patients – <a href="https://stateoflatinohealth.com/" target="_blank" rel="noopener">Invisible: The State of Latino Health</a> – we found that only one-third of Latinos think that behavioral or mental health services are easily accessible. This lack of access to care can have severe consequences, as untreated trauma can push the most vulnerable to substance abuse and addiction. The New York City Department of Health and Mental Hygiene <a href="https://www1.nyc.gov/assets/doh/downloads/pdf/episrv/2017-latino-health.pdf" target="_blank" rel="noopener">reports</a> that almost two-thirds of New York City Latinos who die from drug overdose are, in fact, Puerto Rican.</p> <p>We know another Hurricane Maria will hit – it’s just a matter of when. Until then, we need governments, public leaders, and community groups to ensure Puerto Rico has the right support systems in place to help families rebuild their spirits and psyches, not just their homes. While the financial costs of these disasters may make the biggest headline splash, it’s the often unseen damage that may demand our greatest attention and action.</p> <p style="text-align: center;">[Read: <a href="https://www.gothamgazette.com/opinion/7988-state-of-latino-health-dismal-and-invisible" target="_blank" rel="noopener">State of Latino Health: Dismal, and Invisible</a>]</p> <p>***<br />Ricardo is the Chief Business Development Office for SOMOS Community Care, and the former executive director of Medicaid in Puerto Rico.</p> <p>

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Now ‘Resetting,’ Chirlane McCray’s $850 Million Mental Health Program Has A Lot Riding On It 2018-04-22T04:00:00+00:00 2018-04-22T04:00:00+00:00 https://www.gothamgazette.com/city/7630-now-resetting-chirlane-mccray-s-850-million-mental-health-program-has-a-lot-riding-on-it Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2018/37861315045_e47641e2fb_z.jpg" alt="Chirlane McCray Bill de Blasio" width="600" height="400" /></p> <p>Chirlane McCray, with Bill de Blasio looking on (photo: Benjamin Kanter/Mayor's Office)</p> <hr /> <p>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.</p> <p>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:</p> <p>“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.”</p> <p>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.&nbsp;&nbsp;</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>McCray recently said of two such incidents, including the killing of Saheed Vassell in Crown Heights, “neither one of those tragedies had to be,” <a href="http://observer.com/2018/04/chirlane-mccray-nypd-emotionally-disturbed-people/" target="_blank" rel="noopener">according to Observer</a>, and pointed to ThriveNYC as the plan to fill a long-standing void and prevent such tragedies.</p> <p>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.</p> <p>“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&nbsp;<a href="https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray" target="_blank" rel="noopener">a recent appearance on the Max &amp; Murphy podcast</a> 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.</p> <p>“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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p style="text-align: center;">*****</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>The 15-minute introduction the first lady delivered on that brisk 2015 &nbsp;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.</p> <p>“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.</p> <p>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.</p> <p>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.&nbsp;&nbsp;</p> <p>“If we work together we can make it as easy to talk about anxiety as it is to talk about allergies,” McCray concluded.</p> <p style="text-align: center;">*****</p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/39612480714_e19ced386f_z.jpg" alt="McCray speech" width="300" height="201" style="margin-right: 12px; float: left;" />Two-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.</p> <p>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 <a href="http://www.ibo.nyc.ny.us/iboreports/mayor-increases-budget-for-thrivenyc-initiatives-promoting-access-to-care-expanding-current-programs-march-2016.pdf" target="_blank" rel="noopener">report</a> on Thrive.</p> <p>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 <a href="https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray" target="_blank" rel="noopener">her appearance on the Max &amp; Murphy podcast</a>, McCray said that she reads up on all of them every week.</p> <p>“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 &nbsp;&nbsp;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 &nbsp;how we’re doing.”</p> <p>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"&nbsp;<a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2018/02/Thrive-Year-2-Web-Version.pdf" target="_blank" rel="noopener">report</a>, 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.</p> <p>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.</p> <p>“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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>“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.”</p> <p>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.</p> <p>For example, there are seemingly underwhelming metrics about the number of people who have received mental health first aid training.&nbsp;Thrive’s two-year update&nbsp;<a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2018/02/Thrive-Year-2-Web-Version.pdf">report</a>, which collected data from 2016 through October 2017, indicated hat nearly 37,000 people&nbsp;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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>According to the year-two update, NYC Safe was responsible for adding &nbsp;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.</p> <p>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.</p> <p>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.</p> <p>“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.</p> <p style="text-align: center;">*****</p> <p>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.</p> <p>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.</p> <p>“It’s not an overriding concern,” McCray said on the Max &amp; 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.”</p> <p>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.</p> <p>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.</p> <p>“I would say it’s been a fantastic experience,” said Andrew Cleek, the institute’s chief program officer.</p> <p>For McCray, the experience may be the first of many more politically-minded work in the future.</p> <p>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.</p> <p>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.</p> <p>“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.”</p> <p>***<br />by Maya Miller for Gotham Gazette<br /><a href="https://twitter.com/GothamGazette" target="_blank" rel="noopener">@GothamGazette</a><br />The author is a freelance journalist currently earning an M.A. in health and science journalism at Columbia's Graduate School of Journalism.</p> <p>This article has been corrected to reflect the number of NYC Well is a 1-888 number, not 1-800</p> <p>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.</p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/37861315045_e47641e2fb_z.jpg" alt="Chirlane McCray Bill de Blasio" width="600" height="400" /></p> <p>Chirlane McCray, with Bill de Blasio looking on (photo: Benjamin Kanter/Mayor's Office)</p> <hr /> <p>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.</p> <p>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:</p> <p>“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.”</p> <p>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.&nbsp;&nbsp;</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>McCray recently said of two such incidents, including the killing of Saheed Vassell in Crown Heights, “neither one of those tragedies had to be,” <a href="http://observer.com/2018/04/chirlane-mccray-nypd-emotionally-disturbed-people/" target="_blank" rel="noopener">according to Observer</a>, and pointed to ThriveNYC as the plan to fill a long-standing void and prevent such tragedies.</p> <p>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.</p> <p>“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&nbsp;<a href="https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray" target="_blank" rel="noopener">a recent appearance on the Max &amp; Murphy podcast</a> 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.</p> <p>“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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p style="text-align: center;">*****</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>The 15-minute introduction the first lady delivered on that brisk 2015 &nbsp;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.</p> <p>“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.</p> <p>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.</p> <p>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.&nbsp;&nbsp;</p> <p>“If we work together we can make it as easy to talk about anxiety as it is to talk about allergies,” McCray concluded.</p> <p style="text-align: center;">*****</p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/39612480714_e19ced386f_z.jpg" alt="McCray speech" width="300" height="201" style="margin-right: 12px; float: left;" />Two-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.</p> <p>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 <a href="http://www.ibo.nyc.ny.us/iboreports/mayor-increases-budget-for-thrivenyc-initiatives-promoting-access-to-care-expanding-current-programs-march-2016.pdf" target="_blank" rel="noopener">report</a> on Thrive.</p> <p>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 <a href="https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray" target="_blank" rel="noopener">her appearance on the Max &amp; Murphy podcast</a>, McCray said that she reads up on all of them every week.</p> <p>“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 &nbsp;&nbsp;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 &nbsp;how we’re doing.”</p> <p>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"&nbsp;<a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2018/02/Thrive-Year-2-Web-Version.pdf" target="_blank" rel="noopener">report</a>, 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.</p> <p>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.</p> <p>“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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>“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.”</p> <p>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.</p> <p>For example, there are seemingly underwhelming metrics about the number of people who have received mental health first aid training.&nbsp;Thrive’s two-year update&nbsp;<a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2018/02/Thrive-Year-2-Web-Version.pdf">report</a>, which collected data from 2016 through October 2017, indicated hat nearly 37,000 people&nbsp;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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>According to the year-two update, NYC Safe was responsible for adding &nbsp;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.</p> <p>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.</p> <p>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.</p> <p>“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.</p> <p style="text-align: center;">*****</p> <p>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.</p> <p>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.</p> <p>“It’s not an overriding concern,” McCray said on the Max &amp; 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.”</p> <p>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.</p> <p>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.</p> <p>“I would say it’s been a fantastic experience,” said Andrew Cleek, the institute’s chief program officer.</p> <p>For McCray, the experience may be the first of many more politically-minded work in the future.</p> <p>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.</p> <p>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.</p> <p>“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.”</p> <p>***<br />by Maya Miller for Gotham Gazette<br /><a href="https://twitter.com/GothamGazette" target="_blank" rel="noopener">@GothamGazette</a><br />The author is a freelance journalist currently earning an M.A. in health and science journalism at Columbia's Graduate School of Journalism.</p> <p>This article has been corrected to reflect the number of NYC Well is a 1-888 number, not 1-800</p> <p>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.</p> City Council Progressive Caucus Calls for Crisis Intervention Reforms 2018-04-18T04:00:00+00:00 2018-04-18T04:00:00+00:00 https://www.gothamgazette.com/city/7622-city-council-progressive-caucus-calls-for-crisis-intervention-reforms Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2018/mayornyc-james-o-neil.jpg" alt="mayornyc james o neil" width="640" height="428" /></p> <p>(Credit: Michael Appleton/Mayoral Photography Office)</p> <hr /> <p>The New York City Council Progressive Caucus is stepping up calls for Mayor Bill de Blasio to reconstitute a citywide task force to examine how emergency responders help people suffering from mental illness, and are insisting that the mayor consider creating a parallel response force of social workers and therapists that can answer calls rather than police officers.</p> <p>In a letter sent to the mayor last Wednesday, the 21 members of the Progressive Caucus said the mayor should act by the end of the month to revive the Mayoral Task Force on Behavioral Health and Criminal Justice, which was set up, and concluded its work, in 2014, or create a similar body.</p> <p>“As we’ve seen once again in the last week, the tragic costs of not acting in a sustained and focused manner are too high,” the members wrote, referring to the shooting death of Crown Heights resident Shaheed Vassell by NYPD officers who were not trained to respond to situations involving “emotionally disturbed persons.” The letter noted that since the last task force’s recommendations were put in place, in the summer of 2016, ten people in emotional crisis were killed by police.</p> <p>Late last year, City Council Member Jumaane Williams, a progressive caucus member, had led an effort calling on the mayor to do the same. He was among those who <a href="https://www.gothamgazette.com/city/7603-council-members-renew-call-for-task-force-on-nypd-response-to-emotionally-disturbed-persons" target="_blank" rel="noopener">reiterated that request</a> after the death of Vassell. But though the NYPD says it is on board, the mayor continues to drag his feet. “It’s really a City Hall conversation,” NYPD Deputy Commissioner Susan Herman said at a Council hearing last month.</p> <p>The Progressive Caucus members’ latest request differs slightly from what has been previously sought.</p> <p>Rather than directing efforts at improving NYPD officer behavior, which they nonetheless hope the task force will do, they are calling for the mayor to support a new system that prioritizes professional mental health providers in emergency situations, where 911 operators can divert calls to social workers or therapists instead of the police and where therapists or trained peers can join police at the scene of an emergency. They also call for an expansion of mobile crisis teams and co-response teams that include mental health professionals paired with officers that have received Crisis Intervention Training. Just over 8,000 officers in the 36,000-strong police force have gone through CIT.&nbsp;</p> <p>"Too often, individuals with behavioral and mental health conditions are wrongly introduced to the criminal justice system. In order to improve their safety, we must consider comprehensive strategies that will prioritize preventive care and response tactics by mental health professionals,” said Council Member Diana Ayala, co-chair of the Progressive Caucus and chair of the Council’s Committee on Mental Health, Disabilities and Addiction, in a statement.</p> <p>The Progressive Caucus includes nearly half the 51 members of the City Council, and counts Council Speaker Corey Johnson among its ranks. Council Member Ben Kallos is co-chair with Ayala.</p> <p>Although the Council members praised the administration’s efforts that resulted from the recommendation of the previous task force, they noted that many initiatives stalled and also pointed to the weaknesses in the NYPD’s approach to CIT training as evidenced by a January 2017 report by the Office of the Inspector General for the NYPD.</p> <p>“The deaths of Dwayne Jeune, Saheed Vassell, and too many others have shown that there are fundamental flaws in the way our city handles EDP emergencies,” said Council Member Williams, in a statement.</p> <p>Steve Coe, CEO of Community Access, decried the “lack of leadership around this issue” despite the action plan put in place based on the 2014 task force’s recommendations. He commended the Progressive Caucus’ efforts, stressing that bringing stakeholders such as district attorneys, the city’s health department, NYPD officials, mental health experts and advocates was necessary “to assess what’s working, what’s not working, and develop diversion and treatment strategies that are effective and sustainable.”</p> <p>

***
by Samar Khurshid, senior reporter, Gotham Gazette
     

Read more by this writer.

</p> <p>Note- This article has been updated.&nbsp;</p>
<p><img src="https://www.gothamgazette.com/images/graphics/2018/mayornyc-james-o-neil.jpg" alt="mayornyc james o neil" width="640" height="428" /></p> <p>(Credit: Michael Appleton/Mayoral Photography Office)</p> <hr /> <p>The New York City Council Progressive Caucus is stepping up calls for Mayor Bill de Blasio to reconstitute a citywide task force to examine how emergency responders help people suffering from mental illness, and are insisting that the mayor consider creating a parallel response force of social workers and therapists that can answer calls rather than police officers.</p> <p>In a letter sent to the mayor last Wednesday, the 21 members of the Progressive Caucus said the mayor should act by the end of the month to revive the Mayoral Task Force on Behavioral Health and Criminal Justice, which was set up, and concluded its work, in 2014, or create a similar body.</p> <p>“As we’ve seen once again in the last week, the tragic costs of not acting in a sustained and focused manner are too high,” the members wrote, referring to the shooting death of Crown Heights resident Shaheed Vassell by NYPD officers who were not trained to respond to situations involving “emotionally disturbed persons.” The letter noted that since the last task force’s recommendations were put in place, in the summer of 2016, ten people in emotional crisis were killed by police.</p> <p>Late last year, City Council Member Jumaane Williams, a progressive caucus member, had led an effort calling on the mayor to do the same. He was among those who <a href="https://www.gothamgazette.com/city/7603-council-members-renew-call-for-task-force-on-nypd-response-to-emotionally-disturbed-persons" target="_blank" rel="noopener">reiterated that request</a> after the death of Vassell. But though the NYPD says it is on board, the mayor continues to drag his feet. “It’s really a City Hall conversation,” NYPD Deputy Commissioner Susan Herman said at a Council hearing last month.</p> <p>The Progressive Caucus members’ latest request differs slightly from what has been previously sought.</p> <p>Rather than directing efforts at improving NYPD officer behavior, which they nonetheless hope the task force will do, they are calling for the mayor to support a new system that prioritizes professional mental health providers in emergency situations, where 911 operators can divert calls to social workers or therapists instead of the police and where therapists or trained peers can join police at the scene of an emergency. They also call for an expansion of mobile crisis teams and co-response teams that include mental health professionals paired with officers that have received Crisis Intervention Training. Just over 8,000 officers in the 36,000-strong police force have gone through CIT.&nbsp;</p> <p>"Too often, individuals with behavioral and mental health conditions are wrongly introduced to the criminal justice system. In order to improve their safety, we must consider comprehensive strategies that will prioritize preventive care and response tactics by mental health professionals,” said Council Member Diana Ayala, co-chair of the Progressive Caucus and chair of the Council’s Committee on Mental Health, Disabilities and Addiction, in a statement.</p> <p>The Progressive Caucus includes nearly half the 51 members of the City Council, and counts Council Speaker Corey Johnson among its ranks. Council Member Ben Kallos is co-chair with Ayala.</p> <p>Although the Council members praised the administration’s efforts that resulted from the recommendation of the previous task force, they noted that many initiatives stalled and also pointed to the weaknesses in the NYPD’s approach to CIT training as evidenced by a January 2017 report by the Office of the Inspector General for the NYPD.</p> <p>“The deaths of Dwayne Jeune, Saheed Vassell, and too many others have shown that there are fundamental flaws in the way our city handles EDP emergencies,” said Council Member Williams, in a statement.</p> <p>Steve Coe, CEO of Community Access, decried the “lack of leadership around this issue” despite the action plan put in place based on the 2014 task force’s recommendations. He commended the Progressive Caucus’ efforts, stressing that bringing stakeholders such as district attorneys, the city’s health department, NYPD officials, mental health experts and advocates was necessary “to assess what’s working, what’s not working, and develop diversion and treatment strategies that are effective and sustainable.”</p> <p>

***
by Samar Khurshid, senior reporter, Gotham Gazette
     

Read more by this writer.

</p> <p>Note- This article has been updated.&nbsp;</p>
Max & Murphy Podcast: First Lady Chirlane McCray 2018-03-26T04:00:00+00:00 2018-03-26T04:00:00+00:00 https://www.gothamgazette.com/city/7568-max-murphy-podcast-chirlane-mccray Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/mxm-logo.jpg" alt="mxm logo" width="600" height="239" /></p> <p>Ben Max, left, of Gotham Gazette, and Jarrett Murphy, right, of City Limits</p> <hr /> <p><strong>March 26, 2018 - Max &amp; Murphy Podcast: New York City First Lady Chirlane McCray<br /></strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/ch-mccray-277l.jpg" alt="Chirlane McCray" width="277" height="143" style="margin: 10px; float: left;" /></p> <p>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.</p> <p>Listen to the full conversation and let us know what you think -- we're on Twitter <a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a> and <a href="https://twitter.com/jarrettmurphy" target="_blank" rel="noopener noreferrer">@JarrettMurphy</a>&nbsp;and guest <a href="https://twitter.com/Chirlane" target="_blank" rel="noopener">@Chirlane</a> McCray (<a href="https://twitter.com/NYCFirstLady" target="_blank" rel="noopener">@NYCFirstLady</a>). You can listen to the episode through the embedded audio below or download the episode wherever you get your podcasts.</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/420290176&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="170" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

Read more by this writer.

</p>
<p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/mxm-logo.jpg" alt="mxm logo" width="600" height="239" /></p> <p>Ben Max, left, of Gotham Gazette, and Jarrett Murphy, right, of City Limits</p> <hr /> <p><strong>March 26, 2018 - Max &amp; Murphy Podcast: New York City First Lady Chirlane McCray<br /></strong></p> <p><img src="https://www.gothamgazette.com/images/graphics/2018/podcast18/ch-mccray-277l.jpg" alt="Chirlane McCray" width="277" height="143" style="margin: 10px; float: left;" /></p> <p>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.</p> <p>Listen to the full conversation and let us know what you think -- we're on Twitter <a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a> and <a href="https://twitter.com/jarrettmurphy" target="_blank" rel="noopener noreferrer">@JarrettMurphy</a>&nbsp;and guest <a href="https://twitter.com/Chirlane" target="_blank" rel="noopener">@Chirlane</a> McCray (<a href="https://twitter.com/NYCFirstLady" target="_blank" rel="noopener">@NYCFirstLady</a>). You can listen to the episode through the embedded audio below or download the episode wherever you get your podcasts.</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/420290176&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="170" frameborder="no" scrolling="no"></iframe></p> <p>

***
by Ben Max, Gotham Gazette
     

Read more by this writer.

</p>
Part of ThriveNYC, NYCHA Trains Staff in Mental Health First Aid 2017-07-05T04:00:00+00:00 2017-07-05T04:00:00+00:00 https://www.gothamgazette.com/city/7049-part-of-thrivenyc-nycha-trains-staff-in-mental-health-first-aid Samar Khurshid <p><img src="https://www.gothamgazette.com/images/5716575756_06b18d2c43_z.jpg" alt="5716575756 06b18d2c43 z" width="600" height="400" /></p> <p>NYCHA community gathering at Queensbridge (Pete Mikoleski/NYCHA flickr)&nbsp;</p> <hr /> <p>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.</p> <p>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.</p> <p>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.</p> <p>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 <a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2016/03/ThriveNYC.pdf" target="_blank" rel="noopener noreferrer">roadmap for ThriveNYC</a>. 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.</p> <p>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 <a href="https://thrivenyc.cityofnewyork.us/" target="_blank" rel="noopener noreferrer">ThriveNYC website</a>. 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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p> </p> <p><img src="https://www.gothamgazette.com/images/5716575756_06b18d2c43_z.jpg" alt="5716575756 06b18d2c43 z" width="600" height="400" /></p> <p>NYCHA community gathering at Queensbridge (Pete Mikoleski/NYCHA flickr)&nbsp;</p> <hr /> <p>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.</p> <p>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.</p> <p>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.</p> <p>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 <a href="https://thrivenyc.cityofnewyork.us/wp-content/uploads/2016/03/ThriveNYC.pdf" target="_blank" rel="noopener noreferrer">roadmap for ThriveNYC</a>. 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.</p> <p>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 <a href="https://thrivenyc.cityofnewyork.us/" target="_blank" rel="noopener noreferrer">ThriveNYC website</a>. 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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p> </p> Every Child Needs Access to Mental Health Services 2017-05-29T04:00:00+00:00 2017-05-29T04:00:00+00:00 https://www.gothamgazette.com/130-opinion/6960-every-child-needs-access-to-mental-health-services Ben Max <p><img src="https://www.gothamgazette.com/images/graphics/2017/school_guidance_counselors_kipp.jpg" alt="school guidance counselors kipp" width="600" height="401" /></p> <p>(Dr. Thelma Dye, the author)</p> <hr /> <p>Prince Harry’s recent admission he is seeking treatment to come to terms with his mother’s death made headlines across the globe and for good reason. As recently as 20 years ago public opinion polls here in the U.S. found more than half the country believed depression was a sign of personal or emotional weakness. So when one of the world’s most recognizable and influential figures says not even a royal is immune to mental health challenges, it can have a significant impact.</p> <p>Harry, along with his brother and sister-in-law, the Duke and Duchess of Cambridge, have started an advocacy campaign to remove the stigma of mental illness worldwide, primarily aimed at reaching the younger generations. Given that two out of every three children experience a traumatic event by their 16th birthday, this effort couldn’t have a better audience.</p> <p>In working with children and families for more than 20 years here in New York City, I have seen firsthand how addressing mental health issues at an early age leads to better learning outcomes, stronger family relationships, and improved life outcomes. It’s not a secret that mental health is as critical as physical health in a child’s long-term development, and child psychiatrists see that every day in their work.</p> <p>But advocacy alone won’t be enough to protect the countless children, including many in our own city, who fly under the radar. Untreated mental illness disproportionately affects communities of color. In fact, African-Americans are 20% more likely to experience serious mental health problems than the general population. In our schools, these are the kids most often labeled as “behavior problems” and disproportionately represented in our suspension and dropout rates and in our criminal justice system.</p> <p>Over the past several years, New York City has started to take some important steps towards identifying and supporting the mental health needs of students, but of course we need an even more committed effort.</p> <p>For example, Northside Center, which I lead, recently announced a partnership with CVS to expand Clinic in Schools, an initiative that provides in-school mental health services and referrals for families. In the ten schools in which we currently work, we have seen great strides in treatment for children with anxiety and depression. The partnership will allow us to expand our services more comprehensively in the ten schools we currently serve with an eye on expansion to more schools as space and funding permit.</p> <p>In addition, First Lady Chirlane McCray recently expanded her ThriveNYC program, which provides free mental health services to children ages 0-5 throughout the city. These kinds of programs make a significant difference for the individuals they serve. Schools with full-time social workers and other mental health services report fewer classroom disruptions, lower suspension rates and absenteeism. And we know the more time children spend in school learning, the more likely they are to have better academic outcomes.</p> <p>But we also know there are more than 1,700 public schools and a million school kids across the five boroughs, and many are slipping through the cracks.</p> <p>Mayor de Blasio’s new “3-K” initiative holds tremendous potential in this area. By getting students into formalized education programs at three years old, we can identify and address learning and behavioral challenges even earlier – issues that if left unattended often become major barriers to achievement as these children grow up. As with any health issue, prevention is the most effective treatment.</p> <p>Despite all this progress, I worry about the future. We don’t know how federal health care and Medicaid reforms will affect mental health services for our most vulnerable citizens nor the impact on insurance plans that already undervalue the importance of these treatments. Any program that increases the number of uninsured Americans bodes poorly for our health as a nation.</p> <p>We’ve come a long way as a country in recognizing that mental illness is a common and treatable disease. New public opinion polls show two-thirds of the population view mental illness as a very serious health concern. If depression and anxiety can alter the life path for years of a man like Prince Harry, imagine what it does to a child who doesn’t have the advantages he does. It’s time we turn this increased awareness into action. We can start by making stronger connections for decision-makers that show mental health translates into school, career, and life success, and not just for royals but for everyone.</p> <p>***<br />Dr. Thelma Dye is executive director at Northside Center for Child Development.</p> <p>

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<p><img src="https://www.gothamgazette.com/images/graphics/2017/school_guidance_counselors_kipp.jpg" alt="school guidance counselors kipp" width="600" height="401" /></p> <p>(Dr. Thelma Dye, the author)</p> <hr /> <p>Prince Harry’s recent admission he is seeking treatment to come to terms with his mother’s death made headlines across the globe and for good reason. As recently as 20 years ago public opinion polls here in the U.S. found more than half the country believed depression was a sign of personal or emotional weakness. So when one of the world’s most recognizable and influential figures says not even a royal is immune to mental health challenges, it can have a significant impact.</p> <p>Harry, along with his brother and sister-in-law, the Duke and Duchess of Cambridge, have started an advocacy campaign to remove the stigma of mental illness worldwide, primarily aimed at reaching the younger generations. Given that two out of every three children experience a traumatic event by their 16th birthday, this effort couldn’t have a better audience.</p> <p>In working with children and families for more than 20 years here in New York City, I have seen firsthand how addressing mental health issues at an early age leads to better learning outcomes, stronger family relationships, and improved life outcomes. It’s not a secret that mental health is as critical as physical health in a child’s long-term development, and child psychiatrists see that every day in their work.</p> <p>But advocacy alone won’t be enough to protect the countless children, including many in our own city, who fly under the radar. Untreated mental illness disproportionately affects communities of color. In fact, African-Americans are 20% more likely to experience serious mental health problems than the general population. In our schools, these are the kids most often labeled as “behavior problems” and disproportionately represented in our suspension and dropout rates and in our criminal justice system.</p> <p>Over the past several years, New York City has started to take some important steps towards identifying and supporting the mental health needs of students, but of course we need an even more committed effort.</p> <p>For example, Northside Center, which I lead, recently announced a partnership with CVS to expand Clinic in Schools, an initiative that provides in-school mental health services and referrals for families. In the ten schools in which we currently work, we have seen great strides in treatment for children with anxiety and depression. The partnership will allow us to expand our services more comprehensively in the ten schools we currently serve with an eye on expansion to more schools as space and funding permit.</p> <p>In addition, First Lady Chirlane McCray recently expanded her ThriveNYC program, which provides free mental health services to children ages 0-5 throughout the city. These kinds of programs make a significant difference for the individuals they serve. Schools with full-time social workers and other mental health services report fewer classroom disruptions, lower suspension rates and absenteeism. And we know the more time children spend in school learning, the more likely they are to have better academic outcomes.</p> <p>But we also know there are more than 1,700 public schools and a million school kids across the five boroughs, and many are slipping through the cracks.</p> <p>Mayor de Blasio’s new “3-K” initiative holds tremendous potential in this area. By getting students into formalized education programs at three years old, we can identify and address learning and behavioral challenges even earlier – issues that if left unattended often become major barriers to achievement as these children grow up. As with any health issue, prevention is the most effective treatment.</p> <p>Despite all this progress, I worry about the future. We don’t know how federal health care and Medicaid reforms will affect mental health services for our most vulnerable citizens nor the impact on insurance plans that already undervalue the importance of these treatments. Any program that increases the number of uninsured Americans bodes poorly for our health as a nation.</p> <p>We’ve come a long way as a country in recognizing that mental illness is a common and treatable disease. New public opinion polls show two-thirds of the population view mental illness as a very serious health concern. If depression and anxiety can alter the life path for years of a man like Prince Harry, imagine what it does to a child who doesn’t have the advantages he does. It’s time we turn this increased awareness into action. We can start by making stronger connections for decision-makers that show mental health translates into school, career, and life success, and not just for royals but for everyone.</p> <p>***<br />Dr. Thelma Dye is executive director at Northside Center for Child Development.</p> <p>

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

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