A new push to improve mental health care for homeless New Yorkers
The Manhattan borough president is expected to announce a plan Tuesday that he says will help increase access to psychiatric care and housing for seriously mentally ill homeless people in New York City.
The proposal from City President Mark Levine was intended to address gaps in New York City’s social safety net in the wake of several high-profile incidents involving random attacks by homeless people with mental illness.
It calls for the creation of 240 long-term psychiatric beds in the public hospital system’s extended care units, where patients can be stabilized rather than discharged onto the street, and the addition of intensive mobile treatment teams to care for those patients outside the hospital environment. . Mr. Levine wants the city to double the number of these teams to 62, allowing them to serve about 1,500 people. In August, nearly 480 people were waiting to be assigned to such a team, the data shows.
“We have not invested in the kinds of interventions that put people back on the right path,” said Mr. Levine, a former city council member who took over as borough president last year. “I’m optimistic if we have the will, we can do this well.”
Mr. Levine unveiled his plan in the wake of a New York Times investigation that revealed shortcomings in the city’s mental health system: homeless shelters, hospitals, specialized treatment teams and other organizations. The mistakes preceded nearly a hundred acts of violence over the past decade, The Times found, sometimes by a matter of days or hours.
Mr. Levine said the murder of a financial advisor early last year by a homeless man with schizophrenia and a history of erratic behavior prompted him to examine gaps in mental health care, and what he described as a “crisis that is taking place’. on the streets of New York City.”
General hospitals have cut hundreds of psychiatric beds in recent years, leading to the discharge of patients who were not yet stable. After their release, some patients spent months on waiting lists for allocation to specialized treatment teams. Others have filled homeless shelters or ended up on the streets and in the city’s subway system. Some have disintegrated avoidably and violently.
The Times found that the city had not placed mentally ill homeless people in special mental health shelters where they could receive psychiatric services. Hospitals often discharged patients before they were stable. Workers on specialized treatment teams were often overwhelmed, undertrained, and underpaid, and sometimes failed to help homeless people who showed signs of deterioration.
Many of the failures stemmed from poor communication between the various agencies responsible for treating mentally ill homeless people, The Times found.
So often, Mr. Levine said, we only learn about the kinds of failures documented in the Times investigation “after a terrible act.” He added: “Nobody connected the dots.”
To understand the ways the city’s social safety net worked and the ways it didn’t, Mr. Levine said he toured the different parts of the system. He visited psychiatric facilities and mental health residential units on Randall’s Island and shadowed outpatient teams as they treated people on the street.
What he discovered, he said, was a number of underfunded programs that worked for a small group of people but failed to meet the full need.
As city president, Mr. Levine does not have the power to pass legislation or enforce laws, but he can introduce bills through the city council, working with a council member, and push for the changes he proposes.
Mr. Levine’s plan calls for the state to create 400 new beds in the Transition to Home program at the Manhattan Psychiatric Center, a new inpatient treatment program for homeless people with serious mental illnesses. The program currently has 50 beds, Mr. Levine said.
He also urged city officials to ensure that supportive housing projects, including three being developed in Manhattan, are completed despite community opposition.
As another part of his plan, Mr. Levine urged the city to strengthen opioid treatment for people with serious mental illness and address the behavioral health workforce shortage, including by expanding programs for student loan forgiveness.