Mental Health Update

January 20, 2023

Powerful Op-ed in Crain’s from Amy Dorin of Coalition for Behavioral Health in Response to Homeless Crisis in NYC


Very powerful Op-ed in Crain’s about real responses to the city’s homeless problem (which of course highlights the importance of workforce) by our friend and colleague, Amy Dorin, CEO and President of  the Coalition for Behavioral Health.

Glenn Liebman
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Op-ed: The mayor’s solution to homelessness won’t work

Amy Dorin

The Coalition for Behavioral Health, New York’s largest advocacy organization for community behavioral health providers, agrees with Mayor Eric Adams that people with mental illness who are homeless deserve better than living untreated and unsheltered lives on the streets and subways, but we strongly object to his proposed solution.

Unhoused people with mental illness are a result of inadequate housing and mental health care, not a gray area in the interpretation of mental hygiene law. After decades of failing to address their needs, it’s time we rethink our approach and not do the things we’ve tried repeatedly without success.

Having police involuntarily remove to a hospital homeless people they suspect of having a mental illness, who are not at imminent risk of harming themselves or others, will unnecessarily traumatize them. Even if the Police Department, the Fire Department, the Fire Department’s emergency medical technicians and the Metropolitan Transportation Authority Police Department apply the policy change with nuance and refinement and they remove only small numbers of such people, they will have traumatized them without having significantly improved their condition.

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Even if hospital care is appropriate, our constrained inpatient psychiatric capacity and inadequate continuum of services mean that they are off the streets for only a few hours, days or weeks.

When they leave the hospital, most will end up on the street or in shelters without continuing care to maintain any progress made during hospitalization. They will be wary and will hide from outreach teams and law enforcement to avoid forced hospitalization again.

An approach that builds trust

We urge the mayor and Gov. Kathy Hochul to immediately implement a more effective approach that builds trust with vulnerable New Yorkers and facilitates access to essential services. The governor’s State of the State address included some proposals our coalition’s members have long supported:

  • Expand the supply of supportive housing that combines homes with behavioral health care.
  • Develop more intensive, community-based treatment, such as assertive community treatment and intensive mobile treatment.

Other proposals not in the State of the State address that the city and state should act on immediately

  • Streamline city processes that keep people from accessing help.
  • Use available enhanced federal funding to expand mobile crisis capacity.
  • Increase both outpatient and inpatient treatment capacity.
  • Create additional psychosocial rehabilitation services to help people with serious mental illnesses build lives of productivity and dignity.
  • Add more on-site mental health care to homeless shelters. (Only 71 of 554 city homeless shelters have on-site mental health services.)
  • Address the workforce crisis that is preventing behavioral health providers from expanding.

This crisis is a result of decades of failure by successive administrations to develop and implement a plan to scale up the services that we know work to end homelessness, engage people with severe mental illness in treatment, and address the economic and health care access disparities faced by Black and Latino New Yorkers, who are disproportionately represented in the city’s homeless population.

The mayor’s proposal will cost the city heavily. In addition to the training and other law enforcement costs, there will be significant costs associated with increased emergency medical and hospital services, civil rights lawsuits and incarceration, which will inevitably result from police interactions. These dollars would be better spent on comprehensive solutions that work to transform the behavioral health and homeless services system to positively change the lives of people who are homeless and have a serious mental illness.

The mayor has a historic opportunity to forge a more thoughtful and sustainable approach than past mayors, who failed to address the problem at its roots.

We urge him to collaborate with the city’s community mental health agencies to develop a comprehensive plan to transform lives while he reduces the number of people forced to live in public spaces because they lack a better option.

Amy Dorin is president and CEO of the Coalition for Behavioral Health.

 

 


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