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Mayor de Blasio, First Lady McCray and City Council Members Announce $37 Million Annual Investment in New Strategies to Address Serious Mental Illness

October 21, 2019

City adopts recommendations from the NYC Crisis Prevention and Response Task Force and announces new strategies to ensure those with serious needs stay connected to treatment

NEW YORK—Mayor Bill de Blasio, First Lady Chirlane McCray and City Council Members today announced a $37 million annual investment to close critical gaps in services for New Yorkers with serious mental illness. Many of the strategies were developed by the NYC Crisis Prevention and Response Task Force, composed of over 80 experts including advocates, city agency leadership and community members who have experienced mental illness. Implementation begins immediately.

To reduce mental health crises that result in 911 calls, $23 million of the annual investment will support new teams of mental health responders that will intervene before crises, respond to urgent situations and stabilize people in the weeks following a crisis. To ensure those with the most serious needs stay connected to treatment, today's announcement also includes $14 million to expand intensive services for the narrow population of New Yorkers with untreated serious mental illness who pose a risk of violent behavior.

"One in five New Yorkers suffers from a mental health condition. It's our job to reach those people before crisis strikes," said Mayor de Blasio. "With this new investment, we're connecting people to the services they need and keeping our neighborhoods and most vulnerable New Yorkers safe."

"We want every community in our city to have access to mental health resources and many of these recommendations will bring support to people and their families with the highest need. Every time a New Yorker receives care and treatment because of the changes we are making marks progress for our city," said First Lady McCray, who served as Honorary Co-Chair of the Task Force.

Reduce mental health crises that result in 911 calls

In New York City, as in many cities across the country, police are often the first responders to mental health crises – severe situations in which a person poses a risk to themselves or others. The City will now significantly expand the number of mental health professionals who can intervene before crises occur, respond to urgent situations and help stabilize people in their communities in the critical weeks following a crisis.

Mental health 911 calls have nearly doubled in the last decade in New York City, from 97,132 in 2009 to 179,569 in 2018. With the plan announced today, the City is investing in a new approach to mental health crises that includes a strong public health response to a public health problem, enhanced mental health support in communities, and increased focus on mental health at the Police Department.

To reduce these calls, the City will:

  • Increase the number of mental health responders citywide by:
    • Adding four Health Engagement Assessment Teams (HEAT), composed of one clinician and one peer (a person who has previously experienced a mental health challenge), to proactively engage people with the most frequent 911 contact, connecting them to care and other stabilizing support.
    • Adding six Mobile Crisis Teams composed of clinicians, case managers and peers to ensure better rapid response time to urgent situations. Mobile Crisis Teams are deployed to people's homes, provide crisis intervention, and connect people to appropriate services.
  • Deploy additional resources to two high-need precincts (the 25th and the 47th) by:
    • Adding four additional HEAT teams to proactively engage those at risk of mental health crises.
    • Adding four Co-Response Teams, composed of two police officers and one mental health clinician, to assist in the response to emergency 911 mental health calls. This will be the first time mental health professionals will be part of the City's response to 911; currently, the only 911 deployment options are police and EMS. This work will first be piloted in one of the precincts to develop operational protocols and then move to the second precinct.
    • Creating a community-based mental health safety net of local organizations to provide intensive, wrap-around services to help stabilize people following psychiatric hospitalizations.
  • Intensify focus on mental health at the NYPD:
    • Creating a new Behavioral Health Unit to coordinate policies and programs including those related to mental health crisis response.
    • Incorporating peers into Emergency Services Unit training.
    • Incorporating peers into the orientation for new officers.

Ensure those with the most serious needs stay connected to care

In the past four years, New York City – through ThriveNYC – has significantly expanded intensive, community-based mental healthcare for individuals with serious mental illness. Today's investment expands these innovative strategies, a critical part of ensuring continuous connection to treatment for the narrow category of people with untreated serious mental health needs who pose a risk of violent behavior. Mobile intervention and treatment teams – which bring high-quality behavioral healthcare to people in their communities – are designed to help difficult-to-serve populations and people experiencing homelessness.

Specifically, the City has pledged to invest resources to ensure those with serious needs stay connected to care by funding nine new mobile treatment teams, which provide intensive, ongoing treatment in the community. In addition, the City will add four more Co-Response Teams (CRT), for a total of eight new teams, which are composed of two police officers and one clinician who intervene before and after crises, connecting people to care and other stabilizing support such as housing, benefits or family.

The strategies announced today will be implemented by many city agencies, with oversight provided by the Mayor's Office of ThriveNYC. Specifically, the Mayor's Office of ThriveNYC will chair a standing steering committee of leadership from the agencies responsible for operationalizing these strategies; regularly convene the community members, peers, advocates and elected officials who participated in the NYC Crisis Prevention and Response Task Force; and work toward effective, racially equitable implementation.

In addition to the new strategies announced today, several other initiatives recommended by the Crisis Prevention and Response Task Force are actively underway and managed by other City agencies. These include:

  • Piloting the addition of telehealth to shelters
  • Diverting 911 calls to NYC Well, where appropriate
  • Exploring walk-in services at NYC Health + Hospitals facilities
  • Expanding peer/police training opportunities
  • Creating a data flag for frequent 911 callers

First Lady Chirlane McCray was the honorary co-chair of the Task Force and First Deputy Mayor Dean Fuleihan and former Deputy Mayor for Health and Human Services Dr. Herminia Palacio were joint co-chairs. The Task Force's advisory committee was comprised of Police Commissioner James P. O'Neill, Fire Commissioner Daniel A. Nigro, then Health Commissioner Dr. Mary Travis Bassett, Department of Social Services Commissioner Steven Banks, the Director of the Mayor's Office of Criminal Justice Elizabeth Glazer, and NYC Health + Hospitals President Dr. Mitchell H. Katz. The Task Force's planning committee was jointly led by DOHMH Executive Deputy Commissioner Gary Belkin and NYPD Deputy Commissioner Susan Herman, who is now the Director of the Mayor's Office of ThriveNYC.

"Evidence and experience show that many calls to 911 can be prevented, even at a time that the total number of calls has been climbing citywide. These innovative solutions will help get people the care they need, where and when they need it," said First Deputy Mayor Dean Fuleihan, Co-Chair of the Crisis Prevention and Response Task Force.

"Today marks the beginning of a new chapter in the transformation in how the City responds to mental health crises. The members of this Task Force put in a great deal of time and creative problem solving, and I want to thank the more than 80 people involved from inside and outside government for their efforts," said Susan Herman, Senior Advisor to the Mayor and Director of the Mayor's Office of ThriveNYC, who co-chaired the Task Force's planning committee while Deputy Commissioner, Collaborative Policing at the NYPD.

"Building a robust system of care for people living with serious mental illnesses is an all-in effort requiring input from many parts of City government as well as healthcare providers and others," said Health Commissioner Dr. Oxiris Barbot. "These new resources will help all of us continue to build upon our successes and expand important routes to services and care."

"Every day NYC Health + Hospitals provides high-quality clinical care and resources to New Yorkers, regardless of their housing situation," said Mitchell Katz, MD, President and CEO of NYC Health + Hospitals. "While only a small percentage of the homeless patients we treat have serious mental illness and even fewer are violent, these investments expand crucial interventions in the community and ensure that our patients remain connected to care. We know that a lack of stable housing is often the biggest barrier to staying in treatment, which is why we partner closely with our sister organizations to link patients to housing and other supports. As one of the largest providers of behavioral health services in the City, NYC Health + Hospitals plays a critical role in ensuring that our patients receive the care they need in an environment that is safe and supportive."

"Improving public safety and helping those suffering with mental health issues requires a comprehensive, multi-agency response," said Police Commissioner James P. O'Neill. "Taken together, these new efforts reinforce our core policing philosophies — to hone in with precision on individuals' needs, to comprehensively tackle the most serious societal issues in an era of historically low crime, and to forge deeper connections with those we're sworn to keep safe."

"Reaching those who've fallen through every social safety net requires persistence, compassion, and continued collaboration with all of our City's experts at the table," said Social Services Commissioner Steven Banks. "This Administration is committed to developing the innovative interventions that will help us continue to improve how we support our neighbors experiencing mental health challenges, including those who may be in crisis. By closing gaps in programs, we will keep doing better by those we serve, as well as those who may need our services, but may not be ready to accept assistance yet."

"We know that by working together with our fellow city agencies we will improve the services and support for New Yorkers suffering from mental illness, said Fire Commissioner Daniel A. Nigro. "These new strategies will provide greater help to those in need and continue to improve the safety of our city."

"These new strategies show a real commitment to connecting New Yorkers with the most serious mental health needs to ongoing services, which is absolutely critical to building safe, stable communities, while at the same time working towards more successful outcomes in situations where a 911 call does become necessary. I'm glad to see that many of these strategies are being piloted here in District 8, and I look forward to seeing the results this will have for our neighborhoods," said Council Member Diana Ayala, chair of the Committee on Mental Health, Disability and Addictions.

"New Yorkers need to know that the city will respond with a strong public health response when their family members, friends or neighbors are suffering from a mental health crisis," said Council Member Donovan Richards, chair of the Committee on Public Safety and member of the Crisis Prevention and Response Task Force. "The status quo must change and thankfully the members of the Task Force developed thoughtful policy changes that will reduce 911 calls, expand the efforts of Co-Response Teams, HEAT and Mobile Crisis Teams; and enhance services in communities, shelters and hospitals. This $37 million investment is a critical first step towards addressing serious mental illness with a more compassionate and holistic approach than ever before. I'd like to thank all of the advocates who led this effort and will continue to deliver results for people in crisis, including Carla Rabinowitz and the entire Community Access coalition. I'd also like to thank Mayor de Blasio, Susan Herman, and Dr. Gary Belkin for taking the reins on the Task Force and delivering well-rounded recommendations and policy changes that will truly make a difference for so many New Yorkers across the city."

"We have an urgent need to address the mental health crisis in New York City. This new funding puts us closer to providing necessary services for New Yorkers at a time of need. I look forward to our ongoing work to address our serious mental health needs in the city," said Council Member Keith Powers, chair of the Criminal Justice Committee.

"As a former case manager for mentally ill homeless, assigned to a mobile street team unit, I applaud the City for investing in programs and services to address serious mental illness. Today's announcement is much needed and will provide some of New York's most vulnerable residents with appropriate help and support during a mental health crisis. When calling 911 will now lead to a mental health clinician instead of NYPD alone and an increase in funding for community based organizations, we are finally addressing a real concern head on. I look forward to the rollout and a day when all New Yorkers can live in a safe, peaceful and healthy environment," said Council Member Alicka Ampry-Samuel.

"Fueled by unequal access to treatment, New York City's mental health crisis has reached a critical juncture as it's become patently clear that we can't keep applying a criminal justice solution to a public health problem. This $37 million investment will help ensure that New Yorkers in the midst of a mental health crisis can get the help they need from qualified and trained professionals. I want to thank the Mayor and First Lady for tackling this issue head-on and I'll continue doing everything I can to expand access to treatment in communities across the state," said Assembly Member Mathylde Frontus.

"This Administration's investment in mental health and supporting those with serious mental illness is unprecedented and unparalleled," said Liz Roberts, task force member and Deputy CEO of Safe Horizon, the nation's largest victim services agency. "We are so grateful to the Mayor and First Lady for their deep commitment to this long-ignored issue in our city. This plan responds to our city's needs, and it will save lives."

"I was honored to participate on behalf of CASES in the Crisis Prevention and Response Task Force. These investments signal a critical shift in how New York City responds to individuals in crisis, moving away from a police-led response to comprehensive public health interventions. CASES currently operates seven intensive mobile treatment teams, annually providing nearly 20,000 treatment services in community settings including on the streets to people living with serious mental illness. Almost all of our clients have experienced crisis, and these investments create a new reality for our clients and people in communities throughout the City who live with mental illness and/or addictions, ensuring they achieve rapid access to supports for recovery and wellness," said Ann-Marie Louison, Chief Strategic Initiatives Officer at CASES.

"The adoption of these recommendations marks a huge step for New York City toward ensuring the safety and wellbeing of people in mental health crisis," said Ayesha Delany-Brumsey, Director of Behavioral Health at The Council of State Governments Justice Center. "It is efforts like these that will not only help to meaningfully support some of the city's most vulnerable citizens by quickly, effectively, and compassionately responding to people in crisis, but also serve as an example to other communities working to make the same progress."

David Rivel, CEO of the Jewish Board of Family and Children's Services, said, "The City should be applauded for investing resources to facilitate collaboration between the NYPD and the mental health system, including utilizing the valuable perspectives and expertise offered by peer staff. Specifically, increasing the joint mental health/police capacity to assist persons experiencing mental health crises in a supportive manner will be beneficial to individuals, families, and the community at large. I look forward to continuing to participate in the task force's future efforts."

Dr. Karen Nelson, MD, MPH, who serves as CMO, Central Services Organization at Maimonides Medical Center, said, "We need to connect people to care where and when they need it, stopping crises before they start and helping people stabilize their lives after one occurs. These strategies fill in critical gaps towards that goal, and this investment will make a real difference in people's lives."

"We applaud the City and Mayor for bringing leaders together to begin to change the nature of how we interact with people in crisis. When a person with a serious mental illness experiences a crisis, they need a therapeutive, non-punitive response that focuses on the immediate and underlying needs of the individual, and these recommendations propose steps toward that. We can no longer tolerate a world where emergency rooms, homeless shelters, and jails are our de facto solutions to people in crisis. These recommendations represent a first step in moving toward this future together," said Ashwin Vasan, MD, PhD, President of Fountain House.

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