July 31, 2015
First Lady Chirlane McCray: Thank you, Gabrielle. Good afternoon, everyone, and what a fantastic afternoon it is because we have some very big news to share. The city of New York has been selected to receive a social innovation fund grant of up to $10 million dollars from the Corporation for National and Community Service. This grant is the centerpiece of a $30 million dollar public-private partnership that will launch Connections to Care, an innovative effort to bring mental health services into the communities where they are needed most.
This is the largest public-private initiative to date of the de Blasio administration. It is also one of largest of this type of initiative in the 21-year history of the Mayor’s Fund. You can clap if you want.
I am grateful to many people for helping us make this announcement possible. I thank Gabrielle Fialkoff, who you’ve just heard from, and Darren Bloch the executive director of the Mayor’s Fund. Gabrielle and Darren with their outstanding team and our city agency partners are creating even more enthusiasm for the Mayor’s Fund with terrific programs our private sector is very eager to be involved in. I want to thank you also – say thank you also, to the Corporation for National and Community Service, and their visionary CEO, Wendy Spencer.
Wendy has spent much of her career helping to bring hope – bringing help and hope to people in crisis. So her support for our work is a very big deal. We are deeply grateful to the philanthropic partners who have kicked off our match funding; the Perelman family, the Chapman Perelman Foundation, and the Beneficus Foundation. And I have tremendous praise for our Health Commissioner Dr. Mary Basset and our Executive Deputy Commissioner for Mental Hygiene, Dr. Gary Belkin, who are both with us today.
They are the mighty engine behind our budding mental health initiative and this grant is further proof that they are firing on all cylinders. I salute Mindy Tarlow, Matthew Klein, and everyone at the City Center for Economic Opportunity, which worked closely with the Mayor’s Fund. Thank you.
The Center for Economic Opportunity supports our anti-poverty innovation and evidence based policies and will play an important role in implementing Connections to Care.
I especially appreciate our wonderful host, The Door. They are an acclaimed pioneer when it comes to bringing a wide array of services under one roof.
Now the significance of this multi-million dollar grant cannot be measured in dollars alone. It is a resounding vote of confidence in the Mayor’s Fund, in this administration, in our effort a true mental health system; one that is accessible and culturally competent, and reaches people in their communities.
Now our effort began in earnest back in January when I announced the city’s long term commitment to addressing the mental health crisis and it is truly a crisis. One-in-four adults in New York State will suffer from a diagnosable mental health condition in any given year.
If we were talking about the flu, or heart disease, we would declare it an epidemic. Nearly every family has been touched by mental illness, including my own. Both of my parents suffered from depression. Our daughter Chiara is in recovery now, from depression, anxiety and addiction. And I embrace this challenge for them. I embrace this challenge for all our families, and for every New Yorker who still suffers in silence.
During the past seven months, I’ve traveled all around the city, talking to all kinds of people about their personal experience with mental health. And I’ve heard so many stories. Some of them have moved me to tears. And, and here is how one young person summed up the concerns that I hear most frequently – “First Lady, it is way too hard to find the right services or programs. Everyone’s got a waiting list and they don’t speak my language or understand my culture.” Today’s announcement could not be a better response to a need that is so loud and clear that even our friends in Washington have heard it.
Connections to Care will begin bringing mental health treatment into sites that already provide other services to our most vulnerable and low-income New Yorkers. The staff at these sites will be trained to identify people who suffer from conditions that are prevalent, and will be trained in how to direct them to treatment.
Although depression, anxiety, and substance use disorders are common, the struggle to deal with them is deeply personal. Whether or not someone will reach out for help, or accept that help is often about trust. We are much more likely to talk openly if we are sitting with someone we are comfortable with. And The Door is a great example of the power of trust in action. Some young people come here for career training. Some come for ESOL classes. Some come here to talk about their sexual identity with adults who won’t judge them. And while they may not know it, The Door is also a place where they can get mental health services. And that’s because every staff member – every staff member here at The Door receives mental health training. That means every young person who walks in here with a mental health challenge, whether they are aware of it or not, is much more likely to get the help that they need.
Getting Connections to Care off the ground and creating more places like The Door will require a great deal of hard work, but we are on our way. This fall, we will release a mental health road map, a plan of action that will lay out the steps we must take as a city to build the kind of mental health system we need. And I have to say that days like this remind me of my father. He was by all accounts, a man of very few words. So there are things that he would say that I can never forget. Like, if you have your health, you have everything. Now, I agree with my father about that. But now I have to add another line – if you have your health, you have everything and there is no health without mental health. Thanks to this game-changing grant today, we are one step closer to being a city where getting treatment for anxiety is as easy as getting treatment for allergies.
Thank you, everyone.
Question: Stacy Sager, channel seven. Mrs. McCray, I’m wondering if you could explain to us, logistically or practically, how would this work? Will these agencies be applying for money or applying to be a part of Connections to Care? And when exactly will it begin?
First Lady: Well, the Mayor’s Fund will issue RFP’s in the fall and we expect to select providers in the winter. And we hope that programs be ramped up and ready to go by spring.
Question: And one more question if you don’t mind. How is it that your personal issues, in your own family, really propelled you in this way? Have you had a conversation with your daughter about all of this?
First Lady: Oh my goodness, I’ve had many conversations. And I want you to know that, yes, you know, I actually learned about my parents by doing this work. I’ve realized that, oh my God, my parents had depression. That’s why they didn’t talk. That’s why they withdrew. I mean, I really did not know and that this is also their experience, but I’ve had many other experiences with friends, with neighbors, people on the street. There are so many instances that I could tell you that have propelled me to take on this issue. I feel very uncomfortable when there’s – there’s like an elephant in the room and no one’s talking about it. And I’ve had that experience over and over and over again at all stages of my life. And I’ve felt like this is the time to take it on. Does that answer your question?
Question: Did you talk about it with your daughter?
First Lady: Yes, of course. Of course – oh yes, many conversations.
Question: Ross Barkan, the New York Observer. Also a question for Mrs. McCray – was it through this work that you realized your parents were depressed or did you know previously or was it until recently when it occurred to you?
First Lady: I – you know, it didn’t really occur to me. I didn’t have that word, you know, depression. I didn’t really know what that meant when I was a kid. And I just thought they were sad. They were sad a lot. They were very sad. My father would often not talk for long periods of time. Like, he’d go a week and not – and maybe say good morning and good night. You know? So, that recognition of what they were probably suffering from came to me, again, as I was working on this issue.
Question: For either Mrs. McCray or Dr. Bassett, does the grant money go toward training people who are at these nonprofit agencies to be in any way, sort of, clinically able to diagnose or treat people? And then, second part of that, is this going to increase funding to bring more doctors, or psychologists, trained psychiatrists to areas where there may be a shortage around the city?
Gabrielle Fialkoff, Senior Advisor: Well, this grant will train the existing staff at our partners at the community-based organizations. In applying for the grant, the service provider partners with the mental health provider and they apply together. And the mental health provider will train the staff and then stay involved in the long-term through coaching and follow-up. But they are not clinically diagnosing. It’s really more about – they will learn techniques that there is some initial evidence showing that these techniques can help through counseling, through referrals, through – you know, different measures of getting them the care they need, getting them a referral they need, helping them to talk and open up, and really leveraging staff that already is involved in these folks’ life and creating a network of support.
Question: And is there – just to follow up – is there a sense that a lot of the mental health issues that you’re seeing in low income communities around New York could be adequately addressed just by that level of correspondence, care, and communication? Or do you think there’s a shortage of doctors and –
Executive Deputy Commissioner Gary Belkin, Department of Health and Mental Hygiene: As I often introduce myself, I’m a psychiatrist, but in a good way.
The key – and it was just mentioned – the key about this is building whole new partnerships. So it really widens who participates in various parts of care and reaching people. And so, a lot of the tasks for that can be done by non-specialized people who are often more credible to the folks we are trying to reach. So that’s the driving philosophy of this. So what the RFP will invite are these partnerships to come forward and describe how they are going to work together to optimize that opportunity of the people they are seeing in these CBOs to optimize how they can help them. So we’re excited about the ideas that we may get from this. We’re probably going to list a menu of certain – what we think are core evidence based practices that we know can be done by non-specialized people. And can be very effective, not only in helping people get better, but often to be the key ingredient – what keeps them in care and keeps them understanding, you know, their options. So, the partnership is the key. It’s really reorienting players to work together differently, and spread skills that way.
Question: Do you – is there a problem – I guess I’m sort of backing into this – are there are enough specialist doctors – trained people in the areas that you’re trying to reach to address this mental health crisis, or is that a separate problem?
Executive Deputy Commissioner Belkin: It’s a very related problem in the following way: One is, yes, we – I mean we know from our own surveys that people with serious levels of symptoms report that they don’t get care or they can’t find care. It’s – for various reasons – it’s not acceptable – accessible to them; it’s not familiar to them; they don’t know where to go. And we know that in certain areas of the city compared to other parts of the country we have lower rates of mental health professionals. So, there’s that issue, but specialized people aren’t the key answer or the only part of this equation. I think that’s just be emphasized here. It’s how we leverage their expertise to enable others to also be effective in the things that they can do.
Question: For Dr. Belkin also, if you could – I just wanted to clarify that the mental health provider is going to train the CBO – is that right? Is that what you were saying? And maybe the CBO will give some form of treatment, or maybe the CBO will refer out?
Executive Deputy Commissioner Belkin: Again, we’re inviting our partnerships of CBOs and behavioral health providers to identify how they’re going to work together to share skills, and to identify who they’re trying to reach; and to show how they think they can be effective. So, we are probably going to identify, again, a core set of what we think our – is a starting set of best practices involving screening, basic kinds of counseling, really basic skills that are tested and applicable to non-specialized people to use. But then we really want to spur innovation – how they’re going to progress that. Will there be some on-site presence of the behavioral health partner? Will there be some referral? Are they going to focus on certain subpopulations in their agency that really, you know, are high priority of need? So, a lot of that we want people to show us how they’re going to take advantage of this partnership.
Question: One last thing, could you give some examples of the CBOs you’re hoping to train.
Executive Deputy Commissioner Belkin: Well, I think a lot of the people you’ve heard before me gave a lot of examples of other places in our communities, like this place, where people with issues around mental health walk through every day, and we don’t touch them the way we should to address those issues. So, whether it’s programs that adolescents feel, otherwise, comfortable in; or job training programs; or programs for new mothers or – wherever we find people that are particularly vulnerable is who we would like to see come forward, and try to think boldly about how they can be part of the mental health system.
Unknown: Thanks, guys.