As part of a commitment to close gaps in mental health care and address a mental illness crisis that has affected members of New York City’s first family, the de Blasio administration has revealed an ambitious plan to better integrate mental health services in a manner that will effectively connects residents to the care they need.
Under the proposal that first lady Chirlane McCray presented this week, more than 80 schools would get mental health clinics — an increase of 60 percent — and drug abuse prevention counselors would also be installed in 70 schools currently without those services. Victims’ advocates and social workers within each police precinct would provide psychological care to thousands of families in homeless shelters. And Rikers Island jail’s youngest inmates would receive arts therapy.
The plan will add more than $54 million in mental health programs for the next fiscal year, with that amount to surpass $78 million in the following years. While the city’s health department already spends nearly $300 million annually on mental health care, administration officials and mental health advocates say Mayor de Blasio’s budget proposal serves as the quintessential model of providing support for those reeling with mental illness at every turn.
“New York City is really setting a standard for other cities in the country… They’re really focusing on intervening and improving people’s lives and outcomes,” Katrina Gay, a spokeswoman for the National Alliance on Mental Illness, an advocacy group, told the Associated Press.
McCray has taken on mental health services as her central issue, and has spoken openly about why it’s a personal topic for her family. She says her parents have struggled with depression, while the de Blasios’ daughter has grappled with depression, anxiety, and substance abuse.
“It comes from the heart. It’s my family,” McCray said this week. “But also in my life, I feel as though it’s the one thing that no one ever talks about… It’s something that needs to come out of the shadows.”
The proposed overhaul comes during a tumultuous time for New York City’s mentally ill, law enforcement, and the city administrators tasked with addressing their needs. In the month of April, four people with mental illnesses killed people or had their lives taken by police officers. The city’s mental illness crisis has affected residents of all ages. According to a 2013 study conducted by the New York City Health Department, 20 percent of children in New York City struggle with ADHD, bipolar disorder, anxiety, and depression. However, tesearchers determined that less than 10 percent of youngsters reeling from mental illness had been diagnosed.
The deinstitutionalization of mental health care in previous decades has caused the homeless population in the Bronx, Brooklyn, and Manhattan to outnumber that of people in psychiatric facilities. Nearly 40 percent of discharges from state mental institutions still don’t have a known address six months later. A 2002 landmark study found that the revolving door of homeless people with mental illness cost the city and the state of New York more than $40,000 for their use of emergency rooms, psychiatric hospitals, shelters, and prisons. That study, in part, prompted the expansion of the “Housing First” project, an effort to provide mentally ill homeless people with supportive housing and mental health services.
“We have the solution; no one can say we don’t have the solution,” Dennis Culhane, a University of Pennsylvania researcher, told USA Today last year. “The problem remaining is figuring out how we take this to scale.”
Across the United States, one in four adults suffers from a mental illness, less than 40 percent of whom receive professional treatment. While mental illness is no longer treated as a preexisting condition under the Affordable Care Act, the influx of people seeking mental treatment has overwhelmed health care systems around the country. Congressional lawmakers have yet to pass a comprehensive mental health care reform law that would pave the way for effective community-based health care.
The de Blasio administration’s proposal comes on the heels of what some consider the most comprehensive overhaul of a municipality’s criminal justice system. The four-year, $130 million project that he unveiled last year aims to reduce recidivism among mentally ill jail inmates by focusing on treatment rather than punishment for minor, quality of life offenses. Strategies to meet that goal include the improvement of mental health screenings before arraignment, restarting Medicaid for inmates upon their release, and the expansion of supervised pretrial programs and community services for more than 4,000 prisoners.
However, not everyone is pleased about de Blasio’s proposed budget. The internationally known Samaritan 24-hour hotline lambasted the mayor after finding out that its operating budget would be slashed to make way for a different hotline that members say will answer only one-tenth of the calls. New criterion for a new vendor — particularly the requirement that hotline operators be survivors — has placed Samaritan, a nonprofit of 30 years, out of the running.