In New York City, rates of homelessness, arrest, incarceration, violence, hospitalization and calls to 911 involving the mentally ill are RISING. Yet these critical metrics aren’t included in THRIVE NYC’s Progress Report, presumably because they are trending in the wrong direction
NYC mental health programs deserve to be judged on a simple metric: Does it deliver effective treatment to the untreated seriously ill?
(AKA Kendra's Law or AOT)
This is the current law of the land but the government has not adequately provided for its implementation. As mentioned above it receives a mere $1.2 million (of $165 million!) in budget support. The results are indisputable. Studies have shown that among participants of the program, Kendra's Law has reduced:
At a Federal level, increased aid for AOT has received bipartisan support from current Vice President Kamala Harris as well as the Trump Administration. Redirecting the misused funds of THRIVE NYC to create a properly supported AOT program here in NYC should be the top priority. Areas of focus include: requiring the city’s Department of Health and Mental Hygiene to start evaluating all seriously mentally ill people being discharged from Rikers; all seriously mentally ill leaving shelters; and all mentally ill patients being discharged from city hospitals after an involuntary commitment. Statistically, those are the three highest risk groups. For skeptics: here is a fact sheet addressing some common objections to Kendra's Law/AOT.
In 2015, Mayor de Blasio announced NYC Safe, a $22 million annual investment. It was billed as an unprecedented partnership between law enforcement and health care agencies that would allow New York City to:
NYC Safe is supposed to be providing intensive case management and services to people who cycle in and out of the system. To date, no data on the number of people, diagnosis or outcomes is available.
Currently there is such a shortage of crisis intervention teams that concerned citizens are told to wait two days before seeking support or to call the police directly.
ThriveNYC’s spending plan fails to fund mental-health courts, which can drop charges against arrested mentally ill individuals if they comply with a judge’s order to stay in treatment for a certain period. Mental-health courts prevent the seriously mentally ill from sliding into recidivism (the tendency of a convicted criminal to reoffend)
ThriveNYC doesn’t include funds for “clubhouse” programs like Fountain House, perhaps the best voluntary program for the most seriously ill. Clubhouses provide a physical location where the seriously mentally ill gain a sense of purpose and community through cooking, planning, cleaning, shopping and other necessary daily activities.
NYC Well advertisements placed around the city have called out to New Yorkers who are feeling "under pressure," "stressed," or "anxious." There are no advertisements encouraging people with schizophrenia, bipolar disorder, the homeless or their families to call. There are no billboards asking families of seriously mentally ill who could benefit from Kendra’s Law to call and learn more. Because of the failure of ThriveNYC to create more mobile crisis intervention teams, callers needing crisis stabilization for someone with serious mental illness are told there will be a two day wait and told to call police if the need is urgent.
Despite these deficiencies, NYC Well is expensive. The program spends $11 million on advertising and $12 million on running it. That means it cost $127 for each of the 180,000 calls it has taken as of 2020. Meanwhile, 90% of callers receive no follow-up.
The advertising budget for NYC Well should be cut until a sufficient number of mobile crisis outreach teams are created so that calls about serious mental illness get a response (other than the current standard ‘wait two days’ or ‘call police’.) After the teams are created, the NYC Well advertising budget should focus on getting families and others concerned about the seriously mentally ill to call. Further, NYC Well should have experts and handouts who can inform clinicians and families about how to petition for a Kendra’s Law examination and provide help to those who want to file petitions.