Coalition Testifies on Mental Health Services

Last week, the Coalition for the Homeless and The Legal Aid Society submitted testimony to The New York City Council Committee on Mental Health, Developmental Disability, Alcoholism, Substance Abuse and Disability Services regarding oversight of the ThriveNYC mental health initiative. This issue is particularly relevant to many of the near-record number of homeless men, women and children in NYC: In a 2016 report, the NYC Continuum of Care identified 11,091 homeless New Yorkers with severe mental illnesses, including 24.3 percent of adult shelter residents. The Coalition’s own Crisis Intervention Program has noted an increase in the percentage of clients served who self-reported a psychiatric disability in recent years.

Although ThriveNYC has expanded access to City-funded mental health services for the runaway and homeless youth population, much more work remains to be done in ensuring that both youth and the broader homeless population receive the mental health resources many so urgently need. With the shelter system bursting at the seams, many adults are not receiving appropriate shelter placements to help them stabilize. New Yorkers also continue to encounter obstacles in accessing emergency mental health services. As the Coalition and Legal Aid testified:

The percentage of shelter beds provided for those in need of mental health support dropped from 26 percent to 24.3 percent between 2014 and 2016, and while the shelter capacity grew 17 percent in that time, the mental health capacity grew by only 12 percent.

At a time when the need for additional mental health shelter beds is rising, the supply is not rising to meet that need, leaving too many single adults with mental illness to go without shelter altogether. On 35 out of the first 120 days of 2017, the City’s Department of Homeless Services reported zero mental health bed vacancies for homeless men and on 18 days, they had zero vacant mental health beds for women.

As a result, many clients with psychiatric disabilities have had trouble obtaining shelter placements, including waiting many hours until a bed was provided in a mental health shelter, not receiving a shelter placement and sleeping in a chair, or being offered unstable nightly placements until a bed in a mental health shelter became available.

The City can do better. DHS must offer lawful placements and services to accommodate homeless New Yorkers with disabilities, and ensure that shelter placements are provided in a timely manner. Additional mental health capacity, skills training, and access to mental health services is urgently needed for homeless New Yorkers with psychiatric disabilities. It is imperative that DHS staff throughout the system (including security) are trained to identify and assess the mental health needs of residents. Furthermore, all shelters must be equipped to help residents in need connect with quality mental health care.

Staff and residents must have better access to emergency services, including respite care, inpatient hospitalization, and ACT services for those experiencing acute psychiatric emergencies or in need of intensive preventative care. Medicaid redesign’s focus on avoiding long term inpatient hospital stays and the slow implementation of Health and Recovery Plans are reducing access to inpatient care and ACT teams, leaving many shelter residents who are in crisis to fend for themselves or endure long waiting lists.

Increased mental health shelter capacity, improvements in staff training, and access to appropriate care that meets each individual client’s needs will better ensure the City upholds its legal obligations to psychiatrically disabled homeless New Yorkers. It will contribute to the stability of all shelter residents, facilitate housing placements, and ensure that those in need receive the care they require. Further, new housing being created through the Mayor’s 15-year, 15,000-unit supportive housing commitment must be opened on an accelerated schedule to help the most vulnerable New Yorkers secure stable homes of their own.

The full testimony can be read here.