Today’s Read: A Mental Health Crisis Grips the City

Recent high-profile tragedies and newly announced government initiatives have focused increased attention on the unmet needs of unsheltered homeless people, including those struggling with mental illnesses. In mid-February, Mayor Eric Adams and Governor Kathy Hochul announced a plan to remove people who sleep in the subway system, relying largely on an increased deployment of police to enforce MTA rules. But this plan fails to remove the barriers that block access to voluntary outpatient and inpatient mental health care, low-barrier shelters, and permanent housing.

This week, NY1 reporter Courtney Gross released a special report on mental illness and homelessness highlighting problems in the mental health care system and the urgent need for supportive housing.

The Mayor’s plan emphasizes aggressively removing people from the trains and stations, but the NY1 report shows that involuntary psychiatric removals from the subways and the streets for evaluation at hospitals rose dramatically last year, to little apparent effect:

“The number of times Department of Homeless Services outreach workers involuntarily removed someone from the street or subway to a hospital for evaluation spiked dramatically in 2021 compared to the year before, climbing 431 percent.”

The report exposed several problems with our current system of connecting people to mental health care, echoing many of the issues raised in our recent op-ed and fact-check.

First, there is a dire lack of acute and long-term inpatient psychiatric care, which decreased even more during the pandemic as units serving individuals with mental illnesses were repurposed for COVID-19 care. The City and State repurposed 600 inpatient beds during the pandemic that have yet to be restored to psychiatric service, adding to the decades-long reduction in state psychiatric center capacity needed to serve those who require long-term hospitalization:

“Beds at state-run facilities in the city have been declining for years. In 2006, the state’s psychiatric institutions in the five boroughs had nearly 2,100 beds, but that has steadily declined. Since then, the state has decreased its bed count by 35 percent. Now, there are only 1,351.”

Second, in the last quarter of 2020, psychiatric patients returned to the emergency room within 30 days of discharge at alarmingly high rates: “At Bellevue, 24 percent of patients came back to the ER.” This continuous cycling through the hospital system is not working to help people achieve stability.

But the report highlights a key solution: permanent supportive housing. Gross spoke with Brenda Rosen, CEO of Breaking Ground:

“It’s no doubt a mental health crisis,” Rosen said. “There are people who are unsheltered right now that need significant help. Housing is health care. You cannot ignore the fact that housing with on-site supports has been proven time and time again to be a long-term solution for those that have substance abuse disorder for those that have mental illness, for those that have both.”

Advocates have long noted that housing provides the foundation people need to manage mental illnesses or other challenges. In our statement in response to Mayor Adams’ subway outreach plan, our Deputy Executive Director for Policy Shelly Nortz called for ready access to voluntary inpatient and outpatient psychiatric care, individual hotel rooms for unsheltered individuals, and at least 1,000 immediate low-barrier subsidized permanent housing placements paired with mobile mental health teams.

The report also featured one of our clients, Tyrone Braddy, a senior who has been homeless off and on for 15 years and is diagnosed with schizoaffective disorder. He told NY1 he worries about the dangers of sleeping on the streets, but does not want to go to a shelter.

Thanks to our Client Advocacy Program staff, Mr. Braddy expects to move into his own apartment next week. He’s getting excited, and he gave us a list of things he needs us to help buy for his apartment – including a piggy bank and salt and pepper shakers.

If you’d like to help us provide these items, as well as plates, pans, and more to Mr. Braddy and others, you can donate here.