By Forum Staff
One year after launching a plan to support New Yorkers living with untreated severe mental illness and experiencing homelessness, Mayor Eric Adams on Wednesday updated New Yorkers on the city’s progress, announcing that more New Yorkers are getting connected to the care they need and have begun stabilizing their lives. Thanks to intense coordination between city and state agencies, increased training for first responders, expanded deployment of clinicians, and additional psychiatric beds coming online, over 50 of the 100 hardest to reach New Yorkers living on city streets — those who have been on the Coordinated Behavioral Health Task Force’s two “Top 50” lists, many of who are known or believed to have severe mental illness — now have a roof over their heads and are stabilizing their lives in a hospital or another supportive setting. This represents a 145 percent increase over the prior year. Additionally, hundreds of additional New Yorkers living on city streets believed to have untreated severe mental illness have been connected to hospitals for evaluations.
Adams also announced on Wednesday that homeless outreach staff have referred 70 percent more people experiencing street homelessness to shelter during Fiscal Year 2023 (FY23) compared to FY22 and have moved approximately 1,000 people from Safe Haven and stabilization beds to permanent housing during FY23 — more than double the number from FY22. Ahead of this winter, the city is launching intensified street outreach efforts to help all New Yorkers living on the streets move to safer, healthier indoor conditions.
“One year ago, we made a commitment to New Yorkers that the days of ignoring the mental health crisis playing out on our streets were over,” Adams said. “I’m proud that a year into this effort, we have made progress helping and housing a significant number of those most in need of care and support.”
Progress Supporting New Yorkers with Untreated Severe Mental Illness
Since launching the city’s intensified efforts last year, the Adams administration has made progress to address the ongoing crisis of individuals experiencing severe mental illnesses left untreated and unsheltered in New York City’s streets and subways, while delivering on promises made in the original announcement. While much work remains, the early progress following decades of failed efforts suggests that the administration’s efforts could lay the groundwork for lasting progress.
Over the past year, the city has made progress by:
Bringing More Psychiatric Beds Online: City agencies have partnered closely with the state and the Metropolitan Transportation Authority (MTA) to ensure New Yorkers in need of extended hospitalization to stabilize their lives have access to that care. Through a partnership with the New York State Office of Mental Health, the city is transferring patients to the state’s new Transition to Housing Unit, which provides extended care and is designed to facilitate discharge directly to permanent supportive housing. The city has also opened an Extended Care Unit for this population at H+H/Kings County, building on the success of the existing Extended Care Unit at H+H/Bellevue. Finally, the city announced today that all H+H psychiatric beds closed during the COVID-19 pandemic would be brought back online by the end of 2023, bringing the total H+H psychiatric bed capacity to 1,000 beds.
Improving Communication Between First Responders and NYC Health + Hospitals: A new H+H protocol has vastly improved communication surrounding involuntary removals by certified clinicians, reducing the number of people cycling between hospitals and the street. New communication channels established this year ensure clinical information on removals is received by the hospital — allowing hospital staff to prepare for an arrival and reducing the likelihood of communication breakdowns. Since the implementation of this system, approximately 72 percent of patients for whom H+H received such notifications were admitted to hospitals for a medical or psychiatric need.
Training Clinicians and First Responders: Enhanced training on the legal standards that allow for the last resort of involuntarily removing and involuntarily admitting an individual to a hospital has been delivered to over 400 H+H emergency rooms and inpatient psychiatric clinicians, and 39,500 first responders — representing approximately 95 percent of FDNY emergency medical services personnel, voluntary ambulance emergency medical technicians, and NYPD patrol officers. This training has a new emphasis on the legal authority to intervene when severe mental illness is preventing a person from meeting their basic needs so first responders and clinicians can identify more New Yorkers in need of support.
Implementing Data Collection Processes: Before Mayor Adams’ directive last fall, data was not tracked consistently across the continuum of the removal process. Agencies were not comprehensively tracking the number of involuntary removals being performed, which made monitoring and measuring progress nearly impossible. All agencies involved in the involuntary removal process have now created mechanisms to better track all involuntary removals.
Piloting Joint Response Teams: The city continues to deploy inter-agency teams comprised of clinicians, outreach workers, and first responders to reach and serve New Yorkers in need of varying mental health and shelter services. With multiple team configurations operating throughout New York City, teams are now able to better meet the wide range of needs New Yorkers living on the street have.
Introducing State Legislation: The Supportive Interventions Act — legislation based on Adams’ legislative agenda announced last year — has been introduced by Assemblyman Ed Braunstein (D-Bayside). The new legislation will scale up the city’s efforts and takes aim at several legal barriers to psychiatric crisis care and crisis avoidance. If enacted, this legislation would help ensure timely and effective provision of hospital care — reducing the number of individuals stuck in the mental health system’s revolving door and strengthening coordination of care between inpatient and outpatient providers when patients shuttle between hospitals and the community.
In addition to the plan to assist New Yorkers with untreated severe mental illness experiencing homelessness, the Adams administration has continued to invest in the entire mental health continuum of care to support the mental health of all New Yorkers. As part of these efforts, the administration has committed to tripling the capacity at Clubhouses — spaces that offer support and community to New Yorkers living with severe mental illness — doubling Intensive Mobile Treatment and Assertive Community Treatment teams, and investing in Support and Connection Centers.
Progress Supporting New Yorkers Experiencing Unsheltered Homelessness
As a result of the Adams administration’s unprecedented investments to aggressively expand Safe Havens and stabilization beds, increase outreach staffing, and strengthen interagency coordination, the city is making significant strides in addressing unsheltered homelessness. In FY23, the city more than doubled the number of permanent housing placements from Safe Havens and stabilization beds, which are designed to help New Yorkers experiencing unsheltered homelessness transition off the streets and subways as they receive robust services to stabilize their lives. With a 60 percent increase in outreach staffing since January 2022, overall referrals to shelter placements surpassed 8,500 in FY23 — a 70 percent increase in FY23 compared with FY22. Additionally, since the launch of the Subway Safety Plan in February 2022, more than 6,100 New Yorkers have checked into shelter.
In FY23, the New York City Department of Homeless Services (DHS) connected more than 1,000 New Yorkers in Safe Haven and stabilization settings to permanent housing — a more than 130 percent increase over the prior year.
To continue to build on this progress and ensure robust services for New Yorkers experiencing unsheltered homelessness during the winter, the city is opening 270 Safe Haven and stabilization beds and ramping up training for outreach staff, including collaborative training for clinical staff with DSS, DOHMH, and H+H. Additionally, the city will open a new, hybrid low-barrier program right by one of the city’s busiest end-of-line subway stations. This hybrid model will serve both as a Drop-In Center and stabilization bed site. It is scheduled to open in the coming weeks in Queens.