By Michael V. Cusenza
City Comptroller Brad Lander on Monday released a report that blasted Mayor Eric Adams for ineffectively coordinating a Continuum of Care for people living on the streets and subways with serious mental illness.
“And the results are devastating,” Lander said.
In response to mounting safety concerns, the City and State have launched a slew of initiatives and legislative efforts to confront the issue of street homelessness for people with serious mental illness. But the efforts are piecemeal. People continue to fall through the cracks and there is little public confidence that things will change.
Outreach teams lose track of clients. Hospitals release patients back to the street after a few hours because there aren’t enough inpatient beds to treat them. Judges cannot refer people into programs proven to reduce recidivism and increase adherence to treatment because there are no slots. Jails place just 3 percent of discharged people with serious mental health challenges into supportive housing.
An audit by the comptroller’s office in 2024 of the City’s Intensive Mobile Treatment program for homeless New Yorkers with the most severe histories of mental illness found that the City inadequately measured whether the program was decreasing incarceration because of a lack of coordination among City agencies, that outcomes and treatment measures were inconsistent, and that placements into stable housing had declined precipitously.
Despite these persistent failures, evidence from other cities – and indeed, even from New York City – argues strongly that this crisis can be solved with more diligent leadership, Lander wrote.
Data shows that there are approximately 2,000 people with serious mental illness at risk for street homelessness cycling through City streets, subways, jails, and hospitals. At that scale, a better-coordinated system is within the grasp of a city with the resources and capacity of New York. Indeed, the City is already spending billions on outreach, police overtime, city jails, shelters, and emergency hospitalizations, but City Hall has continuously failed to coordinate these efforts effectively to solve the problem, according to Lander.
The report centers on a “housing first” approach, which evidence shows has had great success in Philadelphia, Houston, Denver, other cities throughout the United States and around the world, and even in New York City. Housing first combines existing housing vouchers and service dollars to get people off the street and directly into stable housing with wraparound services.
Data shows that 70-90 percent of people experiencing street homelessness with serious mental illness will accept permanent housing with a coordinated outreach strategy, and that it will keep them stably housed, off the street, and better connected to the mental health services that will stabilize them.
“The city that never sleeps shouldn’t have our most vulnerable New Yorkers sleeping on the streets or subways,” said Lander, a mayoral candidate. “Public safety – whether you ride the subway every day or sleep on the subway to stay out of the cold – matters to us all. In a city with 8 million people and incredible resources, we should not only aspire to, but be able to achieve, a goal of having no one with a mental illness living on the streets.
