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Bottcher: City and state must address the mental-health crisis

BY THE VILLAGE SUN | After Saturday’s subway-shoving death of a woman at the Times Square station, new Councilmember Erik Bottcher said government must confront the crisis of seriously mentally ill people out there who are not getting proper help.

“This was preventable. It didn’t have to happen,” Bottcher said in a press release, referring to the Midtown tragedy. “We are failing our fellow human beings who are suffering from serious mental illness.”

Bottcher, whose District 3 includes the Times Square station, noted that one of the issues he campaigned on was to better address mental illness in the city. In the press release, he cited his own struggles as a youth growing up Upstate in the Adirondacks and how proper treatment helped get his life back on course.

“The issue of mental health is personally significant to me,” he said. “When I was 15 years old, following a series of suicide attempts, I was involuntarily committed to a mental health hospital for a month.

“The treatment I received at Four Winds Hospital saved my life. Unfortunately, that level of treatment is unavailable to many Americans, especially if they’re poor, or persons of color.”

The victim in Saturday’s random pushing was Michelle Go, 40, an Upper West Sider who worked as a consultant at Deloitte and volunteered with the New York Junior League to help others improve their lives.

Bottcher offered eight “common-sense steps” that he said the city must immediately take — notably including redirecting hundreds of millions of dollars from former Mayor de Blasio’s much-maligned ThriveNYC program toward helping the seriously mentally ill.

First, Bottcher stressed, the closure of inpatient psychiatric beds must be reversed.

“According to the New York State Nurses Association, the number of certified inpatient psychiatric beds in New York State dropped 12 percent between 2000 and 2018, at the same time as the population and the need have mushroomed,” he said. “New York City accounts for 72 percent of the decline in inpatient psychiatric beds between 2000 and 2019, a total loss of 459 beds. This loss of clinical space hasn’t been replaced by community-based services.

“Instead, patients have been funneled into the carceral system and shelter system. New York State needs to reverse the decertification of inpatient psychiatric beds. Any closures of beds must be accompanied by an increase in quality services elsewhere that can serve this vulnerable population. Additionally, there must be an infusion of funding for comprehensive hospital discharge planning, which is currently inadequate.”

Second, he said, “mobile health crisis response teams” must be immediately deployed on the West Side.

In 2020, then-Mayor de Blasio announced a pilot program in which health professionals and crisis workers would be dispatched to respond to mental health crises. That program is being piloted in Northern Manhattan.

“Unfortunately,” Bottcher said, “we do not have time to wait for a lengthy pilot program to be completed before expanding this program. There is an immediate need for these response teams citywide.

“This program should be accelerated and expanded to other neighborhoods, including those in Council District 3. For too long, armed police officers have been the default first responders to mental health crises, and this must change.”

Third, Bottcher said, the number of “crisis stabilization centers” must be increased.

“When unhoused New Yorkers experiencing mental health crises are brought to the hospital, they are released after they are medically stabilized,” he noted. “Frequently, they are not sick enough to stay in the hospital, but are too sick to return to a shelter or the streets. Crisis stabilization centers, also known as medical respite beds, fill this critical need, giving people time and space to recuperate. This provides a critical opportunity to connect them with social services.

“Unfortunately, there are far too few crisis stabilization centers available in New York City. Therefore, many people experiencing mental health crises are taken to the hospital in ambulances, only to be discharged back to the streets hours later. New York City must expand its medical respite program significantly in all five boroughs.”

Fourth, more supportive housing with mental health services is needed, the councilmember said.

“We must greatly accelerate the construction of permanent supportive housing for people with mental illness,” he said. “Supportive housing is affordable housing that offers case management and other supportive services. Extensive evidence has shown that permanent supportive housing is the best way for people with mental health challenges to lead full lives outside of hospital settings, the shelter system or criminal justice system.

“Unfortunately, New York City has only constructed a fraction of the supportive housing that is needed to meet the growing demand. We must create quality supportive housing in all five boroughs, and this should include the conversion of distressed commercial properties.”

Fifth, he stated, the city should embrace and expand the “Clubhouse Model” of pyschosocial rehabilitation.

“The Clubhouse Model, created decades ago by Hell’s Kitchen’s own Fountain House and now used internationally, is a community-based service model that helps people with a history of serious mental illness rejoin society and maintain their place in it,” he explained. “Clubhouses are community centers where people with mental illness can find opportunities for friendship, employment, housing, education and access to medical and psychiatric services in a caring and safe environment.”

Bottcher said New York City should immediately start working to create at least 10 more Clubhouse locations across the five boroughs. Clubhouses are sometimes co-located with supportive housing.

He added that he’s hopeful the appointment of Dr. Ashwin Vasan, the president and C.E.O. of Fountain House, as the commissioner of the city’s Department of Health and Mental Hygiene by Mayor Adams will lead to the expansion of this community-based service model.

Sixth, Bottcher said the city and state should ensure when incacerated individuals are discharged into society, they will be set up with housing.

“Thousands of people with serious mental illness have been funneled into the carceral system because of society’s failure to provide adequate behavioral health treatment,” he said. “Upon release, individuals are discharged with inadequate planning and support services. Those without homes to go to are often released directly into the New York City shelter system, with inadequate case management and few prospects for housing, employment, substance use treatment and mental health care.”

Bottcher said the state should enact legislation currently introduced in Albany that would require the state to assist people in obtaining housing prior to release from a correctional institution, as opposed to being dumped into the shelter system.

Seventh, the councilmember added, behaviorial-health services in middle schools and high schools should be ramped up.

“Serious mental illness often begins to take shape in adolescence,” he noted. “Early diagnosis and treatment are critical, which is why school-based health and social services are essential. At a minimum, schools must have nurses, counselors and social workers on site who are trained to identify warning signs of behavioral health issues and make referrals to behavioral health professionals.”

Finally, Bottcher said, ThriveNYC funds must properly be redirected to address serious mental illness. He said failure to have done so before under Mayor de Blasio, who created the program, was “a big missed opportunity.”

As of 2019, only 10 percent of ThriveNYC’s massive $250 million annual budget was spent on serving those actually with serious mental illness.

“While some effective programs have been brought under the ThriveNYC umbrella, an overall shift in priorities is needed to address this crisis,” Bottcher stressed. “The city should redirect mental health funds to the services listed above to help the tens of thousands of New Yorkers who are suffering.”

The West Side politico said it’s crucial right now to address the reality on the streets and in the subways.

“We cannot allow the status quo to continue,” he declared. “I am committed to working with my colleagues in city, state and federal government to stem this crisis and get our fellow New Yorkers the help they need.”

2 Comments

  1. Bathsheba Bathsheba January 17, 2022

    It’s time to reopen the institutions that were closed down in the 1970s. The “rights” of the mentally ill homeless to live on the streets, not take their meds, etc., do not trump the rights of everyone else to live without having to worry about senseless attacks and killings. Revamp the way these places are run and start filling them up. This is ridiculous — they are out there with no oversight, no supervision, no checks on their behavior — and we pay the price.

  2. redbike redbike January 17, 2022

    Thanks for the coverage. This is IMHO good news.

    New York has a long history of releasing people from in-patient facilities with no meaningful follow-up support. NYC’s / NY State’s history isn’t unique, but we’re talking about NYC.

    Yep, Councilmember Bottcher did campaign on this issue. His announcement isn’t opportunistic. What remains to be seen: whether his specific proposals are actually implemented, wholly or even in part.

    More good news about Bottcher’s proposals: They’re explicitly at odds with Mayor Adams’s reflexive reliance on the NYPD and the carceral system.

    Still more good news: Bottcher emphasizes the urgency of the problem. “Let’s study this” isn’t an answer.

    Let’s see what happens.

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