One year after launching an ambitious plan to support New Yorkers living with untreated severe mental illness and experiencing homelessness.
New York City Mayor Eric Adams 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.
Mayor Adams also today announced 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,” said Mayor Adams. “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. We’re investing in training first responders, bringing psychiatric beds online, and strengthening inter-agency coordination — and the early results show what’s possible when we lean into the most challenging cases with engagement, compassion, and support. While we’re encouraged by the early results, we look forward to working with our partners in Albany to pass the Supportive Interventions Act, as well as engaging even more New Yorkers and providing them with the help they so desperately need. We will not abandon New Yorkers in need, and we’re committed to getting this right so all New Yorkers can live, work, thrive, and be safe.”
“Today’s announcement is a product of work over more than a year to bring hope and support to New Yorkers struggling with severe mental illness,” said Deputy Mayor for Health and Human Services Anne Williams-Isom. “Over that time, we have helped people transition into stable housing, receive care for their mental health and other conditions, and connect them with supports to achieve a more dignified life. Every person we have supported has friends, family, or loved ones who can now witness them in a safe, stable place receiving the care they need. While we know there are many more out there that need support, we come together today to recognize the incredible inter-agency work that has made this all possible and to affirm that this work will continue to help New Yorkers in need.”
“As we mark critical progress expanding and strengthening pathways to stability and permanent housing for some of our most vulnerable New Yorkers, we are seeing the real impact of this administration’s unprecedented investments in specialized beds and outreach resources,” said New York City Department of Social Services (DSS) Commissioner Molly Wasow Park. “We are grateful to our agency partners for bolstering the city’s health care response to this crisis, and especially thankful to our incredible outreach teams for their around-the-clock, citywide efforts to reach and encourage thousands of New Yorkers experiencing unsheltered homelessness to come inside and stabilize their lives. The dedication of countless outreach workers and shelter staff, providing care and supports every step of the way, helped nearly 1,000 New Yorkers who were living unsheltered eventually move into permanent homes in the last fiscal year. We look forward to building on this vital progress as we work to ramp up specialized bed capacity and outreach efforts this winter.”
“As we work together to support our neighbors with serious mental illness and build a healthier city, we have to make sure we’re adjusting our practices to best meet the needs of New Yorkers,” said New York City Department of Health and Mental Hygiene (DOHMH) Commissioner Dr. Ashwin Vasan. “Better communication across agencies means we can focus on ensuring people who have been ignored for too long receive the care, support, and stability they deserve.”
“As the largest provider of behavioral health care in New York City, NYC Health + Hospitals is committed to doing all we can to meet the need of New Yorkers experiencing serious mental illness,” said NYC Health + Hospitals (H+H) President and CEO Mitchell Katz, MD. “We are proud to offer a range of services for our patients with serious mental illness, including two Extended Care Units where patients who are leaving inpatient psychiatric care can stay for up to 120 days to receive additional treatment, music and art therapy, and rehabilitative activities to help them integrate back into the community upon discharge. The mayor’s plan announced last year has helped us improve communication with the city’s mobile outreach teams, and we look forward to continuing this work with DHS, homeless services providers, the city and state health departments, and our other partners to ensure that patients get the care that they need in the most appropriate setting.”
“The Mayor’s Office of Community Mental Health is extremely proud of the accomplishments achieved over the last year supporting New Yorkers with severe mental illness under the leadership of Mayor Adams and Deputy Mayor Williams-Isom. The tireless efforts and seamless coordination required to identify care gaps, devise new strategies, strengthen communication pathways, and develop data collection infrastructure to measure progress are all rooted in this administration’s commitment to effect long-lasting improvement to the continuum of care,” said Mayor’s Office of Community Mental Health Executive Director Eva Wong. “As we move forward, our focus remains unwavering, ensuring a more inclusive and supportive city for vulnerable New Yorkers facing mental health challenges and homelessness.”
“New York City Police Department members are acutely aware of this longstanding, highly complex issue and are proud to be part of the significant advances already being made in our city,” said New York City Police Department (NYPD) Commissioner Edward A. Caban. “We work closely with our many partners each day and night to ensure that all New Yorkers, especially our city’s most vulnerable populations, can access the services they require and deserve. Essential to this vital undertaking is the ongoing support and attention of our collective efforts.”
“Responding to help New Yorkers in need of emergency medical care is the core mission of the FDNY,” said Fire Department of the City of New York (FDNY) Commissioner Laura Kavanagh. “Working together with our government partners, our goal is simple: to be there for every New Yorker during their most difficult moments and provide the critical care they need.”
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-agencyteams 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 Mayor Adams’ legislative agenda announced last year — has been introduced by New York State Assemblymember Edward Braunstein. 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.
“Mayor Adams has taken the boldest action in history to address the mental health crisis, bringing permanent housing and stability to people with severe mental illness who were cycling through emergency rooms, the streets, and the criminal justice system,” said New York State Assemblymember Jenifer Rajkumar. “We have now stabilized the lives of more than half of the ‘hardest to reach New Yorkers’ with severe mental illness who were caught in the cycle. This achievement was possible through the mayor’s unprecedented outreach to our homeless population, resulting in over 6,100 homeless New Yorkers accepting shelter. Also essential was reopening psychiatric beds, improving service delivery, and training first responders to work with the mentally ill. I am proud to partner with Mayor Adams on the state level to advance the legislative solutions in Albany that will build capacity so we can provide compassionate psychiatric care to all New Yorkers.”
“All the mayoral initiatives to provide care to the hardest-to-reach New Yorkers have paid great dividends,” said Staten Island Borough President Vito Fossella. “We applaud the efforts and are pleased with the results. Our borough has identified the mental health needs of school children as a priority and we are working with stakeholders to ensure appropriate timely care. Looking forward to working with City Hall on this initiative.”
“As a registered nurse and an advocate for mental health care, I applaud Mayor Adams’ initiative in addressing the critical issue of severe mental illness in our city,” said New York City Councilmember Mercedes Narcisse. “This effort not only reflects our commitment to the health and well-being of our most vulnerable populations but also is a significant step forward in our ongoing battle to address the challenges of homelessness and mental health. This plan is indeed a beacon of hope for many New Yorkers and a testament to what we can achieve with dedicated action and collaborative efforts.”
“BronxWorks is committed to serving all residents of the Bronx, including our borough’s most vulnerable members,” said Scott Auwarter, assistant executive director, BronxWorks. “To better serve these members of our communities, a continuum of care that includes all of our partners in this work, from our fellow community organizations to our city agencies, to our healthcare systems is absolutely vital. Over the past year, we have seen unprecedented progress in the coordination of services with hospitals and mental health teams for clients with severe mental illness who are the most vulnerable living on the street. Most of our clients subject to removal orders are now receiving comprehensive inpatient treatment and are now able to stabilize so they can succeed in transitional and permanent housing. ”
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