Program description: Assisted Outpatient Treatment (AOT), commonly referred to as Kendra’s Law, is court-ordered mental health treatment and care coordination for people with a history of lack of compliance with treatment for mental illness. To enhance the City’s capacity to implement this important program, ThriveNYC added 20 staff to the Office of Assisted Outpatient Treatment.

Evidence: A 2009 independent evaluation of New York State’s AOT program found a significant reduction of roughly 25% in hospital admissions during the six months after an AOT court order, as compared to the pre-AOT time period. AOT clients also experienced a number of other improved outcomes, including: reduced hospital length of stay, increased receipt of psychotropic medication, and greater engagement in outpatient services [Source].

Reach and impact data highlights:  

• 1,818 people were monitored by the AOT program in FY2021 Q2
• 51.4% of individuals no longer needed AOT because they were likely to engage in treatment voluntarily or survive safely in the community without court ordered treatment as evidenced by their adherence during AOT order and their presentation at a psychiatric exam in FY2021 Q2 (Oct 1, 2020-Dec 31, 2020)

Featured announcements:

• More care, more support: City unveils public safety and public health reforms, December 23, 2019
• Safe and healthy City: Mayor de Blasio orders 30 Day review of intensive mental health intervention programs, October 11, 2019

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Program description: Be Well is a program of the Mayor’s Office of Labor Relations’ WorkWell NYC initiative that offers programs and resources to promote mental health among the 380,000 people employed by New York City. This initiative aims to create work environments that support the mental and emotional well-being of employees and create opportunities for employees to build resilience.

Need: One in five New Yorkers experiences mental illness in a given year [Source]. As the largest employer in New York City with over 380,000 employees [Source], the City has a critical opportunity to promote mental health for its employees.

Evidence: Characteristics of the most effective workplace mental health interventions include providing activities that address both mental and physical health, and support accessing clinical treatment and navigating disability management programs, among others [Source].

Reach and impact data highlights: 13,606 City employees participated in all Be Well activities between 7/01/2019 and 6/30/2020

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Program Description:

The Centralized Mental Health Services for Youth and Young Adults Program consists of eight mental health “hubs” located in all five boroughs and situated in DYCD’s Runaway and Homeless Youth drop-in centers. RHY drop-in centers offer a variety of services to youth ages 14 to 24 who run away, are experiencing homelessness, or are otherwise at risk and vulnerable. Each hub is equipped with experienced behavioral health professionals who are certified and trained to administer screenings and facilitate group and individual therapy to youth. The program provides much needed mental health services to youth who deal with traumatic circumstances and uncertainty or may otherwise benefit from behavioral health support and provides for a continuum of care at a centralized location. RHY drop-in centers and transitional living facilities can refer youth to the hubs for services. 

REACH 

Eight mental health hubs located in DYCD drop-in centers offer mental health services for youth ages 14-24. In FY 23, 518 young people enrolled in therapy at the hubs.  

NEED 

Youth experiencing homelessness in NYC are disproportionately youth of color (95%); gay, lesbian, bisexual, or queer/questioning (42%); and transgender/gender non-binary (8%). Source. 

Mental health problems including depression, PTSD, and suicidal ideation are considerably more prevalent in youth experiencing homelessness than adolescents from the general population. Source. 

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Program Description:

Communities Thrive aims to support communities of color in shaping how and where mental health support is delivered and in exploring new ways to address longstanding barriers to care.  Studies show that locating mental health support in culturally responsive, community-based organizations and healthcare providers can mitigate barriers to care. In partnership with organizations serving Latinx New Yorkers, Communities Thrive will expand access to mental health care through community partnerships and connection to tele-mental healthcare provided by Health + Hospitals Corporation. The program plans to provide access to mental health care for up to 1,000 members of the Latinx community residing in under-resourced and low-income neighborhoods. 

NEED 

New Yorkers of color face a higher risk for mental health needs while receiving less mental health care than white New Yorkers. A serious shortage of mental healthcare providers – including too few culturally-responsive and multilingual clinicians, lack of insurance, and stigma all contribute to inadequate and unequal access to mental healthcare. 

Latinx New Yorkers display higher rates of depression (12%) than white New Yorkers (8%) and are less likely to engage in treatment. Source. 

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Program description: Connections to Care (C2C) integrated mental health support into the work of community-based organizations (CBOs) serving at-risk and low-income communities across the City. Through C2C, CBOs that had not been providing mental health services worked with mental health providers who trained and coached staff to screen their clients for mental health needs, offer direct support when appropriate, and link to local health providers for further care if needed. This program was operated in partnership with the Department of Health and Mental Hygiene, with additional funding through the Mayor’s Fund to Advance New York City.

Update: In the summer of 2021, Connections to Care will be integrated into Jobs Plus, a program operated by the NYC Department of Social Services/Human Resources Administration that provides career training and employment services, with the goal of creating pathways to employment for public housing residents. By adding mental health services to the Jobs Plus program via the Connections to Care initiative (C2C), the City aims to increase clients’ ability to overcome barriers to employment that may be the result of unaddressed mental health challenges and achieve other targeted program-specific outcomes in areas such as job placement and financial independence.

In April 2021, the City announced a new partnership with the CUNY School of Professional Studies to create a Community Behavioral Health Academy that will train more than 5,000 City agency staff and social service providers in three years to better support the mental health of the people they serve. Drawing on the framework of task sharing, and building on the promise of Connections to Care (C2C) and other initiatives, the Academy will equip providers and City agencies with tools and resources to address and promote mental health.

Need: About 30% of the total population of New York City (or around 2.6 million people) resides in federally designated mental health professional shortage areas [Source]. Research has robustly and consistently shown that identities with a history of oppression – such as people of color – among others, experience increased negative mental health symptoms related to experiencing discrimination and harassment. [Source]. C2C provides people the opportunity to access mental health services in places where they are already going for other basic needs. Screening data from Connections to Care reveals that about 1/3 of CBO participants experience mental health symptoms, higher than the prevalence of symptoms in the wider population. (Program data collected by DOHMH/NYC Opportunity)

Evidence: The RAND Corporation led an independent evaluation of C2C from 2016 through 2020, which found that CBOs were able to expand the skillsets of their staff to identify and address mental health needs and promote positive mental health. The evaluation also found a positive effect on mental health and social services outcomes for specific groups, including expecting parents and parents of young children and participants in youth development and workforce development programs [Source].

Reach and impact data highlights: 

• 1,930 CBO staff have been trained and 49,786 participants received services through this program since this program began in 2016 through December 31, 2020
• 70.7% of CBO participants experienced a clinically significant improvement in symptoms of depression or anxiety within 12 weeks of an initial positive screen

Featured publications:

• Helpers in plain sight: A guide to implementing mental health task sharing in community-based organizations
• Mental Health Task-Shifting in Community-Based Organizations

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Program Description:

City implementation partners: Department of Health and Mental Hygiene and the New York City Police Department 

Co-Response Teams (CRT) are a collaboration between the NYPD and DOHMH. CRT is a pre- and post-crisis intervention. Each team includes two police officers and one behavioral health professional. These teams work 14 hours per day, 7 days per week, to serve community members presenting with mental health or substance use challenges who are at an elevated risk of harm to themselves or others. The teams offer short-term engagement to facilitate connections to care and linkages to support services. 

REACH 

Over 3,208 community members have been served through this program since it began in 2016 

NEED 

169,000 mental health emergency 911 calls were received by the NYPD in 2017. The majority (56%) of these calls result in the individual being transported to the hospital, highlighting the need for partnership between law enforcement and public health workers. Source 

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Program description: Taught by Police Academy instructors and mental health experts, Crisis Intervention Training (CIT) helps NYPD officers better recognize and respond to the behaviors and symptoms of emotional distress and mental illness. The training includes role-playing, lectures, and conversations with individuals with mental illness who have had both positive and negative encounters with the police. The four-day training aims to increase officers’ skills in de-escalation of crises and improve the safety of both the officer and the individuals encountered.

Need: 10% of all law enforcement responses nationwide involve adults with untreated serious mental illness [Source].

Evidence: A 2017 systematic review of CIT programs has shown that CIT has positive associations with improved officers’ attitudes and knowledge about mental health, as well as on officers’ confidence in their ability to respond to individuals with mental illness [Source].

Reach and impact data highlights:

• 16,894 NYPD officers and staff were trained in CIT between 06/08/2015 and 3/31/2021
• 83% of trained officers surveyed in 2019 reported that they use the knowledge and skills gained from CIT

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Program Description:

Health Engagement and Assessment Teams (HEAT), comprised of a behavioral health professional and a peer, is a time-limited case management intervention initially launched in late 2018 geared towards individuals exhibiting health or behavioral health needs that can benefit from peer engagement and support. The program is designed to help individuals remain connected to their communities and assist them in obtaining the care and services they need to remain healthy. The expansion of HEAT allows the Department of Health and Mental Hygiene to extend its services to people served by the Behavioral Health Emergency Assistance Response Division (B-HEARD), as needed, including follow-up care for everyone who is served by B-HEARD in their homes. The expansion also allows HEAT to proactively engage New Yorkers who most frequently call 911 and are transported to a hospital by the Fire Department (FDNY) Bureau of Emergency Medical Services (EMS). 

REACH 

HEAT teams served 224 unique individuals referred by FDNY 911 EMS and B-HEARD in FY22.  

NEED 

586 unique New Yorkers required 911-EMS response and transport to a hospital more than 3 times in a single month in a May 2021 analysis by FDNY.

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Program Description:

Intensive Mobile Treatment (IMT) teams provide intensive and continuous support and treatment to individuals right in their communities, where and when they need it. Clients have had recent and frequent contact with the mental health, criminal justice, and homeless services systems, recent behavior that is unsafe and escalating and were poorly served by traditional treatment models. IMT teams include mental health, substance use, and peer specialists who provide support and treatment including medication and facilitate connections to housing and additional supportive services. 

REACH 

837 

clients can be served by IMT teams in New York City at any given time 

NEED 

The 800 individuals most frequently admitted to New York City jails in 2013 were more likely to have serious mental illness: 19% vs. 8.5% in a comparison group. Source 

These 800 individuals are also more likely to have experienced homelessness (51.5% vs. 14.7%) and reported substance use (96.9% vs. 55.6%) than a comparison group. Source 

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Program description: Mental Health First Aid (MHFA) is an evidence-driven, free, eight-hour training that, prior to the COVID-19 pandemic, was regularly provided seven days a week in all five boroughs to expand the number of people who can help New Yorkers in need. Conducted in English, Mandarin and Spanish, MHFA helped trainees recognize mental health needs, learn how to talk about them, and learn where to direct people in need to ongoing care.

Update: In June 2020, Mayor Bill de Blasio announced – as part of the Task Force on Racial Inclusion and Equity -  that DOHMH would re-direct Mental Health First Aid (MHFA) staff to communities hit hardest by the pandemic for a Community Conversations initiative focusing on Mental Health, Equity & Resilience. This program holds structured discussions with communities about the impact of the pandemic, including structural racism, providing coping and resiliency skills, and informing residents of available mental health resources. 

Need: The stigma associated with mental health challenges has been shown to have a direct relationship to lower levels of help-seeking behaviors [Source]. Stigma also has a strong relationship to lower levels of hope and self-esteem, increases the severity of psychiatric symptoms, and lowers the likelihood of staying connected to treatment [Source].

Evidence: MHFA has been shown in numerous studies to affect trainees’ knowledge, behaviors and attitudes towards mental health, including recognition of mental disorders, beliefs about effective treatment, and confidence helping others around mental health [Source].

Reach and impact data highlights: 159,952 individuals were trained in MHFA between 12/01/2015 and 06/30/2020

Featured announcements: Mayor de Blasio and Taskforce on Racial Inclusion & Equity Announce Expansion of NYC Care and Mental Health Services to Address Disparate Impact of COVID-19 on People of Color, June 9, 2020

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Program description:

This program is a collaboration between HRA/DSS, Mayor’s Office of Community Mental Health, Mayor’s Office to End Domestic and Gender based Violence and NYC Health + Hospitals. Through this program, multidisciplinary teams of mental health professionals will provide culturally competent, domestic violence-informed care and treatment to children, teens, and adults in the 55 domestic violence shelters across NYC. Services provided on-site and via telehealth also include crisis support for individuals and families as well as training and support for staff. 

REACH 

9,439 adults and children received domestic violence residential services in 2020. This service will be available and accessible to all shelter residents. The actual number of those who receive clinical services will be reported once the program is fully operational. 

NEED 

30% of adult women who experience intimate partner violence reported “serious psychological distress,” and 31% to 84% of women who have experienced intimate partner violence are estimated to experience PTSD and other problems including depression and higher rates of substance use. Source. 

There are serious mental health consequences for children who witness and or experience domestic violence. Source. 

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Program Description:

Families experiencing homelessness often have multiple service needs – which can be easier to navigate with support from a behavioral health professional. The Mayor’s Office of Community Mental Health and DHS has placed Licensed Master Social Workers (LMSWs) or Licensed Mental Health Counselors (LMHCs) in family shelters to provide assessments to families and coordinate with other shelters' social service staff to better connect families to behavioral health and other services. 

REACH 

34,815 families were screened for behavioral health needs since this program began in 2016. 

NEED 

12,124 families, including 21,726 children, were in New York City’s shelter system as of December 2019. Source 

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Program Description:

Mobile Crisis Teams use face-to-face interventions in a non-emergency crisis to engage, assess, de-escalate, and connect individuals to the most appropriate services. Deployed through NYC Well or hospitals, teams connect children and adults to new providers in addition to reconnecting to pre-existing care. Linkages are made to mental health, substance use, peer services, and social services. Most MCTs include both clinical and peer staff – for example, a licensed social worker and a certified family peer advocate. OCMH partnered with DOHMH to enhance the capacity of the teams to respond quickly – now, from 8 am-8 pm, 7 days a week, MCTs can arrive at a location within two hours, down from an average of 17 hours in 2017. 

REACH 

24 mobile crisis teams now serve New Yorkers citywide and have responded to 10,738 referrals from NYC Well in FY22.  

NEED 

68% of mental health-related emergency department (ED) visits in New York City did not result in admission to the hospital, indicating that not all crises require hospitalization and may be addressed with community-based support. (2015 NYC Mental Health Needs Assessment). 

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Program Description:

In partnership with the Mayor’s Office of Community Mental Health, the Newborn Home Visiting Program was expanded to serve families with newborns up to 2 months of age residing in Department of Homeless Services shelters. With services collaboratively implemented by a public health advisor and a social worker, families are offered three visits and one follow-up phone call over the course of eight weeks, during which a trained public health advisor provides health education, depression screenings, and resources to improve child development, secure attachment, bonding, breastfeeding, infant safe sleep and connects families to community resources. The public health advisor refers caregivers who could benefit, to mental health counseling provided by a Newborn Home Visiting Program social worker and DHS Clinical care Coordinator, (DHS) as well as connects caregivers to mental health services provided in the community. 

REACH 

Over 7,500 caregivers were screened for postpartum depression through this program since this program began in 2015. 

NEED 

Pregnant women experience increased mental health and health risks associated with homelessness.1 One in 10 mothers report experiencing symptoms of postpartum depression.2 

SOURCES

1. Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2019). Homelessness Contributes To Pregnancy Complications. Health affairs (Project Hope), 38(1), 139–146. https://doi.org/10.1377/hlthaff.2018.05156 
    
2. Prevalence of Selected Maternal and Child Health Indicators for New York State, Pregnancy Risk Assessment Monitoring System (PRAMS), 2016-2020 (cdc.gov) 

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Program Description:

NYC Well provides a single point of entry to the City’s mental health and substance misuse services via comprehensive 24/7/365 support over the phone, through text messaging, or through online chat. NYC Well provides robust crisis counseling, referrals to ongoing care, help with scheduling appointments, connection to mobile crisis services, peer support, and follow-up. NYC Well works to connect people to appropriate services regardless of insurance or immigration status. Any New Yorker in need – or who knows someone in need – can call 888-NYC-WELL (1-888-692-9355), text WELL to 65173, or chat online at nyc.gov/nycwell. 

REACH 

1,656,056 calls, texts, and chats have been answered by NYC Well between 10/24/2016 and 06/30/2022  

NEED 

18% of participants in a survey of over 1,000 NYC Well users noted they would not have contacted anyone in the absence of NYC Well. The same survey showed that approximately two-thirds of survey participants reported that their contact with NYC Well helped them a lot, and nearly 90% said it helped at least a little. Source 

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Program Description:

The School Mental Health Program (SMHP) is part of the Office of School Health (OSH).  SMHP began in 2015.  Since this time, SMHP staff work in direct collaboration with schools, mental health provider agencies, students, and families to support the mental health and social-emotional needs of students attending over 1,100 DOE public schools.  In this capacity, SMHP Specialists worked across multiple school settings to provide educational workshops on mental health topics and help schools become more knowledgeable and accepting of mental health care.   

In 2019, in partnership with the Office of Community Mental Health, the SMHP Specialists provided enhanced support to school staff and parents/caregivers with the social, emotional, and behavioral development of students.  In addition to the work already happening, SMHP Specialists provided direct skills groups to address school needs after COVID-19.  The program was restructured to provide more individual services to 300 schools and to expand the capacity to connect students to mental health support in their schools. Specialists also helped identify students who would benefit from trauma-focused group counseling and provided those students with a series of supportive, evidence-based counseling sessions. 

Overall, the SMH program has now expanded program implementation, relationship management, and quality assurance of onsite mental health services in over 700 DOE schools. Those schools ensure adaptation and sustainability of access to services to address the mental health service needs of students through onsite mental health CBO partners. By ensuring access to the almost 400,000 students served, SMH provides hands-on technical assistance, training, and school-level needs assessment.  SMH also develops multiple school-based mental health programs and initiatives and links schools to community-based mental health clinics. 

NEED 

82% of teachers reported an insufficient number of school mental health professionals as a barrier to supporting mental health needs in school settings. Source

EVIDENCE:

A study of evidence-based trauma intervention in schools found reductions in symptoms of post-traumatic stress and increases in child functioning. [Source]. Multitiered models of school-based mental health supports that include mental health promotion, psychoeducation, prevention, and treatment are recommended to meet the increasing mental health needs of school-aged children [Source]. School-based brief group interventions to treat child and adolescent anxiety and depression have yielded positive results [Source]. Specialists expanded children’s access to mental health promotion, prevention, and treatment by offering preventive services as well as  skills based supportive group counseling in schools and by referring youth in need to community-based supports. 

 REACH: 

• In the first 3 quarters of FY 2022, School Mental Health Specialists reached over 200 New York City Department of Education schools.
• During this time, School Mental Health Specialists enrolled 255 students in skills-based group supportive counseling. Eighty-five (85) students were referred to mental health treatment provided by community-based mental health organizations.
• 14,879 students participated in skills-based classroom supportive services facilitated by School Mental Health Specialists.

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Program description: Social, emotional, and behavioral regulation skills are foundational for learning and well-being. Through a partnership between the Mayor's Office of Community Mental Health and the Department of Education, Pre-K and 3-K programs across New York City provide social-emotional learning support to students, families, program leaders and teaching teams.

Need: 43% of children in New York State (0-17) had experienced adverse childhood events in their lifetime, a 2011-2012 survey found [Source]. Adults who had experienced childhood emotional, physical, or sexual abuse were four to twelve times more likely to experience alcoholism, drug abuse, depression, and suicide attempt, according to the Adverse Childhood Experiences Study (ACE Study) [Source].

Evidence: There is a consensus among scholars that schools provide a powerful opportunity to provide social and emotional learning [Source]. Enhancing school staff’s ability to conduct provide successful social and emotional programming through universal interventions can have significant positive effects on students’ social and emotional skills, attitudes, behavior, and academic performance [Source].

Reach and impact data highlights:

Over 3,000 schoolteachers and program staff participated in at least one professional learning session since the program launched in 2016

• More than 3,000 parents and caregivers have attended family workshops to learn social emotional development practices since 2016
• 91.4% of classroom staff reported that they learned one skill or strategy to help children manage their feelings or behaviors between January 1 and March 31, 2021
• 1,979 parents and caregivers participated in family support workshops or trainings between January 1 and March 31, 2021

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Program Description:

Thrive in Your Workplace helps local employers to bring mental health support to the workplace, fostering employee mental health and access to mental health care. Using an evidence-driven assessment and toolkit, Thrive in Your Workplace consults to shape and customize a workplace mental health strategy that takes both employee well-being and organizational priorities into account, and provides technical assistance to implement workplace mental health programs and policies. 

REACH 

133 employers have been engaged between 7/1/2019 and 9/30/2020 

NEED 

7%-16% of employees across all industries are estimated to experience depression. Employees in industries that require frequent or complex interactions with clients or the public and those with high stress and low physical activity have the highest rates of clinical depression. Source. In August 2019, over four million New Yorkers worked in industries involving service provision. Source 

Experiencing major depression has a significant impact on workers’ productivity. Source. Receiving treatment can help workers continue to contribute in the workplace; however, only 57% and 40% of workers who experience moderate or severe depression, respectively, receive treatment. 

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