Note: Intro. 2442-A establishing the Mayor’s Office of Community Mental Health was signed as Local Law 155 of 2021 and is available to view here.

Regarding Intro. 2442

November 17, 2021

Good morning, Chair Louis, Chair Dinowitz, and members of the Committee on Mental Health, Disabilities, and Addiction—and the Committee on Veterans. My name is Susan Herman and I am a Senior Advisor to the Mayor and Director of the Mayor’s Office of Community Mental Health. Thank you for the opportunity to testify in support of Intro. 2442.

Long before the COVID-19 pandemic, mental illness was common in New York City. Every year, one in five New Yorkers experiences mental illness—and hundreds of thousands of them are not connected to care. Over nearly two years of loss, uncertainty, and trauma, the pandemic has exacerbated pre-existing mental health needs and created new ones. These years have also highlighted deep historical structural inequities: New Yorkers of color are more likely to experience mental health needs than white New Yorkers, yet less likely to get the care they need. These profound needs and persistent disparities demand an all-government approach to mental health, and sustained leadership from the highest levels of City government.

That is why, earlier this year, Mayor de Blasio signed Executive Order 68 to establish the Mayor’s Office of Community Mental Health, or OCMH. Our office builds on the vision of ThriveNYC, which represented the first time a large American city dedicated its own funding—not just State and Federal funds—to support the mental health of people who had long been underserved. Today, the Mayor’s Office of Community Mental Health partners with dozens of City agencies and nearly 200 community-based organizations to promote mental health for all New Yorkers.

With the wide-ranging mental health impact of the COVID-19 pandemic likely to linger for years to come, the work of our office is more important than ever. Accordingly, the City strongly supports Intro. 2442, which amends the City’s charter to codify an office of community mental health. To demonstrate the value such an office brings to our city, I would like to describe the core functions of the Mayor’s Office of Community Mental Health.

We work in two distinct ways. First, we close gaps in mental healthcare through innovative approaches. Second, we provide strategic policy guidance and inter-agency coordination to maximize the promotion of mental health across City government. I would like to share some of the remarkable progress we have made over the last few years—progress that is having a measurable impact on the lives of New Yorkers.

CLOSING GAPS IN MENTAL HEALTHCARE THROUGH INNOVATION AND PARTNERSHIP

OCMH oversees initiatives implemented by City agencies and community-based partners—all designed to close gaps in mental healthcare. These initiatives supplement and enhance the pre-existing mental healthcare system. They were never intended to replace it. Our focus on closing gaps in care has led to new or enhanced mental health services in many locations, including shelters, schools, family justice centers, senior centers, residences and drop-in centers for runaway and homeless youth—and mobile services that can reach New Yorkers wherever they are.

In a city our size, it is especially important to test innovative solutions, so we know what to bring to scale. Our office provides programmatic oversight. We assess program performance, meet regularly with agencies to discuss progress, troubleshoot obstacles, and refine our approach when appropriate.

Reach and impact data for each of our programs is publicly available in a user-friendly data dashboard—on our website. Here are a few examples of how our programs are making a measurable impact.

First, New Yorkers are getting help right when they need it. NYC Well, the City’s free, 24/7 helpline for mental health and substance misuse issues, has responded to more than 1.3 million calls, texts, and chats since 2016. People call for crisis counseling, referrals to providers, or urgent care from a mobile crisis team. Over 93 percent of callers consistently say they are satisfied with NYC Well’s services.

Second, victims of crime are feeling safer. Because we recognize that crime can have a serious impact on victims’ mental health, we launched the Crime Victim Assistance Program or CVAP, which places Safe Horizon advocates in every police precinct and Police Service Area citywide. CVAP advocates have served over 200,000 New Yorkers, through supportive counseling, safety planning, referrals to legal and social services, and assistance applying for victim compensation. Last year, almost 95 percent (94.7%) of people surveyed reported feeling safer emotionally and/or physically after receiving assistance from a CVAP advocate.

Third, older New Yorkers are seeing improvements in depression. In partnership with the Department for the Aging, we have added clinicians to 46 senior centers across the city. These clinicians have screened over 3,600 older New Yorkers for a variety of mental health needs and provided more than 38,000 therapy sessions. Therapy helped. In the most recent reporting period, almost 55 percent (54.7%) of older adults experienced a clinically significant improvement in depression after three months of treatment.

A fourth example—more New Yorkers with serious mental illness are staying connected to care. Around 90 percent of people served by Intensive Mobile Treatment teams—people previously disconnected from care—remain in treatment consistently for at least 12 months—a remarkable success given their history.

All of these initiatives are now part of our dynamic portfolio. Here’s how it works: when a strategy or program has achieved proof of concept, it becomes fully integrated into the functions of the implementing agency. Several initiatives have already gone through this process.

Another way we eliminate barriers to care for underserved populations is through partnerships with the non-profit and private sectors. For example, we have provided technical assistance, training and support—to MTA employees who need to know how to identify and respond to people in need—to over 400 faith leaders who wanted training on trauma and grief—and to people working in the nightlife and creative sectors who wanted mental health support. We have also embedded mental health resources into key locations, including public libraries, private sector and non-profit workplaces, and NYCHA Cornerstone Community Centers.

COORDINATING AN ALL-GOVERNMENT APPROACH TO MENTAL HEALTH

The second core function of our office is to provide strategic policy guidance and inter-agency coordination to improve the mental health of New Yorkers. This work—critical to ensuring an all-government approach to promoting mental health—is needed now more than ever. Let me give you a few examples.

This year, we convened four agencies—H+H, FDNY, NYPD, and DOHMH—to bring emergency mental healthcare to people—wherever they are—in their homes or in public places–for the first time in New York City’s history. B-HEARD—our new health-only mental health emergency response—is currently operating across five precincts in upper Manhattan (25, 28, 32, 26, 30 precincts), where social workers and EMTs respond together to mental health 911 calls. The B-HEARD response has already reduced unnecessary hospitalizations and unnecessary use of police resources. For example, in the first three months, 43 percent of people served by B-HEARD were assisted on-site or transported to community-based care—options not available ever before. A cross-agency collaboration of this complexity requires the high-level leadership that a mayoral office can provide.

Recently, we initiated new cross-agency work to prevent 911 mental health emergencies. About 300 people call 911 more than three times a month—that’s a tiny fraction of one percent of our city accounting for six percent of mental health emergencies. We believe these people could be getting more effective care—care that might prevent these costly emergency interventions.  That’s why the FDNY and the Health Department are now beginning to connect frequent utilizers of 911 to teams of peers and social workers, to engage them in ongoing care.  More than anything, this initiative required a simple shift in how agencies do business—one that we believe will have long-term positive impact. It likely would not have happened without the coordination function of a mayoral office.

We also have a more formalized coordination role through the Mental Health Council— first created by Executive Order 15—and convened by our office. Over 30 agencies across government come together regularly to share best practices, request information, and collaborate to create an all-government approach to mental health.

Over recent years, the Mental Health Council discussions have led to development of resource guides for vulnerable populations, embedding mental health screening and referrals into emergency food delivery during the pandemic, and new strategies to prevent vicarious trauma among frontline City workers. Intro. 2442 would incorporate the Mental Health Council into the Charter, with the Mayor’s Office of Community Mental Health continuing to serve as the convener.

ENSURING A LASTING COMMITMENT TO MENTAL HEALTH

New York City has done something that no other large city has done. We have made mental health a priority for City government. With Mayor de Blasio and First Lady Chirlane McCray’s leadership, we started an unprecedented conversation about mental health that is having a lasting impact—but we didn’t stop there. We have significantly expanded support for people with serious mental illness, strengthened our response to mental health crises—and just as importantly—made investments in early intervention, and prevention. All of this with a focus on mental health equity—that will transform our city for years to come.

We have done this intentionally, with innovative solutions designed to address longstanding gaps in care. We have done this transparently, with data for every single program available on our website, to help the public understand the reach and impact of our work. We have done this responsibly, with careful stewardship of taxpayer dollars documented in publicly available programmatic budgets.

This work must continue. In the wake of the pandemic, it must go even further to make sure every New Yorker has mental healthcare, whenever, wherever, and however they need it. Now is the time to enshrine the City’s high-level commitment to mental health—and the office needed to fulfill it—into the Charter of our city.

Thank you for the opportunity to testify today, and for your continued leadership and partnership.