City Council roadmap to mental health vs. mayor’s version

Mental health has been the topic of a huge conversation among electeds in the last few months—not just how to legislate it, but also how to mediate and deal with people on the streets of New York City who need help. 

Mayor Eric Adams put out his own controversial plan back in March and the City Council revealed their plan that “fills in the gaps” this past week, just after Jordan Neely, a homeless Black man with a history of trauma, was choked to death by a white ex-marine in a subway car in Manhattan. A string of protests has broken out in the city on behalf of Neely.

“I’m frustrated, I’m angry, I’m sad, because for the last few years we’re watching—literally, instead of us receiving resources, we are being choked out,” said Councilmember Kevin C. Riley in reference to Neely’s death. Riley is a sponsor of a mental health bill for supportive community centers. “Black men are not safe and I can’t explain this to my kids [anymore].”

What’s in the plan

The Council Committee on Mental Health, Disabilities, and Addiction held a hearing on the Mental Health Roadmap Legislative package on Thursday, May 4. The package includes several bills centered on four main areas: prevention and supportive services, the mental health workforce shortage, decriminalization, and public awareness. 

“We can’t continue to point people toward systems that don’t work and expect frontline workers in hospitals and jails to shoulder the systemic failures that for too long have needed to be urgently addressed,” said Councilmember Carlina Rivera, sponsor of a bill and resolution for more treatment in hospitals and less jailing. 

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The roadmap seeks to increase access to “healthcare and medication, housing, food…, technology and internet access, economic and job stability, and supportive community infrastructure” as a means of treating mental illness and helping individuals. The council wants to expand the number of Crisis Respite Centers, member-run clubhouses, and community centers. But most importantly, the roadmap aims to redirect people from being arrested or going to jail. 

The mayor’s Care, Community, Action: A Mental Health Plan for NYC agenda has language similar to the City Council plans, but diverges in one critical way: The “Care” agenda focuses on mental health services for youth and families, people with serious mental illness, and those at risk of drug overdoses. It also includes a component that allows police officers and the Behavioral Health Emergency Assistance Response Division (B-HEARD) teams to invoke involuntary street and subway removals of those deemed mentally ill, a move that received immediate backlash because of the deep fear most have of being institutionalized. 

In the City Council hearing, Department of Health and Mental Hygiene (DOHMH) Dr. Ashwin Vasan said that overall, the mayor’s office supports the council plans, especially for more respite services, clubhouses, and community centers. Vasan promised that the city is gathering data about the involuntary removals and how their teams are operating on the ground as mandated, without compromising patient privacy. 

“Let me add, given recent events specifically around Mr. Neely, I’m not here to comment on an open investigation but as a doctor, as the city’s doctor, as a New Yorker, and as a human being, this was a tragedy and our hearts go out to Mr. Neely’s family and loved ones,” said Vasan. 

The divide in approaches

Beth Haroules, senior staff attorney at the New York Civil Liberties Union (NYCLU), said the difference is indicative of two primary schools of thought. In the 1960s and ’70s, people viewed mental illness and individuals with it differently from today. More people were locked up in psychiatric hospitals and not necessarily treated, she said. In 1972, TV reporter Geraldo Rivera exposed the horrible living conditions at the Willowbrook facility in Staten Island that housed disabled children and adults, many of whom were left unsupervised, many naked, in unsanitary conditions.

“There were a lot of lawsuits being filed around the country, coming off the model of the Civil Rights Movement, directed at disability justice, so large facilities that were warehouses, where nobody looked at the conditions, were all being closed,” said Haroules.

New York City was a part of the wave of closing its massive psychiatric facilities in an attempt  to deinstitutionalize individuals. Haroules said that New York State was supposed to take the profits from selling off these large facilities and put the monies back into community-based services, but that didn’t materialize. Instead, over the last 50 years, there’s been a huge jump in the criminalization of mental illness, with Rikers Island now considered one of the “three largest providers of psychiatric care in the U.S.” The other two are also jails—the LA County Jail in Los Angeles and Cook County Jail in Chicago, according to the City Council. 

“The government made a policy choice not to put resources into that, and of course, the folks who get impacted the most are men of color, 20 to 45,” said Haroules. 

This is mostly because the care provided is a “white-male–led apparatus” that falsely promises medication as a solution to mental illness and jail for the mentally ill homeless, said Haroules. 

During the onslaught of the pandemic in 2020, this situation only worsened since former Governor Andrew Cuomo ordered most of the psychiatric care beds left at hospitals be converted into COVID surge beds, said Haroules. At the City Council hearing, the health department confirmed that many of these beds are still shut down three years later. 

According to Haroules, people with serious mental illness are being routed to a transitional housing unit facility on Ward’s Island and possibly a rebooted psychiatric facility at Kings County Hospital in Brooklyn. She said it’s hard to track because the city hasn’t dispersed data yet.

What can work

“The City Council is taking the lead in ensuring that from their perspective and a community perspective, because their [efforts] involve community organizations with decades of experience in addressing some of the really difficult issues in a way that, in my experience, the mayor’s plan does not,” said Matt Kudish, CEO of the National Alliance on Mental Illness of New York City (NAMI-NYC). “We heard about the mayor’s plan when it was announced. We didn’t have an opportunity to inform the mayor’s plan as mental health experts.” 

The roadmap emphasizes family support for individuals who are dealing with a serious mental illness, which makes a monumental difference in terms of recovery, said Kudish. 

“We didn’t talk about it. We didn’t know how to talk about it, especially in underserved, marginalized, and minority communities, where there is even more stigma around mental illness and more that gets in the way of seeking support,” said Kudish. 

Assemblymember Monique Chandler-Waterman, who testified at the City Council hearing, said she supports the package of bills and is adamantly opposed to involuntary removals. She is an advocate for peer specialists and family member support programs for  mentally ill individuals. She also wants to address the racial disparity among mental health workers and create more culturally sensitive programming that correctly diagnoses Black and brown people.  

 “Involuntary removals are similar to mental health profiling,” said Chandler-Waterman. “We must stop criminalizing people with mental health conditions. We must have trained mental health professionals, not law enforcement officers. In fact, they often escalate the crisis because they’re not properly trained.”

Institute for Community Living (ICL) CEO Jody Rudin said the City Council plan is going in the right direction by addressing the mental health workforce shortage and establishing pay parity with state-funded programs. “The investments in proven community-based programs, coupled with support for the frontline workforce, are key to a successful mental health effort,” said Rudin. “We know because we run these programs and see their impact daily.”  

Haroules is more skeptical about the implementation of the mayor’s and council plans. She said Adams’s plan leads with force, policing, and psychiatric settings while the council plan “talks the talk” without any real action behind it. She thinks the City Council can take affirmative steps to enact legislation and vote affirmatively to reject Adams’s budget, but there’s already a “major disconnect” in the rollout of Adams’s plan.

“There aren’t resources,” said Haroules. “The criminal system doesn’t have a place to actually refer people to, and the services that do exist are services that people aren’t happy with.”
Ariama C. Long is a Report for America corps member and writes about politics for the Amsterdam News. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by visiting https://bit.ly/amnews1.