City First Lady Chirlane McCray will appear before the City Council Tuesday to explain what exactly her mental-health project, ThriveNYC, has achieved before giving her $250 million a year for the next four years.
New Yorkers can be forgiven for failing to notice positive results, what with the ever-growing ranks of homeless mentally ill in our streets and subways (and prisons). As these pages have repeatedly argued, ThriveNYC hasn’t been focused on helping the most seriously mentally ill.
Here, then, are 10 questions council members should ask the first lady to get to the root of that problem.
One: The first substantive statement that appears on ThriveNYC’s Web site claims that “stigma stops people from getting the care they need.” ThriveNYC’s programmatic priorities reflect this belief. Yet in the past, when you wrote about your own daughter’s struggles with mental health, you noted that finding a doctor, not public attitudes, was the biggest barrier to care. So which is it?
Two: In 2017, Gary Belkin, who at the time served as the city’s mental-health chief and now leads policy and strategy for ThriveNYC, admitted to a reporter that only $165 million of the ThriveNYC’s budgeted $850 million was allocated to people with serious mental illness, with the rest presumably directed to other issues. Doesn’t that get things exactly backward, given the centrality of serious mental illness to the current crisis?
Three: You claim that ThriveNYC is a “prevention” program. But serious mental illnesses like schizophrenia and bipolar disorder can’t be prevented, because we still don’t understand the causes. Do you really believe that ThriveNYC can prevent serious mental illness?
Four: Unemployment, bad grades, gender-identity angst, growing up with a single parent — all can make people feel bad but aren’t mental illnesses. Why, then, are you diverting mental health funds to these issues, while 40 percent of the most seriously mentally ill people in New York go untreated?
Five: ThriveNYC has trained some 100,000 New Yorkers in mental health first aid, or MHFA, which helps them identify people who don’t show symptoms of mental illness. But the asymptomatic are not the problem — the symptomatic are. Given that there is no research supporting MHFA’s effectiveness, why do you continue to fund it?
Six: You claim to be measuring 400 metrics but that it is too early to know if ThriveNYC is working. Given that the number of homeless mentally ill, incarcerated mentally ill, suicides and calls to police about the mentally ill are all rising — isn’t it already clear that ThriveNYC isn’t working? Why not focus on these concrete metrics?
Seven: It is adults over 18 and under 64 who are most likely to be hospitalized, homeless or incarcerated. So then why does the city budget show that your age-targeted programs mainly focus on people under 18 and over 64?
Eight: ThriveNYC is funding ads asking anyone who is “under stress” to call your mental health hotline. But doesn’t that describe nearly all New Yorkers? Again, why won’t you target the ad campaign at people with serious mental illness? And why are the hotline operators telling people who need a crisis intervention team to call the police instead?
Nine: Kendra’s Law has dramatically reduced homelessness, arrest and incarceration of the seriously mentally ill and is therefore the most effective tool the city has to help the neediest cases. But even if it is true that you have increased use of Kendra’s Law, there are still thousands more who should be in it. Why won’t you push to expand Kendra’s Law to serve all who could benefit from it?
Ten: You are distributing ThriveNYC funds based on identity politics. Favored groups include African-Americans, Latinos, Asian-Americans, LGBTQ people and so on. Is there any evidence that the funds are reaching the most seriously mentally ill residents within those subpopulations — or are they going to community centers?
ThriveNYC is giving mental health and social services programs what they want: mental health funds without an obligation to serve the seriously mentally ill. The City Council should put an end to that and require all mental health funds to be used where they can do the most good.
This piece originally appeared at New York Post
DJ Jaffe is an adjunct fellow at the Manhattan Institue, executive director of Mental Illness Policy Org., and author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill.
Photo by Jeff Schear / Getty Images