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The Sane Way to Attack Mental Illness: Focus City Resources on New Yorkers in Deepest Need

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The Sane Way to Attack Mental Illness: Focus City Resources on New Yorkers in Deepest Need

New York Daily News March 11, 2019
Urban PolicyNYC
Health PolicyMental Illness

Last week, an allegedly mentally ill man in lower Manhattan sucker-punched an 8-year-old autistic child on the subway, and in Harlem police shot an allegedly mentally ill man who they thought lunged at them with a weapon.

The Daily News quoted a friend of the shooting victim saying, “He’s schizophrenic. If he’s not on his meds he acts out.”

Incidents like these are all too common in New York, but Mayor de Blasio and his wife Chirlane McCray claim their mental health plan called ThriveNYC, backed by taxpayer spending of $850 million over four years, is working just fine.

It’s simply not true. New York City’s own data show rates of homelessness, police calls and incarceration of the mentally ill are rising.

ThriveNYC is failing to stem the tide for one simple reason: It doesn’t focus on helping the most seriously mentally ill, who are the ones most likely to become homeless, arrested, incarcerated and present dangers to themselves or others without treatment.

Instead, ThriveNYC has become little more than a brand name for a fund that the mayor and his wife use to throw money at social services, simply by wrapping those social services in a mental health narrative. It includes programs to lower divorce rates and address unemployment, angst about gender identity, sadness, bereavement and more. Of course, mild depression is a real problem, but other mental illnesses are far larger threats to the lives of New Yorkers.

ThriveNYC contains, according to the city’s count, 54 discrete programs. When Assemblywoman Nicole Malliotakis ran for mayor, she proposed cutting the programs that don’t help the seriously mentally ill, like Mental Health First Aid, and expanding those that do. That’s the solution the City Council should insist on. MHFA is an eight-hour seminar that ostensibly teaches the public how to assist people who are so asymptomatic that special training is needed to identify them.

The asymptomatic are not the problem, the seriously ill are. And there are virtually no city services for them.

The City Council should insist the mayor develop services for the seriously ill, and that the Mayor’s Management Report, the annual update on how city services are performing, include meaningful metrics such as the number of mentally ill who are homeless, arrested, incarcerated, violent and needlessly hospitalized.

Instead, McCray points to the number of calls to a helpline as an indicator of success. But she is making that number go up by spending millions on advertising to get people who don’t have mental illness to call the number. One transit ad asks anyone who feels “under pressure” to call. What New Yorker doesn’t feel that way sometime?

Programs that ought to be expanded include psychiatric hospital beds, Fountain House — a recovery program for the seriously mentally ill — and Kendra’s Law, which lets a court intervene when family members believe a loved one is at risk to themselves or others.

It’s often said that it’s harder to get into Bellevue than Harvard, and once in you will be discharged sicker and quicker. At a minimum, city hospitals should make wider use of long-acting injectables, which can help prevent the seriously mentally ill from deteriorating for up to three months; clozapine, which can help restore cognitive functioning, and electroconvulsive therapy, which can help people who have not been helped by other treatments.

The mayor and his wife like to say, “the mentally ill are no more violent than others.” That’s true for the treated. But the seriously mentally ill who go untreated are more violent than others, and ThriveNYC lets 40% of them go entirely untreated Instead, it focuses on improving “mental wellness” in all others. That’s lunacy.

This piece originally appeared at New York Daily News

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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.

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