Better solutions for those with mental illness

The mayor’s announcement of involuntary removal of those suffering from severe mental illness, who present a danger to themselves or others, has sparked fierce debate. But the conversation too often devolves into a false choice: security through law enforcement or compassion through services. Neither, on their own, adequately addresses the needs of this population.

Police and social services must work hand in glove with a range of tools if we are going to achieve better outcomes in the long term, address health, psychiatric, and housing needs on an individualized basis, and ensure safety for all New Yorkers. Yet the strained resources among our first responders and care providers means that we must expand the circle of who needs to also show up for our most vulnerable. Other institutional players — including the courts and the business community — also have a critical role to play in helping our communities thrive.

For too long, we have relied upon law enforcement and jail to be our primary response to those in mental distress. Half of those held on Rikers have a mental health issue, 16% with a severe mental health issue. Yet for people with unmet behavioral health needs, an arrest — even for a low-level crime — can mean a lifetime in and out of the criminal justice system.

The seeds for successful, sustainable models for helping those with mental illness voluntarily and outside of incarceration have been planted, and represent exciting opportunities for meaningful change.

In Brooklyn, the Center for Court Innovation and the state court system operate the Brooklyn Mental Health Court, which has served more than 2,000 participants struggling with mental illness, most who have been charged with violent offenses. Under the supervision of the court’s clinical team, participants must adhere to treatment plans and appear in court regularly for the duration of their mandate, the length of which is adjusted depending on compliance. The impact of this program on community safety cannot be overstated: participants are 46% less likely to be re-arrested than those who go through traditional courts.

In Manhattan, the Midtown Community Court partnered with Fountain House (a mental health service provider), Breaking Ground, (a housing organization), and the Times Square Alliance (a business improvement group) to launch Community First, a program that employs people who have experienced homelessness themselves to help the unhoused develop the stability to stay off the streets — and out of jail. At the heart of the program is relationship-building. For this population, in particular, forging a trusting rapport can mean the difference between staying in supportive housing or treatment, and cycling out. Thus far, the program connected more than 400 people with voluntary services and led to a two thirds reduction in the number of people sleeping on the street during the first year of the program.

Citing the success of this program, Manhattan DA Alvin Bragg has announced that his office would invest $9 million into scaling the Community First model by deploying professionally-trained neighborhood and court-based “navigators.” These individuals will support those who are unhoused or facing mental health or substance abuse challenges obtain long term services such as treatment.

In the Bronx, Mayor Adams recently established the Bronx Support and Connection Center (SCC), a treatment and stabilization program for those experiencing mental health or substance use crises, first pioneered in East Harlem. SCC provides clinical services, along with social care, peer support, and psychiatric services to New Yorkers who would traditionally end up in the emergency room or the justice system. Many of the SCC patients are referred through the Behavioral Health Emergency Assistance Response Division (B-HEARD) program, which de-escalates 911 calls involving mental illness by linking callers to care providers who can get the person what they need.

All of these models represent opportunities, in different ways, for the justice system and social service providers, along with members of the local community, to work together for better outcomes.

No two people find themselves in crisis for the same reasons, and solutions must be flexible enough to address individual needs. Engaging those exhibiting mental illness voluntarily in care, support, and treatment should be prioritized and involuntary psychiatric evaluation, a necessary component in a comprehensive plan, should be the last resort.

New York has piloted programs that are effective at getting people struggling with severe mental illness the medical support they need and keep them off the streets — but we need to expand them.

If we all work together — the local community, elected officials, law enforcement, city agencies, the private sector, and social service organizations — we can achieve a safer, more humane city that provides real solutions for our most vulnerable.

Bryan is executive director of the Center for Court Innovation. Harris is president of the Times Square Alliance and a former NYPD inspector.