Over the past year, CASES served more than 1,500 New Yorkers living with serious mental illnesses. The majority were experiencing or had previous experiences of homelessness. With the Mayor’s recently announced directive that emphasizes “removal from the community” for New Yorkers living with serious mental illnesses who are homeless, many of the community members currently engaged in CASES services will now be vulnerable to involuntary commitment.
Despite repeated fatal consequences, the Mayor’s directive will again center police as frontline responders for people experiencing mental health crisis, an approach consistent with the City’s ongoing criminalization of mental illness, perhaps most evident in who is currently detained inside Rikers Island:
- more than half of detainees have mental illness; nearly 90% of all detainees are Black and/or Latino
- of the 18 people who have died inside Rikers this year, many had indications of serious mental illnesses; all but one were Black and/or Latino; and some had been detained more than a year while awaiting trial—consistent with the continuing practice of keeping people with mental illness behind bars
That a continuing reliance on “removal from the community” is neither new nor a surprise makes the Mayor’s announcement no less disheartening. But the Mayor is right: a solution is needed so that all New Yorkers, including the most vulnerable, can be safe in the community. On this front, there is hope. We have solutions that work, many developed with care and investment by the Mayor’s office, City agencies, and City Council.
One example is the Intensive Mobile Treatment (IMT) model created by the City in 2015. IMT teams—like the seven currently operated by CASES—feature psychiatrist, peer specialist, nursing, and clinical staff who work alongside their clients on the ground in communities across the city. IMT teams establish trust by helping clients address emergency and immediate needs, build relationships including through engagement with peer specialists with lived experience of recovery, and provide expert treatment integrated with support for navigating challenges, including securing housing.
While the City has scaled the model in recent years, IMT teams have long waitlists. This demand highlights the opportunity for further investment. In addition to IMT, other proven approaches in need of investment include Certified Community Behavioral Health Clinics. These clinics—CCBHCs—provide comprehensive behavioral health, care management, peer support, and primary care services integrated at a single location. Widely identified as a best practice, CCBHCs across the country work with law enforcement to receive individuals experiencing crisis. Other proven community health approaches include mobile care vans staffed by clinical and peer teams, crisis respite, and supportive housing.
It is time to fully invest in what we know works, not return to failed policies reliant on police response and removal from the community, the latter based on ambiguous and expansive criteria that will replicate the racial inequities rife in who is incarcerated and for how long. Recovery is possible. We see it every day at CASES in programs like IMT. We commend the Mayor for naming the vulnerability of New Yorkers living with serious mental illnesses who are homeless. We look to his leadership not in a return to failed, harmful policies but in a vision that invests in healing and recovery achieved through the scaling of proven solutions.