Testimony: We need in-house mental health professionals in family shelters


RE: Intro. 0522-2022, a Local Law to amend the administrative code of the city of New York, in relation to requiring mental health professionals in families with children shelters

Good afternoon Chair Ayala and members of the Committee on General Welfare.  Thank you for holding this space today to hear from peers living with mental health conditions, their loved ones, and the community-based organizations that strive to support peers in their recovery. My name is Kimberly Blair, and I serve as the Director of Public Policy and Advocacy for the National Alliance on Mental Illness of NYC (NAMI-NYC). We are a grassroots mental health advocacy organization, and one of the largest affiliates of the National Alliance on Mental Illness.  On a personal note, I also identify as someone who lives with mental health conditions and who has benefitted from life-saving psychotherapy, such as that proposed in Intro. 0522-2022, a Local Law to amend the administrative code of the City of New York, in relation to requiring mental health professionals in families with children shelters, which I encourage you to support today.

First and foremost, before we delve into the bill, I think it is important to orient you as to what my organization does. NAMI-NYC has been a leading service organization to the mental health community for 40 years in New York City. Our organization provides groundbreaking advocacy, education, and support services for individuals affected by mental illness, their families, and the greater public, all completely free of charge. Our renowned peer- and evidence-based services are unique in that they are led both for and by members of the mental health community and are reflective of the diversity across New York City.

As part of our support efforts, we also run a confidential Helpline from 10:00am to 6:00pm that connects peers and family members with referrals for mental health services, housing, and legal support. Most of the calls we receive are from peers or family members in the aftermath of a great crisis, whether that is a mental health crisis that includes hospitalization or a crisis that involves losing housing, benefits, or employment due to a mental health episode. 

In our experience, people struggling through these crises often come to us because they have great difficulty navigating the confusing terrain of mental health providers and insurance restrictions on their own, especially if seeking low-income or culturally and linguistically appropriate mental healthcare in New York City. All these hurdles delay critical care and delay family members ultimately reaching the recovery that is responsible for keeping family units together and not furthering the cycle of trauma onto younger generations.

Now, imagine going through all these hurdles while also navigating homelessness, which in essence, is a traumatic experience itself. This is what 12,124 families in New York City’s shelters have faced since 2019 because the social workers introduced by the city to the shelter system long before that in 2016 have not been able to exercise the full range of their qualifications to provide essential psychotherapy in-house. To make matters worse, the reason these clinicians cannot provide these services is not because they do not want to or because there is not a need, but rather, due to a lack of financial resources and personnel. 

Meanwhile, data from the Mayor’s Office of Community Mental Health demonstrates that 66.7% of families have been screened for behavioral health needs, including mental health and substance use conditions. Yet, only 0.4% of families have been able to attend an appointment from January to March of this year and only 2.3% of families from April to June of this year. While we need more publicly available data and analysis in order to dig into the deeper reasons why families receiving referrals to care have not been able to get into care, we know for a fact there are a number of barriers all people facing mental health conditions face, including mental health stigma, long wait times and lack of financial resources. These barriers must be exacerbated for families whose main priorities at the moment are housing, stability and survival.  So, 66.7% of families (i.e., the majority of families) in shelters need life-saving treatment, and the city’s current response is to provide 0% of that treatment at the most critical point in the timeline of adverse life events a family may face—homelessness. Our organization sees this as unacceptable and as a moral failing on behalf of our city to families in crisis. 

However, with a small investment, Intro. 0522-2022 can help remediate this failing by ensuring that family units dealing with unaddressed mental health conditions and homelessness receive the care that they need until they can get connected with long-term care providers.  We hold steady that $40 million annually is a small investment in New York City’s families when one considers the returns the city could receive on: 

  1. reduced incidents requiring emergency service visits to family shelters;
  2. reduced psychiatric emergency visits for family members experiencing homelessness who have been referred to external mental health providers by shelter staff but currently have gaps in continuity of care due to long wait times to see said providers;
  3. reduced number of families returning for lengthier and more costly shelter stays because their underlying needs were not addressed the first time they came to the shelter; and
  4. increased number of families living independently afterwards in supportive housing because they received the appropriate screening needed for this service while in shelter.

Furthermore, this investment goes a long way when we think of our providers themselves. Since the onset of the pandemic, many social workers and other mental health professionals have seen their caseloads increase exponentially without any increase in compensation, which in turn, has attributed to burn out, vacancies in critical shelter positions and a reduction in the quality of care needed to address this social issue we are discussing today. The increased cases of families experiencing homelessness is a separate problem than the increase in inflation and economic burdens, which our state attempted to address with its cost-of-living adjustment issued earlier this year. We know that the financial investment proposed along with Intro. 0522-2022 will help tackle these additional challenges so that shelters can fix staff shortages and compensation issues.

For all these reasons, we ask that the Committee please vote this legislation FAVORABLY on Intro. 0522-2022 to invest in families in need. Thank you.