We believe in a person-centered approach to healthcare to assist people living with mental illness. Integral to the goal of person-centered healthcare is the ability for people living with a mental illness to access the most appropriate treatments to advance their specific recovery. Healthcare projects NAMI-NYC supports include:
Through research we conducted, we advocate for several items that would enhance the overall psychiatric emergency room experience for peers, including improvements in wait times, bed availability, quality of care, community resources, and intermediary services.
NAMI-NYC’s Board Advocacy Committee and member organizations of Manhattan Together originally launched a survey in September 2019 to capture the experiences of patients and their supporting friends and family members after visiting psychiatric emergency rooms across New York City. From the first survey and other anecdotal information, the items that we believe would enhance the overall psych ER experience for peers include:
We’re launching the second part of our psychiatric Emergency Room survey in Spring 2023 to collect more data that we will share with legislators and hospital executives in order to demand improvements in quality of care standards in psych ERs.
Themes we’re focusing on include fewer closures, better staff to patient ratio, more humane treatment, and knowledge of follow-up resources in the community, e.g. supportive housing, alternatives to crisis care, mental health professionals, and more.
Mental Health Equity
We are advocating for funding to establish a state-run or city-run fellowship to promote behavioral workforce development. Currently, New York is facing a shortage of mental health professionals. We support growth in the number of BIPOC mental health professionals and mental health professionals who speak more than one language. We also need to establish funding to continue cultural competency training among professionals.
Crisis Respite Centers
We need more city funding and an increase in the “health diversion centers” where individuals can get short-term treatment until they are stable. These respite centers can be a key step in helping shift people with a substance use disorder or a mental health episode away from the criminal legal system and towards recovery.
We would also like to see increased city funding available for community-based organizations to operate respite centers in order to promote more local care and resources that are culturally-competent and linguistically-appropriate. We believe that putting these centers in the hands of organizations who are well-experienced in operating them will also ensure the success of these centers emphasizing long-term treatment and recovery.
New York Health Act
This legislation will provide more affordable, easier to access mental healthcare for all New Yorkers through a single-payer health insurance system.
The New York Health Act (S.5474/A.6058) would create a single-payer healthcare system for New York, eliminating the power of insurance companies to dictate treatment, and providing healthcare access for the uninsured as well. NAMI-NYC supports the New York Health Act, as it will provide cheaper, easier to access, mental healthcare for all New Yorkers.
Education is a critical instrument in fighting mental health stigma and creating healthier communities. Education projects NAMI-NYC supports include:
Supporting Mental Health Education in Schools
Understanding mental health can make a big difference in the lives of students. We support bringing NAMI-NYC’s Ending the Silence presentations to all schools in NYC. Ending the Silence includes information on warning signs, facts and statistics, along with next steps for approaching support. Citywide support for these presentations within public schools will benefit a much larger pool of local teachers, students, and family members.
Promoting Mental Health Crisis Response in Schools
School Public Safety Officers must be removed as a first contact when dealing with student mental health crisis response in order to prevent further escalation and/or trauma. Schools must set and follow school protocols if a student has a crisis, especially if they aren’t otherwise identified as having a Behavioral Intervention Plan (BIP). Int 0543-2022 would establish protocols for responding to students experiencing mental health crises.
Further, we support improving our criminal legal system and the movement towards decarceration, to help ensure the best outcomes for people living with a mental illness who enter or exit the system. Some ways NAMI-NYC supports decriminalizing mental illness include:
Effective Implementation of a 988 Number
The new nationwide 3-digit number, 988, is a line to call or text for mental health crisis and suicide prevention services. We support 988, because it drastically reduces the likelihood of the police potentially responding when someone needs the support of a mental health professional and/or connection to resources. Now, we must ensure that the implementation of 988 actually pairs mental health crisis calls to appropriate peer-led mobile crisis response teams.
There are still some flaws we see with 988, including the use of phone area codes to connect callers to their dispatchers. Many people live in or are visiting New York City but do not have a NYC-based phone number. We are advocating to switch to geolocation services so individuals, loved ones, and practitioners can be directly connected to dispatchers who can connect them with support in the area they are calling from. Additionally, many people are unaware of 988 and when and how it may be used. More needs to be done with public awareness campaigns so information on 988 is accessible to as many people as possible.
#CAHOOTSinNYC (Peer-led, Non-Police Crisis Response)
As a Steering Committee Member of the Correct Crisis Intervention Today-NYC (CCIT-NYC) coalition, NAMI-NYC strives to transform how New York City responds to the 200,000+ mental health crises calls that the NYPD responds to. We do this by advocating for the implementation of a non-police, peer-led response model to mental health crisis calls in NYC. Since 2015, 19 people have been murdered after the police responded to mental health crisis calls in our city — most of those individuals identified as Black or brown.
While NYC’s pilot program, B-HEARD, running in Northern Manhattan, the South Bronx, and parts of Brooklyn, aims to provide an alternative to police response to mental health crisis, NAMI-NYC believes that the current model must shift toward a peer-led response (including 500 hours of training for each peer) that also utilizes independent medical responders. Additionally, the response model should connect to NYC Well and/or 988 call lines and more work in tandem with community care and respite centers. We would like to see expansion to all boroughs and to increase operation to 24 hours per day, 7 days per week.
The ideal crisis model would mirror the community-based, peer-led mobile CAHOOTS teams that have proven successful in responding to mental health crises calls in Eugene, Oregon for over 30 years. We know from evidence, as well as through a series of conversations with different impacted community members across NYC, that it is past due for our city government to implement a similar CAHOOTS approach to crisis response in NYC, consisting of 1 trained peer crisis worker and 1 independent medic, that could save countless lives. NAMI-NYC specifically advocates for city funding allocated for non-police response to go toward instituting the CCIT-NYC model, which is the only model to center peers at its core and to have known positive outcomes.
One of the largest providers of psychiatric care in the nation should not be a jail. Conditions on Rikers have deprived New Yorkers of their human rights and even their lives, including the loss of Elijah Muhammad in July 2022 and Michael Nieves in August 2022. The systems in place on Rikers Island disregard inmates’ right to medical and mental health care. Reform is simply not enough and we endorse the Campaign to Close Rikers.
Mental Health Courts
As part of the Treatment Not Jails coalition, we support the use of mental health courts as an off-ramp from the criminal legal system. We must properly treat mental illnesses underlying some criminal offenses, rather than further deteriorating an individual’s mental health in jail or prison.
The goal of mental health courts is to reduce the incarceration and recidivism of individuals with mental health conditions who committed low-level non-violent offenses by linking them to local behavioral health science providers to develop individualized treatment plans. As part of the Treatment Not Jails coalition, NAMI-NYC supports the passing of the Treatment Not Jails Act (S.2881/A.6603), which would improve the use of these courts, especially those that accept defendants with Axis I diagnoses, PTSD, and substance use disorders. Our goal is to invest in community resources so that people living with mental health conditions do not end up arrested. We’re also committed to promoting awareness about mental health courts as an alternative to typical criminal proceedings.
Enforcement of the H.A.L.T. Act
H.A.L.T. (Humane Alternatives to Long-Term Solitary Confinement Act) reformed the use of long-term isolation as punishment for vulnerable population members, such as individuals living with mental illnesses. While true victory would have been to eradicate solitary confinement in all forms since research shows its long-term negative effects on mental health, NAMI-NYC still commends the State for taking a step in the right direction. It is our advocacy goal to make sure that all prisons located within or near NYC actively adhere to the H.A.L.T.
Everyone deserves safe and stable housing. In the supportive housing model, various support services combined with affordable housing help provide stability and assistance for people living with disabilities like serious and persistent mental illness or dual diagnoses.
Know Your Rights
In conjunction with SHOUT- Supportive Housing Organizations & United Tenants, NAMI-NYC is launching a Know Your Rights campaign with trainings to help tenants advocate for themselves. The best way for supportive housing tenants to advocate for themselves is to know their rights. We are excited to see that Int 2176-2020 was passed to ensure that a document outlining supportive housing tenant’s rights is made regularly available to tenants, but adequate implementation is key to working toward tenants’ wellbeing.
Mental Health Professionals in Shelters
We advocate for the passage of City Council bill Int 0522-2022, which would require mental health professionals to be available in families with children shelters in the city. This legislation would require DHS to maintain a ratio of at least one full-time mental health professional for up to every 50 families with children. NAMI-NYC also supports the same model for the provision of on-site mental health services to expand to single adult shelters, given the increase of individuals with mental health conditions in need of these services at shelters since the start of the pandemic.
Safer Consumption Services
NAMI-NYC supports the Safer Consumption Services Act (S.603/A.224) to expand safe injection sites in the state. This will help prevent overdose deaths by having medical professionals on site. It also will minimize improperly discarded syringes through syringe exchange and disposal. We hope to see an increase in comprehensive overdose prevention centers. These sites increase access to treatment for substance use and mental health, along with connections to resources to care for individuals’ other basic needs and social services supports.
Parity for Mental Health & Substance Use Disorders
We support stronger enforcement of the Mental Health Parity and Addiction Equity Act of 2008 to ensure equitable health insurance coverage for individuals needing coverage for mental health conditions/substance use disorder.
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that aims to prevent health insurance companies from reducing coverage or imposing less favorable benefit limitations for individuals needing coverage for mental health conditions/substance use disorder. While this effort to stop discrimination against those who have mental health parity has been a law for well over a decade, there have been issues of noncompliance. We support stronger enforcement of the act to ensure equitable coverage.
Supporting Parents with Postpartum Depression and Other Mood and Anxiety Disorders
The Maternal Mental Health Depression Screening Tool Bill (S7753) was passed in 2022. This bill comes in response to the under-diagnosis and treatment of women in vulnerable, at-risk populations, particularly Black women. The current screening tool (the EPDS) does not account for social determinants of health and is less effective. The bill requires a study to be conducted on how sensitive and accurate screening tests are and to identify ways to reduce discrimination in transgender & non-binary and racial & ethnic health care that contribute to disparities within current postpartum depression screening protocols. NAMI-NYC is working with the NYS OMH to enforce implementation of this bill.
The Maternal Mental Health Work Group Bill (S7752) would create a workgroup that conducts studies on maternal mental health to improve gaps in identification and support for individuals with perinatal and postpartum mood and anxiety disorders. After looking into racial and ethnic disparities, risk factors, and successful screening and treatment methods, the research will result in a formal report that also looks to better understand programs, funding, risk factors, screening and treatment methods. This bill was passed by the NYS House and Senate in 2022 but was vetoed by the Governor.
Bill S7865 has not yet been passed and is related to maternal depression screening requirements. When care is being provided for an infant, this bill would require a provider to invite new mothers to fill out a questionnaire to detect maternal depression at prenatal, postnatal, and pediatric checkups for the mother’s child. Postpartum care should be an ongoing process.
In 2019, a coalition led by NAMI-NYC and Manhattan Together conducted surveys of patients and their family members who had received psychiatric treatment in New York City hospital emergency rooms.
Find out what these patients and their family members say about the emergency room experience, and what they would like to see done to improve the quality of care.
Co-sponsored with Manhattan Together.
Approximately 60% of individuals in the prison and jail systems live with a diagnosable mental illness, and most find out for the first time after they have been incarcerated. This is completely unjust. One of NAMI-NYC’s advocacy goals is to promote non-police response to mental health crises calls across the city, including the implementation of a 988 number, and peer-led response teams, to prevent this issue.
Panelists discuss the root causes of the over-criminalization of people living with mental illness, especially Black and brown individuals. We delve into the issues of broken windows policing around the city and within NYCHA housing, bias and discrimination in non-peers responding to crises calls, the mental health care infrastructure needed to respond to crises calls around the city, as well as other crucial topics regarding mental health and decriminalization. Our goal is to have audience members act to ensure that our new leadership knows how to appropriately address these issues across the city.