Crisis Assessment of NYC Mental Health
New York City has a history of struggling to serve its populations with lower socioeconomic status – a community which has grown in number since the start of the pandemic. Unsurprisingly, mental illness is disproportionately prevalent in the lower income communities, as they struggle to access social resources including basic medical and mental health services. As a result, mental illness is on the rise and it is currently estimated that 20% of New Yorkers struggle with their mental health each year. This systemic crisis impacts the entire city of New York, with men, minorities, and lower income communities affected the most.
As a counseling student who is just beginning to learn the ins and outs of crisis counseling, it is clear to me that what NYC is currently experiencing would qualify as a systemic crisis. In addition to the already considerable number of citizens struggling with their mental health on an annual basis, NYC systems have been further stressed by the sudden immigration of tens of thousands of asylum seekers, leaving public officials and organizations struggling to keep up with demand. This came at a time when the current mayor, Eric Adams, had refocused mayoral efforts on improving the mental health of New Yorkers. While there are several models of crisis intervention through which to examine this situation, a Contextual-Ecological Model is perhaps the most appropriate. With reference to this model, James & Gilliland, (2017) explain that this model “poses questions and generates premises that can help us understand the impact of the crisis as it interacts between and within a variety of systems and individuals.” Within the context of the NYC mental health crisis, this model fits best as it acknowledges that the crisis is influenced by considerable systemic issues. For example, New Yorkers do not have equal access to mental health services. Those in need are roughly 10% less likely to receive care if they do not currently have health insurance. Additionally, there is a recognized shortage of inpatient hospital beds in psychiatric facilities, leaving people who need serious mental health services, without treatment. These are systemic issues that contribute to the crisis, and without addressing them, there is little that can be done using an equilibrium, cognitive, or psychosocial model.
Sadly, there is no straightforward solution when aiming to provide mental health services for an entire city, let alone one as large as NY with such a significant population in need. However, examining the issue through the lens of the ACT model for acute crisis intervention can help contextualize the issue. ACT is an acronym, which essentially stands for the 3 phases of crisis assessment - assess, connect, and treatment plans. Given the plethora of available statistics and the publicly acknowledged issue of mental health in NYC, it seems that most of the assessing work has been done already. However, in my view, the bulk of work needs to be done in the “C” category (i.e. connecting citizens to proper services). Connecting those in need of mental health services with support groups, crisis intervention services, and inpatient treatment options could be an impactful way to make significant change in the system. More funding could be directed towards opening more beds in psychiatric hospitals. More beds generally equal more people treated. In addition, an open-door, brief treatment, crisis counseling program could give people a reliable resource when it is needed most. Paired with an expanded out-patient program, the system could more effectively treat people for the long term, instead of cycling them through the system repeatedly with little-to-no long-term results. From there, with time, help, and funding, the healing could begin as we move into phase “T” for giving and providing actual treatment.
It is clear that there is plenty of work to do in the NY community. However, I believe using the ACT model to examine the situation provides a more actionable view of the issues. We are a city that is experiencing a crisis and it is time we label it for what it is in a more public fashion. For what it’s worth, with the growing increase in mental health, I believe we can be cautiously optimistic that with renewed efforts and an influx of funding for mental health, things will begin to turn around.
