The year that came to a close Monday threw the Big Apple’s mental health crisis into stark relief.
From addicts openly injecting at St. Mary’s Park in the Bronx; to the shooting death in April of Saheed Vassell, a disturbed man who was menacing pedestrians in Brooklyn; and finally to the homeless people now ubiquitous on streets and subway platforms — the thread that stitched all of these disparate stories together was serious mental illness.
Most New Yorkers come into daily contact with that last facet of the crisis: namely, the homeless mentally ill. Not all homeless people are mentally ill, to be sure, but as many as a third are. As the Manhattan Institute’s Stephen Eide noted in these pages recently, from 2015 to 2017, the ranks of the city’s homeless mentally ill swelled by 2,200, or more than 20 percent.
And nowadays, drugs, including traditional street highs as well as opioids, cloud the already fragile minds of many of these unfortunate souls. Their presence lends a Dickensian aspect to Times Square, Grand Central Station and other iconic spots.
If you visit, say, the intersection of Seventh Avenue and 40th Street at the twilit hours, chances are the homeless and addicted will outnumber tourists and area workers. Ditto for the caverns of Port Authority and Penn Station. Normally, the sight of human beings with needle-scarred limbs meandering zombie-like or else sound asleep on the grates arouses pity. Yet there is always the fear, not unjustified, of some outbreak of random, senseless violence.
This can’t go on.
A number of factors have brought the city to this point, many of them outside City Hall’s and Albany’s spheres of control. Mayor Bill de Blasio and Gov. Andrew Cuomo didn’t start the push to shutter traditional psychiatric hospitals. That began in the 1950s and went into overdrive by the ’70s. The old facilities were dehumanizing, but the pendulum swung too far in the opposite direction, and now we dehumanize the mentally ill in the name of their “autonomy.”
Nor are local and state government directly to blame for the opioid scourge, for widespread family breakdown, for neglectful and abusive homes, for spiritual malaise and for many other social ills whose combined weight is especially hard to bear for the mentally ill.
But none of these things absolves government’s failure to meaningfully address the problem. De Blasio made mental health a central plank of his two mayoral campaigns, and he and city first lady Chirlane McCray in November 2015 launched their ThriveNYC initiative to great hoopla. But more than three years later, the “treatment gaps” they set out to close remain open.
Whatever it is de Blasio is doing, it isn’t working. Eide, the Manhattan Institute scholar, has pinpointed the initiative’s major shortcoming, and it’s a paradoxical one.
To wit, by overstating the size and the nature of the crisis — claiming, for example, that one in five New Yorkers suffers a mental health disorder annually — ThriveNYC ends up casting too wide a net and missing the neediest cases: the estimated 240,000 New Yorkers who live with serious mental illness. Much of the resources end up going to people who may be facing adversity but who aren’t seriously mentally ill.
What this population desperately needs are long-term psychiatric care, including hospitalization, and more wraparound services like supportive housing. What they get from ThriveNYC and other city programming is a messy patchwork of services mainly aimed at stabilizing them at the point of crisis.
The number of available state psychiatric beds in New York continues to plummet — by 15 percent over the past four years — and the Cuomo administration is, if anything, accelerating the demise of traditional care. The obsession with outpatient therapy for all persists; the most vulnerable New Yorkers pay the price.
Many will fall through the cracks, and even those caught and nurtured briefly are bound to fall through other cracks later. With the enormous sums we spend on mental health, the city and state can and must do better. Two-thousand-nineteen should be the year we reverse course.
Sohrab Ahmari is the op-ed editor of The Post.