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Dr. Gary Belkin, New York City's top mental health official, defended the city's $850 million program to improve mental health services during a Tuesday panel discussion after one of the program's leading critics argued that too few resources are being...

City mental health commissioner defends ThriveNYC's commitment to serious mental illness

Dr. Gary Belkin, New York City's top mental health official, defended the city's $850 million program to improve mental health services during a Tuesday panel discussion after one of the program's leading critics argued that too few resources are being...

City mental health commissioner defends ThriveNYC's commitment to serious mental illness

Dr. Gary Belkin, New York City's top mental health official, defended the city's $850 million program to improve mental health services during a Tuesday panel discussion after one of the program's leading critics argued that too few resources are being used to help people with a serious mental illness.

The ThriveNYC plan includes 54 separate initiatives that seek to address a wide range of mental health issues, whether they occur in prekindergarten classrooms or prisons. The program is based on a 2015 road map, which estimated that one in five New Yorkers suffer from a mental health disorder in any given year.

But D.J. Jaffe, executive director of the Mental Illness Policy Organization, said he believes ThriveNYC focuses too few of its resources on the 4% of New Yorkers who suffer from a serious mental illness such as bipolar disorder or schizophrenia, and instead devotes too much attention to addressing social problems such as poverty and school bullying.

article continues below advertisement "It's not focused on the seriously ill," Jaffe said in an interview following the panel discussion. The event, at 7 World Trade Center, was hosted by the Manhattan Institute. "It wraps worthy social services in a mental health narrative," Jaffe said.

"If you treat the seriously ill, it not only helps them and their families, it helps arrest homelessness and incarceration." The city estimates that about 35% of people in shelters suffer from a serious mental illness, with the number rising to about 40% among the homeless living on the street.

Belkin, executive deputy commissioner for mental health at the city Department of Health and Mental Hygiene, disagreed with Jaffe's characterization and argued that the notion of a seriously mentally ill population is a "fake category." Because that term refers to the current severity of the illness, not the initial diagnosis, people are constantly moving in and out of such a category, he said.

About $165 million is dedicated to treating the seriously mentally ill--which Belkin said represents "one of the largest, if not the largest, chunks" of spending. "There's a perception that we're not [spending money on the seriously mentally ill], but in fact there's a huge investment there," he said.

"There are 54 Thrive initiatives, and [those] are 54 initiatives for the seriously mentally ill," he added.

Among the key components of ThriveNYC is a plan to train 250,000 New Yorkers in mental-health first aid. The educational program would help community members, including teachers, police officers and clergy, identify and respond to signs of mental illness and substance abuse. The city is also building a mental-health corps of 400 clinicians to treat people in places where it is difficult to access care.

Notably absent from the panel were representatives from the city's hospitals. They have a big role to play in helping coordinate care for the mentally ill, said Muzzy Rosenblatt, chief executive and president of BRC, a Manhattan-based social services agency that treats about 10,000 people annually.

"We need to see a lot more care coordination in [psychiatric] episodes," Rosenblatt said. "We would love when one of our clients has an episode that requires hospitalization--whether they're living on the street or in our shelter--for that hospital, before discharge, to call us, so we can continue that care in a less severe setting."

On that point, Belkin agreed.

"I think [hospitals] need to change, and the leadership we talk to knows they need to change," he said. "Treatment has often been bottled up in highly specialized places. It has to open up. A lot of the skills that help can be done by non-highly specialized folks, by peers or at other places. The thrust behind Thrive is to push that out and expand those kinds of approaches. That benefits the seriously mentally ill."

Dr. Gary Belkin, New York City's top mental health official, defended the city's $850 million program to improve mental health services during a Tuesday panel discussion after one of the program's leading critics argued that too few resources are being used to help people with a serious mental illness.

The ThriveNYC plan includes 54 separate initiatives that seek to address a wide range of mental health issues, whether they occur in prekindergarten classrooms or prisons. The program is based on a 2015 road map, which estimated that one in five New Yorkers suffer from a mental health disorder in any given year.

But D.J. Jaffe, executive director of the Mental Illness Policy Organization, said he believes ThriveNYC focuses too few of its resources on the 4% of New Yorkers who suffer from a serious mental illness such as bipolar disorder or schizophrenia, and instead devotes too much attention to addressing social problems such as poverty and school bullying.

article continues below advertisement "It's not focused on the seriously ill," Jaffe said in an interview following the panel discussion. The event, at 7 World Trade Center, was hosted by the Manhattan Institute. "It wraps worthy social services in a mental health narrative," Jaffe said.

"If you treat the seriously ill, it not only helps them and their families, it helps arrest homelessness and incarceration." The city estimates that about 35% of people in shelters suffer from a serious mental illness, with the number rising to about 40% among the homeless living on the street.

Belkin, executive deputy commissioner for mental health at the city Department of Health and Mental Hygiene, disagreed with Jaffe's characterization and argued that the notion of a seriously mentally ill population is a "fake category." Because that term refers to the current severity of the illness, not the initial diagnosis, people are constantly moving in and out of such a category, he said.

About $165 million is dedicated to treating the seriously mentally ill--which Belkin said represents "one of the largest, if not the largest, chunks" of spending. "There's a perception that we're not [spending money on the seriously mentally ill], but in fact there's a huge investment there," he said.

"There are 54 Thrive initiatives, and [those] are 54 initiatives for the seriously mentally ill," he added.

Among the key components of ThriveNYC is a plan to train 250,000 New Yorkers in mental-health first aid. The educational program would help community members, including teachers, police officers and clergy, identify and respond to signs of mental illness and substance abuse. The city is also building a mental-health corps of 400 clinicians to treat people in places where it is difficult to access care.

Notably absent from the panel were representatives from the city's hospitals. They have a big role to play in helping coordinate care for the mentally ill, said Muzzy Rosenblatt, chief executive and president of BRC, a Manhattan-based social services agency that treats about 10,000 people annually.

"We need to see a lot more care coordination in [psychiatric] episodes," Rosenblatt said. "We would love when one of our clients has an episode that requires hospitalization--whether they're living on the street or in our shelter--for that hospital, before discharge, to call us, so we can continue that care in a less severe setting."

On that point, Belkin agreed.

"I think [hospitals] need to change, and the leadership we talk to knows they need to change," he said. "Treatment has often been bottled up in highly specialized places. It has to open up. A lot of the skills that help can be done by non-highly specialized folks, by peers or at other places. The thrust behind Thrive is to push that out and expand those kinds of approaches. That benefits the seriously mentally ill."

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