The pandemic has left many individuals homeless or without proper resources to manage deteriorating mental health. Citizens and government officials alike talk of New York City being in a mental health crisis, yet policies that address core issues like incompetent mental health services and housing shortages are ignored in favor of increasing police presence in places like the subway. However, policing homeless individuals is misguided and only reduces homeless visibility rather than addressing systemic issues. Recently, there has been some effort from the Mayor’s Office via outreach programs to address increased homelessness and mental health crises with the HOME-STAT program and the B-HEARD program. These two programs have a similar goal, yet the disparity in outcome is stark and points to a powerful aspect of mental health intervention: community.
HOME-STAT is an outreach team across all 5 boroughs that New Yorkers can request via a 311 call if they want to report an unsheltered New Yorker in need of assistance. An outreach team is dispatched to connect the individual with mental health or housing services. The premise is promising compared to interactions between police and homeless persons. B-HEARD, on the other hand, is a pilot initiative in neighborhoods with high volumes of 911 calls including East Harlem and Inwood where EMTs are accompanied by licensed mental health professionals to respond to non-violent mental health 911 calls. The goal is de-escalation and possible transportation to local mental health centers, such as the East Harlem Support and Connection Center.
So how do these services stack up in helping public mental health? Citywide HOME-STAT’s effects are well-intentioned but questionable. Anyone can “report” a homeless person, whether they are simply angry to see these individuals on their commute or genuinely concerned about their safety. (Please click on this animation for a visual and color-coded representation of the implementation of HOME-STAT.) Most 311 calls ended in the outreach team being unable to find the reported individual, or with the individuals refusing help. Outreach teams offer to transport individuals to shelters that many unsheltered people have already visited and found inadequate. They are more often accompanied by police than essentials like socks or care kits, making homeless individuals less trusting of them. B-HEARD, however, only in its first year of functioning has been more fruitful. 47% of people served by B-HEARD were served in their community for behavioral healthcare, either served onsite with counseling or transported to a local service location. Compared to most factors in a traditional 911 response, fewer people refused medical assistance, and significantly fewer were transported to a hospital. Everyone served by B-HEARD was even offered follow-up care.
B-HEARD has shown more promising results in handling NYC’s mental health crisis compared to other city initiatives in a quarter of the time, and this is a testament to the power of providing local, community-based resources that are actually accessible to individuals and tailored to meet their needs. Citywide programs and policies need to map services within specific communities rather than look to NYC as one big entity. B-HEARD’s expansion in the future should continue to emphasize the dispatch of local mental health professionals and not fall victim to the pitfalls of generalization like HOME-STAT.