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City officials this week are unveiling an overhaul of first lady Chirlane McCray’s ThriveNYC mental health project — cutting programs, establishing new goals and putting a greater emphasis on people with serious mental illness.
More than four years into ThriveNYC, officials also are releasing some key metrics — but there are still few or no numbers for programs receiving nearly 70% of the initiative’s $222 million budget for fiscal year 2020.
Officials shared 85 data points with THE CITY ahead of plans to post the figures on Tuesday. The numbers suggest therapeutic improvements in a small group of people, measured over a short time period — generally through surveys of those helped.
ThriveNYC Director Susan Herman said the planned changes — which include reducing the number of programs from an initial 54 to 31 — are part of a “natural evolution.”
A $555 Million Tab
The reboot comes as McCray mulls a run for Brooklyn borough president next year while her husband, Mayor Bill de Blasio, finishes out his second and final term.
The restructuring also follows a year in which a growing number of elected officials criticized a lack of transparency surrounding ThriveNYC’s budget — the program has cost taxpayers $555 million in its first four years — and the absence of data on the project’s impact.
At the same time, news reports have revealed significant struggles at some of ThriveNYC’s programs — including one of its once-largest, the Mental Health Service Corps.
Some elected officials have questioned why ThriveNYC doesn’t dedicate more resources to people with serious mental illness. City Council Speaker Corey Johnson recently knocked the initiative for putting less than 13% of its funding toward that population last year — saying the figure should be above 50%.
“The goal of Thrive is a really good goal because we have not done enough for people who are mentally ill in New York City,” he said Thursday at City Hall. “[But] it is a program that needs better metrics, that needs better tracking, that needs better reporting, that needs to spend more money on people with serious mental illness.”
A revised budget set for release this week by ThriveNYC shows funding for serious mental illness boosted by $34 million through 2022 — when it will comprise 26% of the budget.
“We’ve done a lot of work to try and clarify what our goals are, clarify what our budget is, develop new ways of measuring the impact we’re having on people’s lives,” Herman said Friday during an interview in her Lower Manhattan office.
“We’ve significantly redesigned some programs and we’ve launched some brand new programs,” added Herman, a former NYPD deputy commissioner who was tapped to head ThriveNYC in February 2019. “All of that has happened in the last year.”
A Changing Roadmap
De Blasio and McCray launched ThriveNYC in November 2015 with 54 programs designed to increase access to mental health services and to reduce the stigma around seeking help.
The effort sought to transform an existing mental health hotline into a one-stop support and referral hub, train city workers and the public on identifying mental health challenges, and expand help into underserved areas.
After more than four years, ThriveNYC officials have shuttered a half-dozen programs, moved about a dozen to other agencies and introduced a handful of new ones — lowering the total of funded programs to 31. The latest staff headcount is 671, documents show.
The project was initially organized around six guiding principles — such as closing treatment gaps and teaming up with communities.
Now there are four specific goals: promoting mental health for the youngest New Yorkers, eliminating barriers to care, reaching people with the highest need, and strengthening crisis prevention and response.
The budget for crisis prevention and response — which covers people with the most serious mental health challenges — will nearly double to $74.5 million by the 2022 fiscal year.
That area has garnered the most scrutiny.
The deaths of at least 15 mentally ill people at the hands of the NYPD since 2015 — including the April 2018 shooting of Saheed Vassell in Brooklyn — have spurred calls for an overhaul of emergency responses in such cases.
The increased funds will help pay for three types of mobile teams of health workers who can travel anywhere to provide treatment, referrals or other support to people facing challenges connecting to traditional care.
There also are plans to boost the number of mobile crisis teams that aim to reduce 911 calls by defusing potentially explosive situations.
And a new effort to pair mental health workers with NYPD officers to respond to 911 calls about people experiencing crises is in the works, but hasn’t yet launched, according to Herman.
Another program that transports individuals in mental health crises to a treatment center rather than a police precinct went live only last week in East Harlem’s 25th Precinct.
A significant chunk of funding is also dedicated to assessing and serving people who have experienced trauma — including crime victims, homeless families in shelters, veterans and runaway youth. The budget for reaching “people with the highest need” will be $71.7 million in the 2022 fiscal year.
Reach and Outcomes
ThriveNYC officials provided THE CITY with a nine-page chart containing the number of people reached by each program, 15 of which had no or only partial outcome data. These include some of ThriveNYC’s biggest and costliest programs.
Much of the pending data is due this summer, or is connected with programs that recently launched or will go live in the coming fiscal year.
The outcomes were based largely on surveys of how respondents felt after they were provided services. Among the numbers touted:
• 48% of homeless individuals (77 of 160) served by traveling teams that provide intensive services secured non-shelter housing from Jan. 1, 2016 through Sept. 30, 2019.
• 53% of adults who received treatment in a senior center experienced clinically significant improvements in depression three months after beginning treatment.
• 65% of new moms living in homeless shelters who were visited by public health advisors kept scheduled medical appointment follow-ups; 28% kept scheduled community and social service referral appointments. The data came from 108 survey responses over three months last year.
The ThriveNYC progress chart also notes that 94% of callers to the 1-888-NYC-WELL hotline from July to September last year said the conversation “helped them.” That’s out of the 670 who opted into the survey.
A survey of crime victims, who are now offered services at every precinct, showed that 89% reported feeling better due to the assistance provided.
Officials offered no data, though, for the Mental Health Service Corps, once ThriveNYC’s largest program, with a budget of $48 million. The program was redesigned last year and relaunched in January. Its budget will be reduced to $13 million annually, starting July 1.
Past Struggles
The Mental Health Service Corps was built to assign 400 early-career clinicians across the city, teaming them with other medical and service providers.
As THE CITY has reported, however, retention issues plagued the program from the start, and it never managed to maintain more than 260 clinicians.
The new version of the program calls for just 60 clinicians, working solely out of the city’s public hospitals. Officials now describe the program as a means to “train the mental health workforce of tomorrow,” according to a Department of Mental Health and Hygiene spokesperson.
Among ThriveNYC’s other early stumbles: A plan to train all 36,000 NYPD officers on how to respond to people experiencing mental distress has fallen well short of its goals.
Through Dec. 31, just under 16,000 officers had been given the so-called Crisis Intervention Team training.
ThriveNYC’s involvement in a separate effort announced by McCray in May 2017 to screen pregnant women and new moms for depression at city hospitals ended last year, officials said — following a PoliticoNY report that the program had a slow start.
And a $10.9 million program designed to place 85 clinical social workers at schools starting six months ago isn’t fully staffed. As of last month, 63 workers had come on board, officials said.
Defining Thrive
City Comptroller Scott Stringer recently raised questions over how officials determine which programs are included under ThriveNYC’s umbrella.
Last month, McCray announced a $43 million program that will provide home visiting mental health services to new parents throughout the city — starting in Brooklyn, where she may run for office.
While ThriveNYC offers a similar service for new parents in shelters, the home-visiting program will be run by the city Department of Health, officials said.
Stringer last week noted that clinical services at family shelters are provided through ThriveNYC, but the same services at single adult shelters falls under the Department of Homeless Services.
“There is no clear rhyme or reason for why certain programs under Thrive exist, while other very similar programs do not — or for why programs are called Thrive one day, but are not the next,” he said.
Herman says the dividing lines are now clearer and easier to define: Programs need to meet at least one of the four goals, be innovative and primarily address mental health.
“The overarching goal of Thrive is to have mental care for all New Yorkers — so anybody who needs it can be connected to care,” she said.
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