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No 24/7 mental health service: Staffing challenges limit NYC’s crisis response program
By
Caroline Lewis
Published May 16, 2023
Modified May 16, 2023
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By
Caroline Lewis
Published May 16, 2023
Modified May 16, 2023
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New York City’s program providing a non-police response to mental health crisis calls has recently expanded to new neighborhoods, and Mayor Eric Adams has said he wants the program to eventually operate citywide.
But staffing is a challenge and the program’s hours of operation are likely to remain limited, NYC Health + Hospitals officials said at a City Council hearing on Tuesday. The public hospital system hires the social workers for the program.
The city’s Behavioral Health Emergency Assistance Response Division, or B-HEARD, currently operates 16 hours per day, from 9 a.m. to 1 a.m. in select neighborhoods across the city. During those hours, 911 dispatchers are able to send teams of social workers and EMTs instead of police to respond to some mental health crisis calls — something advocates say is crucial for avoiding the violence that sometimes occurs when armed officers respond to a mental health call.
But B-HEARD is unlikely to operate 24/7 anytime soon, Jason Hansman, senior adviser of behavioral health communications and policy at NYC Health + Hospitals, said at Tuesday’s hearing.
“That eight hours overnight is one of hardest shifts to recruit for,” particularly since mental health providers are currently in such high demand, Hansman told city councilmembers. According to his testimony, about 1 in 5 mental health calls arrive between 1 a.m and 9 a.m.
Hansman added that the current priority is staffing existing shifts and continuing to expand to new parts of the city. As of March, the program was operating in 25 of the city’s 77 precincts, touching every borough except Staten Island.
Even in those areas, there’s no guarantee the police won’t show up if someone dials 911 to report a mental health crisis. Between July 2021 and June 2022, fewer than 1 in 4 mental health calls to 911 were routed to B-HEARD teams in the precincts where they operate, according to a city report.
And B-HEARD teams were only able to respond to 73% of the calls routed to them – 1,729 calls in all. When they couldn’t respond, it was typically because all the teams in the area were already busy on another call, the report said. In those cases, the calls received a traditional response, including NYPD and EMTs.
Councilmember Mercedes Narcisse, who chairs the hospitals committee, questioned why those figures have not improved since the start of the program. Hansman said city officials were working to figure out how B-HEARD teams could take on more calls.
Hansman also noted that in cases when someone poses an imminent risk to themselves or others – for instance, when the caller says they have a weapon, or are standing in traffic or on the subway tracks – police are still dispatched. He was unable to answer specific questions from councilmembers about the training 911 operators receive regarding the triage of mental health calls.
Adams initially committed $55 million for the B-HEARD program for this fiscal year but that figure has since been reduced to $43 million, Politico reported in April. The mayor’s executive budget, released late last month, includes $27 million to expand B-HEARD, but those funds are not going to NYC Health + Hospitals.
Dr. Mitchell Katz, president and CEO of the public hospital system, said he is confident his agency will get more funding if it's able to ramp up the number of social workers it can hire for the program, but he said hiring is currently a challenge.
“We are in favor of 24-hour coverage [for B-HEARD],” Katz said. But he added, “COVID has really disrupted the mental health market.”
He noted that the hospital system is also struggling to recruit psychiatrists for its facilities.
There are currently 25 mental health clinicians in the B-HEARD program, according to NYC Health + Hospitals spokesperson Stephanie Buhle. Asked about the number of vacancies, she said the program hires on a rolling basis. She did not respond to a question about the timeline for expanding the service citywide.
At the hearing on the city hospital budget, Katz also faced questions about other staffing challenges across the system. The hospital system spent $549 million on temporary nursing staff to fill gaps in the workforce in 2022, according to Linda DeHart, the system's vice president of finance. Katz said temporary staffing is still prevalent, but he said city officials are working to reach a new contract agreement with the New York State Nurses Association to boost regular wages, so hiring for full-time positions becomes easier.
On the bright side, Katz said he anticipates the system will break even this fiscal year, rather than closing it out with a $144 million deficit, as he predicted in March, due to higher-than-anticipated operating revenues.
This story was updated with a comment from NYC Health + Hospitals about B-HEARD staffing numbers.
Tagged
Health and Science
new york city
mental health
public safety
nypd
City Council
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
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