NYC’s new model for mental health clinics centers on fostering community spaces

Henry Street Settlement on the Lower East Side has long operated an outpatient mental health clinic – with services such as psychiatric evaluations, therapy and medication management.

But in January, the social services and arts organization transitioned to a new model – a program known as CONNECT, or Continuous Engagement between Community and Clinic Treatment. It’s now one of nine sites across the Bronx, Manhattan and Brooklyn that are piloting the program that seeks to embed mental health clinics within more dynamic community centers.

Something of a grab bag, CONNECT seeks to expand behavioral health care beyond the clinic walls by allowing staff to engage patients outside of the facility – while still offering people a home base. It’s that physical community space that differentiates it from the city’s mobile mental health teams. Each program site will have a full-time community liaison who will work to gauge the neighborhood’s needs and adapt the services accordingly. As an example, the city said, a site could decide to offer individual or group behavioral health services at a non-traditional location such as a soup kitchen.

Henry Street’s clinic is now co-located with a food pantry, a pottery studio, and an area that will be used for activities such as yoga and meditation, although the space will likely continue to evolve. It is also working to connect clients with non-clinical services such as housing and employment assistance.

The city’s health commissioner Dr. Aswhin Vasan unveiled the program this week as part of his broader vision for mental health and addiction services.

Speaking in Henry Street’s garden Tuesday, Vasan said the goal is to treat the whole person and break down the social isolation many people with mental illnesses face.

“We must move away from the idea that all people living with serious mental illness are simply moving from crisis to crisis and can only be helped with acute care and hospitals,” Vasan said. “We must instead move towards a model of prevention and recovery centered on breaking isolation.”

This idea of ​​community and social connection as crucial to mental health is something Vasan also championed as the former president and CEO of Fountain Housea clubhouse for people with serious mental illnesses with sites in Manhattan and the Bronx.

Rather than just offering people appointments and support groups onsite, Henry Street’s clinicians are now able to meet with patients in their homes or take them out for lunch when they do not want to come in. Staff have also started doing outreach in the community to see what other types of services people want and need.

Whitney Coulson, the director of CONNECT at Henry Street, said the answers are, first and foremost, food and housing. But they were also just looking for a peaceful place to be.

“We’re just really thinking of things in a different, new, exciting way to really meet folks where they are and to provide services that they really need,” Coulson said.

It’s a model that acknowledges that people’s mental health can be affected by whether their basic needs are being met. During the pandemic, research from the US Census Bureau showed that New Yorkers living in households experiencing food insecurity were also more likely to have symptoms of anxiety and depression.

Now, someone can come in to take advantage of the food pantry at Henry Street and then be connected to behavioral health services. In other cases, a patient who’s already been seen at the clinic might be referred to the onsite art studio as part of their treatment plan.

Depending on community needs, CONNECT sites might offer services such as a legal clinic or housing assistance, or they might refer people to existing programs. The goal is to serve up to 900 new clients across the nine pilot sites once the program is fully scaled up, the city said in a press release.

Henry Street is getting $ 1.2 million per year for three years from the city to operate the program, and the city is spending $ 32.4 million on the pilot overall. The money has gone toward hiring new staff and helps pay for the services the clinic can not bill insurance for, said Coulson. It has also allowed the clinic to start seeing patients who are uninsured, including those who are undocumented, she said.

Jo-Ann Abrams, a psychiatric nurse at Henry Street, said the CONNECT program gives her the flexibility to not only meet with people in the community but also visit and advocate for them in different health care settings.

“One client I have, we’re actually going to see in her rehab,” Abrams said. “She’s in a short-term rehab, and she’s doing really well because of the collaborative care I had with the medical doctor [there]. ”

The broader plan that Vasan laid out Tuesday for post-pandemic mental health and addiction care in New York City touched on school-based services for young people, non-police responses to mental health crises, NYC Well and a range of other programs and initiatives , many of which have already been established.

“We’re building off of the foundations laid over years past,” Vasan said, “but we have work to do to make it better.”

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