As New York City appears to near the end of a fearsome 14-month battle against COVID-19, the lingering effects of the virus on our collective mental health endure.
The problem is as complex as the people who suffer, from those grappling with isolation, burnout, depression and anxiety to those who need acute, inpatient psychiatric care for longstanding issues worsened by the pandemic.
The numbers reveal the severity of the situation.
Nearly one in every 25 New Yorkers live with a serious mental illness, with around 280,000 adults dealing with diagnoses like major depressive disorder or schizophrenia, city health officials reported last month.
The city’s 311 system recorded over 17,330 calls between March and December 2020 related to mental health issues — nearly 85 times more than the 206 calls recorded during the same time period in 2019, city data shows. Another 5,866 were recorded between January and April 1 of this year.
About 40% of single adults in city shelters say they suffer from a mental illness, according to the Department of Homeless Services. Among city jail inmates 53% of them — 2,965 of about 5,640 total — have repeatedly received mental health treatment, have a known mental health diagnosis, or have attempted suicide during a previous stint behind bars, Correction Department data shows.
The city has worked to address the issue by bolstering its telehealth services and expanding its mobile crisis teams to respond to behavioral health calls. NYC Well, the city’s 24/7 mental health hotline, answered more than 300,000 calls and messages since the start of the pandemic, according to Health Department stats.
The 2022 executive budget also includes $112 million to expand crisis teams’ 911 call response, the allocation of about $50 million in new services for people with serious mental illnesses and $225 million in community-based mental health services at places like shelters and police precincts.
Yet providing people help requires even more resources, said psychiatric nurse Irving Campbell — and one place to start, he said, is with the city’s the most vulnerable.
“For those who have been cascaded by society… and see them where they cannot receive services is really hurtful. It’s disturbing,” said Campbell, a nurse works at NewYork-Presbyterian Brooklyn Methodist, which shutdown its psych unit during the pandemic to repurpose beds for COVID-19 patients and remains closed due to construction.
“Telehealth and tele psychiatry are not a replacement for inpatient hospitalization. Those who are suicidal, homicidal, extremely psychotic, they come through the emergency room, they come through NYPD custody, they come to us in their worst state,” he added, noting that he has seen his former patients wandering the streets.
Thirty hospitals statewide have repurposed about 600 psychiatric beds for COVID-19 patients, according to the state Office of Mental Health. All told, the state has 5,815 licensed psychiatric beds, including the 600 not currently being used for psych patients — a decrease of about 30 beds statewide since 2019.
“For myself, my colleagues and other mental health advocates, [we understood closing the units] when were looking at a COVID positivity rate that’s over 10%, [when] every day we were seeing numbers in the 1,000s of people who [needed] hospital beds,” said Campbell. “Some of these beds should [now] be shifted back to provide this vital [psychiatric] service. The number of licensed beds have been decreasing over time… and another concern is many will not return.
“We’re seeing a New York City where everybody who’s vaccinated can take the mask off… And still, we have a lot of mentally ill people in the streets, we have them in the subways, we have them surrounding hospitals, and they’re begging for the help that is not there.”
The subways have seen a spike in the number of homeless people since the overnight shutdown during the pandemic — driving the MTA board last year to formalize emergency rules designed to curtail homeless riders.
While there’s no evidence that people with mental illnesses are committing more crimes, NYPD officials say, an apparent uptick in unprovoked attacks on both the subways and city streets have prompted officials to explore how to address the city’s broader mental health dilemma.
“We’re in lockstep with the union leaders and their request for additional police presence now and additional mental health services,” MTA Chairman and CEO Patrick Foye told 1010 Wins radio after a 12-minute spate of three unprovoked subway slashings and one slugging early Friday.
One of the suspects in that case lives in a transitional housing for adults with mental illness in Brooklyn, police said.
“The emotionally disturbed need help,” Foye said. “They don’t need to be living on city streets or in the subways, and it is critical and as we look to increase the number of commuters and buses, and commuter rails that our customers and employees not only are safe, but feel safe.”
Dr. Manish Sapra, executive director of behavioral health services at Northwell Health, said his hospital system has also seen a surge in emergency department visits to treat mental health issues.
“It’s difficult to quantify in the last few months, but since November [the number of visits have] come back with a vengeance,” said Sapra, noting that the ERs saw fewer patients suffering from psychiatric issues at the height of the pandemic.
“We’re [now] seeing people not getting access to regular care. We’re seeing people who stopped taking their medication, and they’re not seeing their health care provider,” he said. “I don’t think we have seen the peak yet.”
With Carla Roman, Thomas Tracy and Clayton Guse
