- December 29, 2021
$1B later and little to show for it, NYC’s mental health initiative proved disappointing: ‘We didn’t do a good job’
Mayor de Blasio launched a sprawling public health initiative known as ThriveNYC in 2015 with a promise to rectify decades of “broken promises” for New Yorkers suffering from mental illness.
“It will take years to address the problem the way it should be addressed, but we need to start now, we need to start aggressively,” de Blasio said at a press conference at the time, flanked by his wife, First Lady Chirlane McCray, who would become the public face of the program. “The people of NYC deserve nothing less.”
New York City Mayor Bill de Blasio and First Lady Chirlane McCray (left) announce the launch of the mental health initiative ThriveNYC in East Harlem, Manhattan, New York.
But six years and more than $1.2 billion later, mental health experts and fiscal watchdogs are questioning what exactly the program has achieved and what the shape of it will be when de Blasio leaves office on Jan. 1.
Even Gary Belkin, a co-founder of Thrive who served as its former chief of policy and strategy, said the program faltered because the de Blasio administration never staked out specific goals or set up a system for measuring progress, leaving it vulnerable to criticism.
“We didn’t do a good job of actually laying out that we were actually moving in a long-overdue, needed new direction, not the old politics, not the old expectations, not the old ruts that weren’t working,” Belkin, who left the administration in October 2019, said in a recent interview.
“We didn’t have a clear set of metrics and a clear pathway of how we were going to get to where we were going to, and so, I think we needed to listen to those things. I felt at the time that that was actually when we should have doubled down on the vision. We were never going to get that kind of attention again … That strategic direction was not taken, which I think was a missed opportunity to reinforce a new consensus. And so, I left.”
The Mayor’s Office of Community Mental Health, which was established in a May rebrand of the Thrive project, argued it has taken a metrics-based approach.
Susan Herman, the director of the office, said in a statement that the city has seen “statistically significant improvements in anxiety and depression for older adults served in senior centers, victims of crime feeling safer because of advocates in every precinct, and New Yorkers with serious mental illness staying more engaged in care.”
In its current form, Thrive is made up of 20 mental health initiatives — down from 54 at its inception — and touches on everything from counseling services for students to psychiatric clinics at senior centers and crime victim assistance efforts coordinated with the NYPD.
With an annual budget of $225 million, a major plank of Thrive is NYCWell, a free around-the-clock mental health hotline that can connect New Yorkers in distress with crisis intervention and other services.
McCray touted in an interview on NY1 earlier this year that NYCWell logged 33,000 calls, text messages and online chats this January — an 83% spike in use from 2020. The Mayor’s Office of Community Health said New Yorkers had reached NYCWell more than 1.5 million times overall, and that surveys have indicated satisfaction with responses.
However, Andrew Rein, president of the nonpartisan Citizens Budget Commission, said it’s unclear if services like NYCWell have produced desired results.
“I’m sure some money had a good effect on people, but there’s also no confidence that most of it had as great an impact as it could’ve because there were no goals, no evidence-based solutions, and still the money kept flowing,” Rein said.
Despite ambitious initiatives like NYCWell, mental health in the city overall isn’t improving — and certainly not thriving.
Data on Thrive’s website says one in five New Yorkers still suffer from mental illness in any given year — the same rate as when the program was launched in 2015.
In another worrisome statistic, nearly one in every 25 New Yorkers — or about 280,000 residents — suffer from serious mental illness, such as major depressive disorder, schizophrenia or bipolar disorder, according to data released by the administration in April.
Problems are even worse among the city’s homeless and incarcerated population, with 40% of single adults in shelters and 53% of those behind bars battling a variety of mental illnesses, according to the April data.
De Blasio and his advisers have pinned the city’s deepening mental health crisis on the COVID-19 pandemic, noting that similar trends have played out nationally in the past two years.
But Steve Coe, former chief executive of Community Access, which provides supportive housing and social services to the city’s mentally ill, said Thrive “wasn’t a professional operation” and focused too much on gathering positive press for the administration.
“A lot of these ideas weren’t bad,” he said. “But it was really poorly executed, and it needed to be thought out. It needed a lot more feedback from people who actually run programs and people who use programs.”
NYC Mayor de Blasio and his advisers have pinned the city’s deepening mental health crisis on the COVID-19 pandemic, noting that similar trends have played out nationally in the past two years.
And Coe added that the costs of Thrive opened it up to criticism at a time that when many New Yorkers were witnessing a mental health crisis across the five boroughs.
“There’s a lot of visibly mentally ill people on the streets and subways. So, if you don’t address that issue in some way, no matter what else you’re doing, it really doesn’t look like you’re doing anything that’s successful,” he said.
Even though he doesn’t have much data to show for it, de Blasio recently name-dropped Thrive when asked to list some of his proudest accomplishments in office.
“Everything around mental health (that) has started with Thrive — now it’s a bigger umbrella: Mental health for all,” de Blasio said in a Dec. 7 interview. “We rewrote the playbook, I believe in my heart. And I think they’ll be built upon much more going forward.”
Belkin did not paint quite as rosy of a picture, though he agreed with de Blasio that Thrive kickstarted an important conversation: “It did change the game in many ways, the momentum and the possibilities for finally moving in that initial direction.”
It remains to be seen whether Mayor-elect Eric Adams will keep Thrive intact after he takes office on Jan. 1. The Mayor’s Office of Community Mental Health was codified into the City Charter last week, but Adams could still dramatically remake it.
Adams spokesman Evan Thies said the mayor-elect’s transition team is reviewing all agencies for potential reform, but declined to comment further.
During the campaign earlier this year, Adams signaled that he wanted to rejigger Thrive to focus more on severe mental illness.
“Our primary focus must be on supporting individuals with severe mental health challenges,” he said in June.