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CityFixer

Free Mental Health Care, on Demand

A city-run hotline connects New Yorkers with local counselors.

Robert Galbraith/Reuters

In New York, one in five people—around 1.6 million—struggle with mental illness. A new program launched this week aims to give each of them a way to do something about it.

NYC Well, part of New York’s $850 million comprehensive mental health plan, ThriveNYC, makes free, round-the-clock counseling available via phone, text, or online chat; conversations with trained counselors are confidential and accessible in over 200 languages.

Mental health hotlines are not a new concept: New York has operated LifeNet, a suicide-prevention hotline, since 1996, and CityLab recently reported on San Francisco’s partnership with the national Crisis Text Line to connect suicidal individuals with services. But most existing resources are tailored specifically toward in-the-moment crisis intervention, says Chirlane McCray, the first lady of New York City who spearheads ThriveNYC. The idea behind NYC Well, McCray adds, “is to change the culture around mental health, and the way New York City and its partners deliver services.”

That begins with making counseling available to anyone, at any time. In a statement from the Mayor’s Office, McCray said:

No matter where you live or how much money you make, you can reach out to NYC Well with a call, text or chat. If you are a spouse worrying that drugs or alcohol are taking over your partner’s life; a parent concerned about changes in your teenager’s behavior; so stressed that you can’t work or so sad and lonely, you struggle to leave your home, NYC Well is here for you.

Rather than the one-time call offered through Lifenet, NYC Well could become an ongoing presence in residents’ lives, Gothamist reported. In addition to the preliminary chat—either over the phone or via the online portal—NYC Well counselors can make people appointments with therapists in their insurance network, and follow up to make sure the recommendation was a fit, McCray says. In developing NYC Well, McCray and her team looked to other city resources and call centers to identify shortcomings; a lack of preventative services and sustained care options were some of the key gaps they hope to fill for New Yorkers.

This level of investment in a public health issue from a city government is significant, says Heather Butts, a lecturer in health policy and management at Columbia University. “We’ve gotten used to private organizations doing this kind of work, but cities have a long history of launching public health initiatives,” Butts says. It goes back to a 1905 case, Jacobson v. Massachusetts, where the court ruled that the city of Cambridge could make smallpox vaccinations mandatory. While applications of the case have been broad, Butts says, “the crux of the piece really is this: does a city have a responsibility to protect its citizens? And the answer is yes, it does.”

While New York has partnered with a nonprofit, the Mental Health Association of New York City, to administer the services, Butts says Well NYC is a step toward recognizing the need for civic responsibility in the face of the public health crises of mental illness and addiction. The initiative, Butts adds, makes outreach and care “a priority for the city in a meaningful way.”

But McCray recognizes that creating a platform for these services is not enough—people need to use it. A texting hotline for teenagers that McCray launched in New York City public schools last year failed to draw substantial interest, but in the New York Post, the Crisis Text Line founder Nancy Lublin attributed its lackluster effect to its limited window of availability: 2:30 p.m. to 9 p.m. (Most calls for help, she added, come later at night.) NYC Well will run 24/7. McCray is also launching a multi-million dollar public awareness campaign, including subway and TV adds, and also door-to-door outreach in high-risk neighborhoods (where lower incomes often exacerbate stress), “so people will be able to get this information in their own language, from someone who knows their culture,” McCray says.

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