Dr. Eric Wei, CEO, Bellevue Hospital: Alright, good morning, everyone. I’m Dr. Eric Wei, emergency physician and CEO of Bellevue Hospital. So my pleasure to welcome you here to this historic hospital while the city, the greatest city in the world is 400 years old. This hospital is almost 289 years old. And so it’s with my distinct pleasure to introduce you to our 110th mayor of this great city, Mayor Eric Adams.
Mayor Eric Adams: Thank you, thank you. Thank you so much, doctor and the entire Bellevue team. I recall my days of policing, we would use this facility so much. They do so much every day. And during COVID and other major incidents, this was really a focal point for the entire city. Dr. Katz and entire H&H operation.
Oftentimes, we don’t realize how much of the team members behind us and those who are on the side, how much they contribute to the city. We just want to personally say thank you for the work that you do. And that work is really highlighted in what you do around those with severe mental health illness. As we think about it, and many of us have forgotten, but I have not, almost three years ago today, Michelle Go, a young, promising New Yorker was shoved to the subway track and we lost her. I would be speaking with her parents later today, as I often do during this time, because although the time may move forward, the pain does not dissipate.
It still reminds you each time you have to think about what took place. And far too many New Yorkers are dealing with severe mental health illness. And we made a commitment when I took office, for far too long, we were walking past them, acting like they don’t exist, allowing them to sleep on the side of the highways and allowing them to sleep in our subway stations and in our streets. And we just act like everything was fine. I refuse to do that. And we receive a lot of pushback when we stated that we would not allow our city to become a city where encampments would define us as a city.
There’s nothing dignified about allowing someone to sleep on the street, someone to sleep in the subway system. And no matter how much noise people put in place, telling us that it could not be solved, we refuse to surrender, we refuse to submit. New Yorkers don’t submit. We solve problems. And that’s what this administration made clear. The team members here under the leadership of Deputy Mayor Williams-Isom and Molly and Dr. Katz, and our entire operation has been focused on this issue. We brought on Brian to help us become smarter in this place.
Homelessness did not start January 1st, 2022 when I became the mayor. Let’s be clear on that. Administration after administration after administration have been trying to tackle not only this local problem, but [the] national problem of homelessness. Go Google other cities and see the encampments lining the streets, how people are living under roadways and pathways and highways. You don’t see that here in this city because our North Star is not to allow that to happen. No matter what people are saying, we are moving forward in real result. Government has failed to care for and to help those who are unhoused New Yorkers, but this administration refused to surrender.
Through our subway safety plan, we doubled the number of outreach staff working with unhoused New Yorkers. We reached over 8,000 New Yorkers and helped over 2,800 move into permanent affordable housing. Think about that. 2,800 of our fellow New Yorkers who have fallen on hard times are no longer living in our subway system. They’re living in permanent housing. And when I took office back in January, February, 2022, and I went into the streets and I talked to people who were living in tents, living in encampments.
When I looked inside their tents, I saw human waste, drug paraphernalia, schizophrenia, bipolar, stale food. I saw people who just really surrendered. And one of them was a retired police officer that found himself just living on the street. Everyday New Yorkers. Everyday New Yorkers were living on the streets and we were walking past them. And 2,800 of them, this team was able to get off our subway system. A key part of our subway safety plan, the PATH and SCOUT programs, which bring together law enforcement and trained clinicians to do co-response in the subways. Since our PATH program began last year, our teams have made contact with over 7,400 unhoused New Yorkers and delivered services to over 2,200 people.
When you talk to these team members who are here, part of initiatives like this, they would tell you the challenge and the difficulty of getting someone off the system and off the street when they don’t know they need care. That is a challenging task that you must build trust, trust, build community and continuously engage in interacting with them so that they can realize that they need the help that they deserve. And we know we have to do more.
There’s more work to be done. This is an endless cycle because each time we pull people inside, there’s another group that goes back outside, but we want to be committed. And today we’re announcing further details on a historic $650 million effort to address homelessness that includes 620 million invested directly in street homelessness and support for those with severe mental illness. This administration, we have committed the largest annual investment in serving street homeless in the city’s history. And we have more than doubled our street programming budget from when we came into office, the largest in the city’s history.
We’re excited to unveil the new bridge to home model that will meet New Yorkers where they are and provide a supportive facility that gets them the treatment and temporary housing they need while keeping them out of the hospitals and off our subways. Really hats off to Dr. Katz and Brian and the team from hearing from their on the ground workers that this is something we must do and we’re going to put the money to get it done. And we know New Yorkers cycle between hospital and homelessness. Those of you who use our public subway system and our other systems of transportation, you know you see the same individuals over and over and over again.
Our goal is to give them the trust they need to come inside. And we’re here at Bellevue Hospital, one of our great public hospitals, which treats people experiencing street homelessness every day. Many of these people come back again and again and again. They see the revolving door. We know how much personal trauma this is to all of us to experience watching people go through this over and over again. And so the new facility will provide a safe space for New Yorkers with mental illness to live, to heal and be cared for so they get the life changing help they need. It will also help reduce unnecessary emergency room visits and inpatient hospitals. If we don’t get people off the streets that are dealing with medical issues, diabetes, heart disease, asthma, they end up in the emergency room.
That just does not make any sense. And our goal is to stop that cycle of homelessness. It would also help reduce unnecessary issues that they would face. And we would decrease street homelessness and reliance on shelters and lowering interaction with the criminal justice system. We cannot have a system with 51 percent of Rikers Island inmates have a mental health issue. 20 percent have a severe mental health issue.
The real crime is not only what they committed on the streets, but the criminalization of our failure to address their issues beforehand. We also know that safe haven beds are one of the most effective tools we have for helping people on the subway system. We know we can do better. And consider this, our administration has moved 2,800 people from safe haven and stabilization beds into permanent affordable housing.
So we’re going to add 900 safe haven shelter beds and 100 runaway and homeless youth beds to our system. That’s an increase of over 1,000 street beds that we know are in high demand that are highly effective. These facilities offer services to meet basic needs such as shelter, employment, food and clothing, and sometimes severe mental health support. And we know that people experiencing homelessness are much more likely to accept, even a baby is cheering today. And we know that people experiencing homelessness are much more likely to accept these safe haven beds when presented the option. We know these beds work.
That is why we’re going to continue to lean in this area. And that is the right thing to do, the compassionate thing to do. And I’ve seen both sides of this issue living on the verge of homelessness as a child. I know what it is not to have housing stability, how it impacts. And if a child grows up in a homeless shelter, they’re less likely to graduate from high school. If you don’t educate, you will incarcerate. And we have to stop the path line and pipeline of incarceration. And so I’m pleased here. And to hear from the governor yesterday, who share our vision and our commitment at our state of the state address, she talked about some of the common sense solutions we’ve been advocating for to help people with severe mental health illness and close many of the loopholes in our system.
Finally, this issue is placed front and center in this state with the leadership of the governor. And so today’s historic investment in eventual changes to state law, we’re going to reach many more New Yorkers in need, keep our city safe and protect our fellow New Yorkers. They deserve better and we’re going to give them better. Thank you. And I want to thank the team behind us on the work that they do. They’re unsung heroes. Oftentimes we don’t see the work that hospitals like Bellevue and entire team here, but we acknowledge their presence every day. And I’m going to turn it over to my good friend, Dr. Katz.
Dr. Mitchell Katz, President and CEO, Health and Hospitals: Thank you so much, sir. Thank you. I’m Dr. Mitch Katz. I’m the proud CEO and president of New York City Health and Hospitals and a practicing primary care doctor. And I have to say to you, Mr. Mayor, that in my 30 years as a public hospital doctor, I have pleaded with people to fix this hole. I have pleaded with people to recognize that our existing system has a fundamental gap and that that fundamental gap is what’s propelling what people are seeing on the street. And to understand that gap, I want you all to think about what the job of a hospital like Bellevue is with somebody with serious mental illness.
The people who get hospitalized at a place like Bellevue are in tremendous distress. They are usually either psychotic, meaning they are hearing voices or having thoughts that are not their own. They are having such severe mood disorders that they cannot get themselves out of bed. They are having thoughts of hurting themselves. They are having thoughts of hurting others. And then this great hospital and the doctors, the nurses, the social workers, the rehab people work with them for seven days, for 14 days, for 28 days. 24 hours a day, seven days a week, these people are getting constant care.
They’re getting the medicines they need and they are getting improved. And in every system across this country, what do we do after that 14 or 21 or 28 days? We send them out to nothing, to essentially nothing. Nothing in this case, best case scenario is you have an outpatient visit with a loving case manager five days later. How can a system possibly work providing 24 hours, seven day a week, doctor, nurse, social worker, rehab person or therapist, and then go to, okay, we want you to come next Thursday for your outpatient visit.
So think about this in real terms. If this were your child or this were your mother and you could, you would take them to your house, right? And you would watch them 24 hours a day, seven days a week. You would give them their medicine and you would make sure that that recovery stuck, right? Because you appreciated how the hospital took your loved person from the point of psychosis to a point where they could function. And you would make sure that that was not lost.
But what if you don’t have a loving family who is watching you, who is reorienting you, who is making sure that you take your medicines? And in the absence of that, which this absence, this hole again exists in every system I’ve ever worked in, right, what do we think is going to happen to the majority of people who leave the hospital? They’re going to lose all of that great work, all of that effort that was put into their recovery. And Mr. Mayor, by approving this program, you have in many ways fulfilled the dream for me, which is that we would have the right place.
So in our bridge, we will be able to provide people with their own room in a setting where we will have onsite services so that we can maintain their recovery. All of us are committed to housing, but people do not go from 24 hour day, seven day a week, psychiatric hospitalization next day into permanent housing. It’s not possible. There’s too much work that has to be done, but you need a place, a landing place, a safe place.
Part of what promotes psychosis is being on a subway car without any other support. Part of what promotes recovery are other people reorienting you, talking to you, engaging with you. And that’s what we’re going to have at this facility. And when people are ready, then we will be able to move them to permanent housing.
So, this is this huge gap that has resulted in a revolving door of hospitalization, shelter, emergency, psychiatric room care back into the hospital, perhaps with a visit to Rikers in between. And finally, this program is going to break that cycle. So it is now with great pleasure, I say, when you have a really difficult health problem, what do you do? You call a nurse. And as it happens, we are incredibly blessed in the city to have the chair of the Health Committee be Councilwoman Narcisse. And she is a nurse and really knows what’s going on. Thank you.
City Councilmember Mercedes Narcisse: Good morning. I ran here because it’s so important for me to be here. Mr. Mayor, thank you for that plan. And you said it all, doctor, because you know what we’ve been going through, especially when you have to discharge a patient. Even if you don’t have mental issues to discharge you, knowing that you have nowhere to go, no one to look after you, and you feel so guilty. And can you imagine someone that have mental problem that they’re dealing with, and you’re discharging that person, knowing that they have nowhere to go.
So Mr. Mayor, what you have done is addressing issues that matters to most of us. New Yorkers been complaining about homelessness. They’ve been complaining, people are there, they’re on the trench sleeping, they’re everywhere they pass by, they’re on the sidewalk. And those are the folks, those are our neighbors. Those are our New Yorkers.
So Mr. Mayor, Dr. Katz, you had said everything. I don’t even want to push on it, but being a nurse, a registered nurse, living that, knowing that we have nowhere, [inaudible], bring it home to us. It is about time for us New Yorkers to help each other. And most importantly, someone that is dealing with mental illness.
We know the problem that we face in New York City and post-pandemic, if it’s [inaudible]. So it is imperative for us New Yorkers to support each other. Mr. Mayor, you’re giving us a chance to address problems that we have been putting on the side, the folks that need us the most. So I want to say thank you to all my colleagues here in the back, all the healthcare workers. I love you, Dr. Long, because we are excited. I am so excited to be here. All of y’all. And the team that make it possible. So I want to say thank you all of you. So today we make a big, a huge step to have a home, a place that called home for the most vulnerable folks in our city. So thank you, God bless.
Dr. Katz: One of the things that the mayor insists on is that all of his departments work very closely together. And I couldn’t have a better partner than Molly Park, the commissioner of DHS and Department of Social Services.
All of this program is in collaboration with her and her great team. And that’s why it’s going to work. And as part of that, I want to next introduce a DHS worker who knows from his daily work, the struggles of the people that we are talking about and how this program is going to make a huge difference in their life. Andrew.
Andrew Walker, Outreach Worker, Department of Homeless Services: Good morning. Thank you, Mr. Mayor for having me here today. Hello, my name is Andrew Walker and I’ve been working with the Department of Homeless Services for two years as an outreach worker.
I’m so proud of the work that we do every day in these streets. We’re in these streets 24/7. That’s 24/7 supporting our most vulnerable New Yorkers. Some of the most hardest New Yorkers to reach, cycling through various forms of trauma. New Yorkers that are unraveling in the public as their mental health deteriorates in our city streets and subways.
We work every day to build trust and encourage them to come inside and receive the services that they need in a safe setting. We bring a lot of empathy and compassion, listening, understanding, meeting the individual where they’re at and understanding the challenges that they face.
In most cases, critical assessment to ensure that the most vulnerable are connected to life-saving health care support. Safe havens are the biggest piece of New Yorkers. It’s a place where an individual are able to have intimate case management, assessment and attention. Safe havens are the first and important step of helping many individuals start process and getting back on their feet.
Outreach workers, like myself and shelter staff, work closely together to ensure that individuals receive quality care and stay connected to services so that they’re able to move into the future. And stay connected to services so that they’re able to move into permanent housing. Sometimes it’s just that one person who’s just one paycheck away that doesn’t get a place to sleep.
Sometimes it’s someone who’s dealing with severe substance abuse and mental health and challenges that need to stay, the challenges that we need to use every day or tools that we need to use every day to support that individual. We will continue to work and to make those important connections for New Yorkers and the need to bring them inside. And make no mistake, we will not rest until we reach every individual out there. Thank you, Mr. Mayor, for these investments, resources that will better equip us to serve New Yorkers experiencing unsheltered homelessness. Thank you.
Mayor Adams: We’re going to open up to some questions, but I think that, I hope people didn’t miss what Dr. Katz stated, that when you’re dealing with the severe mental health crisis and some of the descriptions that the doctor gave, we had a 14-year-old boy who was stabbed the other day, and in court, the person who did the assault stated that he was hearing voices from the devil. He was working for the devil.
And when you bring them into, when Andrew and his team, when they get them inside, those who are out there saying, as soon as they come inside, put them in their own apartment. Are you kidding me? I mean, that’s just how untouched, out of touch, people who are sitting in a sterilized environments of their offices don’t understand the real work that it takes that’s on the ground. And many of the people who are making these suggestions, they probably haven’t even been on a subway system. They probably were never in an encampment. They’re sitting back being philosophical.
Idealism collides with realism when you’re talking to a person that’s hearing voices from the devil and you’re trying to get them inside and give them the care that he needs. We need adults, not the cult, to tell us how to fix this problem. That’s what we need right now. And every time we move forward and make these tough adult decisions, we have those with the cult philosophies with this idealism. No, this is real work, real work that we are doing. And the people behind me are doing.
Question: So I was just wondering how you guys are going to choose the 100 people for this first model. And then I’m wondering for you, Mr. Mayor, it’s going to be outreach teams and officers who are going to be helping to sweep up some of these people on the subway. Just wondering what you thought of Governor Hochul’s State of the State proposal yesterday of having officers on every subway train overnight, if there are enough resources for that.
Mayor Adams: I love the concept as a former transit police officer. I was a transit cop. We used to do what’s called TPF, tactical patrol force. We rode the trains from eight at night to six in the morning, mandatory two hours overtime every night. We were dealing with a different transit system.
Many of us who were policing during the 80s, everything from homelessness to crime, violence on our subway system. And so I think what the governor presented is in alignment with the partnership that we’ve had when we rolled out the subway safety plan. And we have to be really clear of what the task is for the governor and I and the MTA.
We have to deal with the perception that people are not feeling safe. We have 4.6 million riders a day, 4.6 million riders a day, six felonies a day on our system. And so although we have brought down crime, people are feeling unsafe. And so the omnipresence of a uniformed officer, when I’m in the subway system, that’s what people are asking for.
Walking through the subway cars is just a reassurance. Engaging those who are dealing with homelessness, violating transit rules. We want to continue to do that. The police commissioner’s on board and I think we’re going to find a real synergy in partnership with the governor on what she announced. I was really pleased to hear her announce that. Who wants to answer the-
Dr. Katz: Thank you for your question. So the idea is to break the revolving door. So the people who will come into this program are people who have been already in a psychiatric acute hospitalization or have been in an emergency room, psychiatric hospitalization, and have already been assessed and have a clear plan.
And the idea is to really break the old mold, which is we have a plan, but then you can’t follow the plan, to say, okay, we’ve invested all this money and time in you, and now we have a way of maintaining the plan. So everybody who comes will be coming from a facility where they’ve already been assessed, they’re on the right medication, and the goal is to keep them on the right thing so they don’t just wind up revolving back onto the street.
Question: Mayor, you’ve called for more power for the city to be able to do involuntary calls, and it feels like if you get that from Albany, that 100 beds seems like a small number in terms of the people that may begin cycling through the system or are already leaving the system. So I’m wondering, is there a plan to increase that number, and how do you… do you feel a 100-person facility will meet the need? And then second of all, in terms of the governor’s policing plan, I’m wondering if you think that money might be better spent on something like this. [Inaudible.]
Mayor Adams: Yeah, what happened after COVID, many of the psychiatric beds went offline, and even in our private hospitals. We must find a clear pathway to ensure that those beds are back online. The need of psychiatric beds are not as profitable in the hospital universe as other medical procedures that are done. And so we must take all of this into account as we ensure if the 100 beds are not enough, we have to increase the number.
No one that’s looking for that help should not have a bed that they can go to, that we need to be very clear on that. And it’s not only the city’s issue, it’s the state’s and it’s the federal issue. Far too many people are sitting on the sidelines with great ideas, but the question we need to ask on your level of government, what are you doing to solve the problem? Don’t just say, hey, the city needs to be solving the problem. Homelessness is a federal, a state, and a city issue. We’re doing our part.
The governor has announced she wants to help do her part. Everyone must play a role in this. And there’s not a one-size-fits-all, Jeff. It’s not just if we have the 100 beds. There are many rivers that feed the sea of homelessness. We’ve got to dam each river. We’ve been damming rivers. Now we need everyone to start damming some of the rivers that are flowing from their origin, their place of origin. And it’s not a one-size-fits-all. We need to be very clear on that.
When we do this initiative, there are other initiatives that we have to do to get this issue addressed. And so that’s what the police commissioner, Commissioner Tisch, and the governor’s plan, when those officers walk through the subway system, they’re going to be engaging in people who are clearly a homeless. If you’re sitting on the train in 10 degrees weather, you don’t have any shoes on, you’re [inaudible], you have human waste on you, you’re yelling and screaming that you’re hearing from the devil, officers can no longer walk past that. We have to stop and we have to engage.
Commissioner Molly Wasow Park, Department of Social Services: Thank you. We’re also adding 900 safe haven beds, right? We have about 4,000 of them in operation now. We’re going to 4,900. These, as the mayor said earlier, we know it’s a proven solution for serving those who have experienced unsheltered homelessness.
Some people will come directly from the streets and subways into the safe havens. Others may come from the bridge to home into a safe haven. And then we’re going to continue the focus as well on permanent housing placements.
As the mayor noted, we placed 2,800 individuals who were experiencing unsheltered homelessness into permanent housing. Just last year, there were 4,800 supportive housing placements. That’s a 19 percent increase from the year before. So it isn’t… the goal is always that it isn’t a one and done, but that we’re really flowing people through the continuum of housing options.
Question: I just have a question about timeline and locations. And by the way, that guy who stabbed the 14-year-old, he lived across the street from the 40th Precinct the last year and a half. He wasn’t homeless. He was just crazy.
But anyway, the locations and timeline of the shelter that you’re talking about, the facility that’s going to be created, do we have an actual timeline? Brad Lander is making comments that, you know, five years from now doesn’t really help us. And also this 900 beds, is there a timeline on those being added as well?
Mayor Adams: Well, okay, first of all, unless you really understand proper governance, while you’re dealing with an immediate problem, you got to build out for the future problem. So anyone who will attempt to state that we’re sitting on our hands while we build out something or while we build the new facilities, is not listening to what Molly just stated.
We have already been in the subway system. We’re already doing the work. We already have PATH and SCOUT out there. We already partnering with police and clinicians. We’re doing the work. But as we do deal with the immediate crisis that we’re facing right now, we need to be building towards the future as well.
And so again, that’s the difference between the adults and the cult, you know? So it’s great for him to have all these grand ideas, but the reality is every time the adults come up with real solutions, 30-day program of getting migrants out of our asylum seekers, the cults attack us. Taking 20,000 guns off the streets when the adults say it, the cults attack us. Dealing with the revolving door of the mental health facility, the cults attack us. Closing down encampments on our streets, the adults make the decision, the cults attack us.
Listen, you can’t say cult without Brad. The fact is, we know the long-term plans must match the immediate things that we’re doing. As Molly stated, from safe havens to removing and helping thousands of people off our subway system, to putting those numbers into permanent housing, we’re doing the work. Do we have the timetable on—
Dr. Katz: Timetable is immediate. And you know, anyone who watched what the mayor and our team did with Molly and health and hospitals when we needed to create 65,000 places so that asylum seekers’ families would not be sleeping on the streets, the city did it.
We are talking now about creating 100 beds. There is, of course, a public process. We will engage with the neighborhood about the site of the future facility, but I don’t anticipate any problems. People recognize that these people are on the street and having them be in a safe facility, I think will turn out to be a very popular solution to communities.
Commissioner Wasow Park: And on the safe haven beds, we have an existing open-ended RFP. We’ll have all the sites identified by the end of the calendar year, and we’ll start to see openings as early as this summer.
Question: Mayor, the outreach worker, and forgive me for forgetting your name, Andrew? You’ve laid out so eloquently the difficulty out there. So I’m wondering if you plan on pairing mental health professionals with this new surge of overnight police officers, because as he stated, I mean, it’s one thing when they encounter an officer, it’s another thing they encounter a worker. So is that going to be part of the overnight surge?
Mayor Adams: No. The volume of having those overnight police officers walking through the trains, having an outreach worker partnering with each police officer is not realistic, and the volume is just beyond belief. And many outreach workers at that volume of working those hours, the beauty of the Police Department is that they’re round the clock, 24 hours, seven day a week at the right volume.
So the goal is to be able to, if they need an outreach worker, is to make sure we can get one on the scene, train those officers on how to interact properly. And so we need to be really creative. As Andrew stated, building trust. And some of you, I said two days ago, when I was out with NJ walking in the system, it was just real, as we saw. There were people, when you come near them, they become violent.
Just the mere fact, if you come near them. And if you don’t have that right balance of having a clinician and a law enforcement officer, it goes from zero to 100 quickly. And so many people who are coming up with these creative, idealistic approaches, they’ve never been out there on the street. They’ve never been on a subway system, walking up to someone, where the mere fact you walk up to them in uniform or not in uniform, they turn violent.
That’s real. And because people can’t properly come up with the right solutions, because they’re not on the ground. They’re not on the ground. If you were to go to some of these folks giving solutions, ask them when the last time they’ve been on a subway system. They don’t even know what a MetroCard looks like. I’m in the system. I speak to these people. I interact with them. And I know that’s the type of leadership we need. And that’s the difference between the adult and the cult. Thank you.
