For Minority Mental Health Month and Beyond, Services Must Meet People Where They Are

Proven mental health interventions provided by trusted community-based organizations make an impact.

By Toya Williford, Executive Director of the Mayor’s Fund to Advance New York City; and Christopher Watler, Executive Director of New York State for the Center for Employment Opportunities

The scenario was familiar to anyone working in social services: a young man sat in the reception area of the Center for Employment Opportunities’ New York City office waiting for a weekly appointment with his job coach. Recently released from incarceration, he had enrolled in CEO’s reentry employment services, joined a CEO work crew, and was honing his skills and resume to rejoin the workforce and rebuild his life.

But as minutes wore on, the young man grew visibly irritated, and descended rapidly into threats and homicidal ideation. Although none of the CEO staff present had the words “clinician” or “mental health service provider” in their job descriptions, they were prepared to intervene: they had been trained on Mental Health First Aid (MHFA) through Connections to Care (C2C), an initiative of ThriveNYC.

A large percentage of the people served through C2C are people of color — and people of color and those living in poverty bear the greatest mental health burden. Despite this fact, they are among the least likely to get help or access mental health services, according to a ThriveNYC report.

As Minority Mental Health Month comes to a close, it is urgent that we increase awareness for programs like ThriveNYC’s C2C. Developed by the Mayor’s Office for Economic Opportunity and the Department of Health and Mental Hygiene with support from the Mayor’s Fund to Advance New York City and private funders, C2C integrates mental health services at trusted non-health community-based organizations that serve vulnerable populations. It destigmatizes the process of asking for help, makes lasting connections to services, and meets people where they are. It did that afternoon, when staff at CEO and their on-site social worker from the Center for Alternative Sentencing and Employment Services (CASES) got a young man in crisis into the back of an ambulance instead of the back of a police car.

As the Executive Director of the Mayor’s Fund to Advance New York City and CEO’s Executive Director for New York, we view C2C from two different vantage points, but we agree unequivocally on the need for such programming and can speak firsthand to the impact evidence-based strategies can have when employed with the right people and at the right time. The City of New York recognizes it too, and after three years of supporting this approach, the City is starting to dedicate more City funding to interventions like C2C.

The scenario that played out at CEO is a real-life, high-stakes example of C2C at work. But historically, this level of support has been inaccessible for far too many New Yorkers, especially those with low incomes, people who were formerly incarcerated, and those in under-resourced communities.

African Americans are less likely to engage in counseling or to take medication for their illness than whites, and Latina adolescents are more likely to attempt suicide; often because services are not available to them, or are not available in ways that are accessible and culturally and linguistically competent, among other factors. Additionally, national studies suggest that African Americans can be half as likely as whites to receive community-based health care, but twice as likely to be hospitalized.

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C2C launched in 2015 with the goal of reaching 40,000 New Yorkers over five years through collaboration between community-based organizations (CBOs) and mental health providers (MHPs). To increase awareness of mental health needs and access to services, C2C equipped CBOs and their MHPs with new capacity to recognize and begin to address clients’ mental health needs, and to link those individuals with the most serious needs to additional clinical treatment. Fourteen CBOs, including CEO, deliver C2C around the city.

As of March 2019, participating CBOs had trained more than 1,600 CBO employees and served more than 29,000 New Yorkers. Moreover, in the first quarter of this year, 79 percent of people who received a referral through a C2C CBO followed through with at least one appointment with a clinician.

C2C has also netted positive qualitative results. An interim evaluation report published by the RAND Corporation in November 2018 found that C2C was seen as driving a positive shift in organizational culture around mental health. The evaluation also found that more than half of the CBO staff trained in C2C skills reported high confidence in using those skills with clients. CBO staff also noted that they believe C2C deepens their understanding of clients’ needs and even affects how they understand their own mental health.

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From the CBO perspective, these data points are an accurate and holistic representation of what we experience each day in our NYC office. And as the largest reentry employment provider in the country — with offices in 25 cities and eight states — CEO knows that this problem, and the need for interventions like C2C, is not specific to NYC.

Nationwide, 85 percent of our participants are people of color, and more than half of them are young people between the ages of 18 and 30. The majority of them have no education beyond a high school diploma, have no prior work experience when they come to us, and are caregivers of children.

Needless to say, the barriers they face are many and varied, but particularly in minority communities, the stigma surrounding mental health care can feel like an insurmountable challenge. CEO staff who work directly with our participants can tell you just how vital a person’s physical and mental health is to maintaining a steady job and building a career capable of supporting themselves and their families. Because of C2C, we can address these needs and hopefully improve employment outcomes for our participants.

With C2C, and in partnership with our MHP CASES, we’re able to screen all incoming participants for mental health needs. We also provide on-site access to a licensed social worker to work with our participants on a care plan. Now in our fourth year of the program, we’ve screened more than 5,000 participants — and 78 percent of those who screened positive for a mental health issue met with a social worker for a consultation.

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Through the unique partnerships facilitated by C2C at CEO and at organizations across New York City — with the backing of the Mayor’s Fund and our dedicated private funders and civic investors — many dedicated professionals are working to build environments where care is available to those who need it, and where asking for help does not carry a stigma.

We know there are many people we have yet to reach, but with interventions like the one that occurred in the CEO waiting room taking place at CBOs in all five boroughs, we know that progress is being made.