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Q&A
Dr. Katz explains the rationale and structure of the Bridge to Home program
0:11:00
ยท
5 min
Dr. Mitch Katz provides a comprehensive explanation of the new Bridge to Home program, designed to support homeless individuals with severe mental health issues. He outlines the current gaps in the mental health system and how this program aims to address them.
- The program will provide single rooms and steady support to stabilize patients after hospitalization, before they transition to supportive housing.
- It aims to break the cycle of hospitalization, shelter, and incarceration that many severely mentally ill homeless individuals experience.
- The program is expected to improve quality of life for participants and potentially reduce strain on city services.
Mercedes Narcisse
0:11:00
Okay.
0:11:01
Bridge to Home, which I believe is a great it's a it's a it was about time for us to approach the mental health folks in our city.
0:11:16
And I'm so grateful that I know a doctor isn't in charge because you you can understand when someone going on I mean, what's going on with someone with mental health, and that's the biggest problem we have in the city of New York, unfortunately.
0:11:32
The preliminary plan includes a new needs of six million in fiscal twenty twenty six and a baseline funding of 12,900,000.0 starting in fiscal twenty twenty seven for a new pilot program to support homeless individuals with severe mental health issues.
0:11:51
What factors were considered creating this new program?
Dr. Mitch Katz
0:11:56
Well, thanks so much for highlighting it and I'm I'm happy to talk about it and I think it helps all of us to understand the limitations in the mental health system as they are created.
0:12:09
If someone is severely in a mental health crisis with psychotic features, meaning that they're hearing things that are not being said, they're seeing things that are not in front of them, They are of danger to themselves or to others.
0:12:25
We have excellent inpatient psychiatric facilities where we will hospitalize somebody.
0:12:32
After something like seven to fourteen days, most patients can be given a medical regimen that will take away the psychosis, that will enable them to return to their baseline state.
0:12:45
The problem is that at that point, once they are stable, they will normally be discharged.
0:12:51
Now if they were a family member of any of us, what would we do?
0:12:55
We would take them home.
0:12:57
We would make sure that they got enough food.
0:12:59
We'd make sure they took their medicine every day.
0:13:02
We would make sure that they went to their visits.
0:13:05
We would make sure that we were a loving presence if they started to feel at all unsafe.
0:13:12
Okay.
0:13:13
So now let's take the same person, but they're homeless.
0:13:17
What happens now?
0:13:19
So our social workers will do their absolute best to give a good plan, but the absolute best at the moment would be a shelter system bed, which is a congregate bed, and if you can imagine what it would be like to have a serious mental illness with paranoid features and to sleep in a room with 16 other strangers, and how that might affect your paranoia.
0:13:46
And those shelter beds, and you know, I admire the shelter providers, but as it stands out, we don't pay them to do mental health services.
0:13:55
It's a That's it's purpose, so that people are not sleeping outside.
0:13:59
Mhmm.
0:14:00
But we don't do the kind of intensive services that somebody who just left.
0:14:06
I mean, then again, it's the gap.
0:14:08
You generally in a in a medical hospital, you wouldn't go from the ICU to discharge.
0:14:14
Go ICU, you'd go to a step down, you'd go to a medical Yeah.
0:14:18
Bed.
0:14:19
Maybe then you'd go to a rehab bed, then you'd go to a a bed where you would go for regular long term care.
0:14:27
Mhmm.
0:14:28
But in mental health, you could you would one moment be in a facility twenty four hours a day of doctors, nurses, social workers being in a shelter with a appointment to see someone.
0:14:41
Again, we would never leave people out, but it's not surprising that many people given that leave the shelter.
0:14:48
We give them medicines to hold them, but those medicines often get lost.
0:14:53
People don't attend their appointments.
0:14:57
And then all of that work and expense that goes into providing twenty four hour care for seven to fourteen days can often be lost in a matter of weeks.
0:15:09
People lose their medicines, don't take their medicines, don't take the follow-up appointment, and so then you're back in the same circle.
0:15:17
And we have noticed that there is a circle between the shelter, the psychiatric emergency room, the inpatient unit, Rykers, back to shelter.
0:15:29
And the goal of Bridge to Health is to interrupt that, to be able to give people single rooms, which we believe will enable people with serious paranoia and other mental illnesses to be able to stay, give them steady nutrition, nursing staff there so they don't have to go somewhere else, other mental health programming, rehab programming, so that we can actually be able to stabilize them and ultimately discharge them to supportive housing.
0:16:06
We do have resources, but you someone cannot go from a psychiatric twenty four hour a day hospitalization into supportive housing.
0:16:16
It's just not possible.
0:16:18
They need time, leases, find the unit, that's not going to work.
0:16:23
So I feel like this really, it will fill a hole and that while the numbers may not seem large, I believe this is a group that creates a lot of expense and work in New York City as they cycle through the shelter and Rikers and the emergency departments.
0:16:43
That if we could really focus on this group of very, very high need people, people, we would be give them a better chance and we would also see improvements in quality of life across New York City.