Dr. Ashwin Vasan, Commissioner, Department of Health and Mental Hygiene: All right. I think it's time to get started. Good morning. I'm Dr. Ashwin Vasan, I'm the City Health Commissioner. It's really wonderful to be here with you today. Someone yesterday told me, Dr. Vasan, you're a thinker, not a feeler. We need a feeler. So I'm going to start with a little bit of feeling. This is really a difficult moment in our city and in our nation. The effects of the last two and a half years are showing themselves. They're showing themselves in a host of intersecting crises. It's also showing in our own thoughts, our own attitudes and behaviors. And I want to start by just encouraging everyone here, anyone listening as well, just give yourself a little bit of time to breathe out, extend yourself and others a little bit of empathy and grace that we all deserve.
Dr. Vasan: The work we do is hard. The times we've been through and are going through are harder. But we'll get through it if we remember that we're all connected. We're connected as human beings and we're connected as people trying to make better lives for ourselves and our families. And of course we're connected as New Yorkers. And so it's wonderful to be here today to emphasize the importance of connection and community and tackling our mental health and addiction crises. In May, I released a high level vision for the administration's mental health priorities. And in that vision, I spoke about the need to combat our second pandemic of mental illness by incorporating the tools of public health, prevention, a focus on the upstream social and economic determinants of mental health and wellbeing, as well as on high quality treatment and supports. And to maintain a focus on equity and to address the underlying policy and structural barriers that push people with serious mental illness and addiction issues into extreme social isolation.
Dr. Vasan: I focused on three pillars of recovery. Healthcare, housing, and community. The three legs of a stool that people need, at a minimum, to stand on their own and to navigate the ups and downs of living with a chronic mental illness or addiction issue. And while there's been a lot of talk about healthcare and the ways we can expand access to hospital beds and psychiatry, as well as community based care, and while this administration continues to push the envelope in plans addressing supportive housing needs, we have not talked as much about that third leg of the stool. Community and connection. This is a form of infrastructure. You're sitting in it now. In this case, social infrastructure, where connection happens and community is formed. The physical places or destinations, even transitional ones like this one, where people can go to connect, to break isolation and to begin the journey to long-term recovery and dealing with the ups and downs of navigating life with a serious mental illness or substance use disorder.
Dr. Vasan: Because as you all know, mental health is deeper than a pill or a person to talk to once in a while in a clinic or a white coat. It's about building community, connecting to people, especially to people who have been through what you're going through and to resources. And it's about understanding the underlying social and economic and environmental factors that are impacting your health and mental health. It's about having the support so that you don't feel alone. And so that's why I'm so excited to be here today, to open this support and connection center here in the Bronx. It's in the name. I'm proud because this is precisely the kind of place where New Yorkers can find connection, community support they need to begin the process of healing and recovery. Just like its counterpart site in East Harlem, the Bronx Support and Connection Center will serve to break the seemingly endless cycle of housing instability, contact with our law enforcement and legal systems and emergency room visits.
Dr. Vasan: That is the reality for far too many New Yorkers with intersecting mental health crises and substance use issues. The Support and Connection Center will serve as an alternative and an opportunity to interrupt that cycle. First responders will be able to guide these New Yorkers to this center where they can receive immediate short-term supports and have their basic needs met while working with staff to have a longer-term plan in place. This includes simple things like a hot meal or a hot shower. A clean and safe place to sleep, but it also means immediate access to healthcare, mental healthcare, and social work services. For far too long, we've treated these New Yorkers as political or quality of life issues. Get them off the street or out of sight, out of mind is the prevailing attitude towards so many of these neighbors of ours.
Dr. Vasan: But when community members visit or are brought to the Support and Connection Center here in the Bronx, as in East Harlem, they will find a healing, welcoming and dignified space in keeping with their humanity, a place that will lift them up and not tear them down. And we see the results of this at our sister site in East Harlem. Over half the community members who have visited that site and have been referred to that East Harlem site come back on their own to keep connecting into services, showing that these supports are helpful and meaningful to the people who use them. The Support and Connection Centers are only one piece of a broader fabric of social infrastructure for mental health and addiction that our city is building. From programs to form longer-term community, like our mental health clubhouses and our recently launched Connect Program, based in CBOs and FQHCs across the city to our harm reduction hubs, overdose prevention centers that give people using drugs, the opportunity to connect to services, to healthcare and addiction treatment, to our immediate crises supports, like be heard and mobile crisis teams.
Dr. Vasan: And of course, to NYC Well. Our mental health helpline, where any New Yorker can reach out for support. New York is working to address the complex mental health and substance use needs of all. And finally, this is but trust by our growing subway and street outreach teamwork, which the Mayor has bravely led on. That work is hard. It's complex work. It requires stubbornness and grit, not expediency or looking for quick fixes. This is exactly the kind of place where we want New Yorkers brought out from underground or out of street encampments to be brought over time, to begin their journey for recovery. So it's an honor to be here today to see another portion of that social infrastructure, that fabric be woven in. It's a moment of hope for the present and for the future and another signal of more to come in this space. And so thank you so much, and I'm going to turn it over to our Mayor.
[Crosstalk]
Dr. Vasan: Oh, we'll change the order. I'm going to turn it over to Mitchell Netburn, CEO of Samaritan Daytop Village and our partner in this space. Thank you so much, Mitch.
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Mayor Eric Adams: Thank you. And if I can, I have amazing partners here in the Bronx. We spent so much time here in the Bronx as we committed to and promised during our campaign season. And I just want to take a step back and turn it over to an amazing borough president, Borough President Vanessa Gibson, and then our senator, Senator Jamaal Bailey. Vanessa?
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Mayor Adams: Thank you. Appreciate you. It's clearly important to hear from all of our partners and I really want to thank Chief Tobin of Interagency Operations for the NYPD, for the job that you are doing. I see you have some of your sergeants and offices that are here. We unfairly treated the New York City Police Department in this city in so many ways. We called on them to do everything. We called on them, when someone had a gun. We called on them, when someone had a cat up the tree. We called on them, when someone was going through a mental health crisis. We called on them for everything and didn't realize that we had other agencies that we should have coordinated with, that can properly do the function that we were calling on the police department to do. And that's what we analyze.
Mayor Adams: We analyze what can we take off the plates of the men and women who are on the front line of fighting violence. And one area that we zeroed in on was mental health illnesses. It was an indictment on our entire system and city that 48% of those inmates at Rikers Island had mental health illnesses. 48%. Our answer to those who were seeking help was to lock them up and place them on Rikers Island. That is the system that we had. And so when Dr. Vasan came in with his knowledge and understanding of, if you create the right environment, then you will borrow from Mel Gibson, Field of Dreams, I believe it was. If you build it, they will come.
Dr. Vasan: That's right.
Mayor Adams: And so we built it and they're going to come. They're going to come and they're going to walk through the meditation room. They're going to come and have a place where they can get their medication if needed. They're going to come and get three meals, a shower, a place to sleep just to de-escalate your crisis. Instead of having to call the police to respond in that blue uniform, which sometimes can aggravate the situation instead of deescalate the situation. So this is an amazing partnership. And I think Senator Bailey touched on something.
Mayor Adams: Why is it a challenge to house something in the community? A person that's dealing with a mental health crisis, that's your brother, your sister, your aunt, your mother, that comes from your block. And when you say don't build it here, then you're saying, don't give people the care that they deserve. We are not going to allow that to happen.
Mayor Adams: This is an amazing opportunity and the increase and expansion that we put in place to make sure that we create more facilities in taking this forward thinking approach to mental health crisis, reimagine it. This is bold and let me tell you something, the stuff we are doing, you have to ask yourself why are you placing yourself in harm's way like this? We could do something politically correct. We could ignore the encampments on the subway system. We could say we're not going to engage people and just walk by and it doesn't exist. 'Cause the first week we only had 22 people that took us up on our offer. Now we took 1,700 people off the subway system because we engaged them.
Mayor Adams: We could have said let's continue to allow police to respond to calls of mental health illnesses and continue to fill Rikers with those with mental health crises. But we said no, we're going to double the size of these important initiatives of support and connection. These are bold steps we are taking with pre existing problems and then you stop bottlenecking the emergency rooms. It is more costly to wait for someone not getting their proper medication, not getting the proper healthcare they need, allowing their chronic disease to go into a crisis mode. Then they go to the emergency room and use it as their primary care. That is costing taxpayers’ dollars.
Mayor Adams: But when you go upstream, you could prevent it from happening. You're giving folks the counseling they need. You're giving them the resources they need and the long term medical and mental care that they deserve. That's what we're getting right here in this location. We're going to break the links that mental health and public safety are the same things. They are not. The answer to a mental health crisis is not a public safety response. It is a health response and changing that dynamic is crucial.
Mayor Adams: Mental health crisis is not a crime. It's a crime not to give people the services they need when they're going through a mental health crisis. We are stopping the criminality of people who are dealing with mental health crises in our city. So we're not going to put those who are already suffering in additional suffering in a crisis mode. That's the goal of this partnership that we have developed and the optimum turn is dignity. If you walk through this place, those of you who are staffers here, I want to thank you. You can feel the dignity in this place. You can feel that this is an inviting place to deal with someone when they're experiencing a crisis.
Mayor Adams: So the officers in the Fourth Seventh, 47th precinct, and the B-HEARD teams, we want to thank you for your support. You can bring people here who are in crises and give them the help that they deserve. We want to also let the behavioral health emergency assistant response division, the acronym B-HEARD. It's a pilot project that was launched in spring of last year. Under our administration we have more than doubled the B-HEARD pilot area and we're not just talking about it. We're putting the money there. $55 million investment. This is a real dollar amount we're attaching to this and each dollar will be spent on treating mental health crises compassionately.
Mayor Adams: It's going to save us thousands of dollars in the process and not to mention it's going to save the heartaches to the family members who are seeking help. You hear it over and over again. Crime takes place with someone with mental health illness, you hear the family members stated we tried to reach out and get them help and we couldn't find a place to get them help. It's unimaginable when you see your person, your family member, your loved one declining to the point that they need help and you can't find that help for them to stop them to harming someone else. That's what our goal is. It's an upstream way of dealing with a downstream crises.
Mayor Adams: So I'm proud to be here. I'm proud of our partners that have come together and stated that we can do something different and save the lives of people while going through a difficult moment. Dr. Vasan was clear. COVID has traumatized all of us. All of us. All of us know someone that is in our life that is experiencing something post COVID and we have to have a post COVID response. This health commissioner, he has taken a holistic approach, not just checking the boxes, not just going through the motion. He has been thoughtful on how do we handle COVID? Sometimes it's a retrospective appreciation. You look back and say that this was the right person at the right time to navigate our city out of this difficult moment. I'm proud that he's part of our team. I'm proud of his team.
Mayor Adams: We are going to step up to the challenge that's facing us and we're going to make sure that all of us as New Yorkers come out of it together. Thank you very much. Thank you. Over to any question to Dr. Vasan. Any on topic questions.
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Question: Sure. Mayor, can you talk a little bit about why here in this particular community in the Bronx. Are there particular considerations here? Is it just that the resources were here already? What led you to this?
Mayor Adams: Well, Dr. Vasan you could deal into that, but I would say this. I told both Borough President Gibson, Senator Bailey throughout my time in the Bronx when I was campaigning and speaking of Rubin Diaz Jr., who started to move the Bronx in the right direction. The Bronx has historically been denied over and over and over again. I made a commitment that we were going to spend time here in the Bronx. We're going to look at some of the issues that are important and we had a list of things that were crucial, and this was on the list, having adequate mental health treatment facilities.
Mayor Adams: We were in the Bronx over the weekend for high speed broadband wifi. We were in the Bronx for our summer youth programs in our schools. We have been in the Bronx over and over again, because if you lift the Bronx, you going to lift the entire city. The Bronx has been denied and this is not going to be the administration that’s denying and this is one of the things that they talked about. Dr. Vasan?
Dr. Vasan: Yeah, it's pretty simple. Thanks mayor. It's pretty simple why we came here because the South Bronx and the Bronx in general has one of the highest rates of psychiatric hospitalizations in the city. It also has one of the highest rates of incarceration in the city. It has one of the highest rates of 911 calls for mental health crises and emotionally disturb people in the city. So along with our East Harlem center, we wanted to go where the need was the greatest as a start. But as we build this out, we want to see this all across the five boroughs of course.
Mayor Adams: Yeah. Yeah. Just as some of the other highest. Highest number of traffic issues, fatalities in others. Highest number of shootings, one of the highest numbers of students that are not reaching proficiency. All of those negatives. All of those negatives, it's just feeders. These electives have been saying we need help. We need help. It's just been falling on deaf ears and we just not going to do that.
Question: Yeah. Can I ask one of you guys to talk more about how people end up here? I mean, obviously there's walk-ins but do the B-HEARD teams just refer people or do they actually physically bring them here? Does EMS bring and also homeless services? How does that work?
Dr. Vasan: So it's a great question. As we're starting out the gate it's first responders of different kinds. Police, EMS, B-HEARD teams bringing people in. People can also walk in off the street of their own volition. We'd like to see that expand to the subway outreach teams and so forth as that program matures. Ultimately, we want to take a bunch of... We want to take people who are directly referred and brought here as an alternative to other carceral or other destinations, but we also want people to feel like they can just walk through the front door and get help when they need it. So that's really the referral pathway that we're looking for. Referral pathways.
Mayor Adams: A crisis doesn't impact you on an appointment. Crises don't wait and say, listen, I want to impact you on Monday at three o'clock. No, it hits you. You must be able to have a place to go to when a crises hits you. So the referral is important. As Dr. Vasan and I were walking through here, 'cause we're constantly modifying, Dr. Vasan said, "Listen, this may be something we could do with our subway safety plan." We're in this constant state of how do we build a better mouse trap? That is where we are and when you are at that place, sometimes people critique what you're doing, but we are on the front line.
Mayor Adams: This administration is immune to being critiques. We just said, listen, that's just a lot of noise. We know were going to do the best for the city. So we going to continue to shift and I'm happy the boldness of the leadership. Yes.
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Question: So I have a question about the initial police response that would lead someone here. We had the man in Queens over the weekend who had a history of mental health issues who ended up getting shot by the police. You, Mr. Mayor described him as a bad guy. So where do we draw the line between someone who can come here versus someone who is deemed too dangerous to come here, even if they do have a history of mental health problems?
Mayor Adams: Well Dr. Vasan to talk about that. The police shooting in Queens, when you hear the tape, clearly you are dealing with someone that had a mental health issue in my belief. I'm not a medical professional. That mental health issue had him as being a bad guy. He wanted to do something bad. He wanted to do something harmful. What we must do when people are in that state and go from a law abiding person to a bad guy, we must be there before they get there. And we must respond when they are there. You cannot tell officers that are responding to someone that had a gun, discharged a gun and made it clear on what his action was going to do. Those officers, I really take my hat off to them for walking into harm's way that they knew they was about to walk into.
Question: In a dangerous situation like that, is it still possible to come at them with this mental health first response?
Mayor Adams: I'm going to respond from a law enforcement, going to Dr. Vasan respond. I am not going to have city workers go into an environment that we know is going to possess imminent danger. Based on that information that came through that 911… I got to take my hat off to the operators. Based on that information, it would be irresponsible for us to send someone there that is not properly trained to deal with imminent violence, imminent violence. We are not going to send civilians into harm's way. Dr. Vasan?
Dr. Vasan: I think your question highlights the challenges we face in our emergency response system with 911, much in the way that the mayor talked about asking police to do a whole host of things, we're asking 911 to be the single dispatch for a whole host of things. And so not only does this city have NYC Well, but this city will be a leader on the implementation of 988, the federal crisis response hotline. We want New Yorkers and Americans to know that starting soon they can call 988, get crisis response services, get the kind of health first approaches that we're talking about here, and also get access to all the suite of services offered through NYC Well today.
Dr. Vasan: They can call NYC Well, they can call 988. Eventually over time, we'd like that to be a single number. Now, the other piece here is we're often talking about these places, this social infrastructure as recipients of people, but it's also a preventive. And that's the part that we don't talk enough about. It's the cyclical nature of these encounters between police, law enforcement, the justice system, homelessness services, emergency rooms that we're trying to interrupt. And to break that cycle with this as not just a destination for people in a place you can send folks, but it's a place that will prevent the next crisis. And so the more of this that we have, the fewer crises we'll have.
Question: Thank you. Dr. Vasan, you mentioned that there's a counterpart site in East Harlem. Just to clarify, are these the only two functioning sites of this kind as of now? And if so, what are the plans to expand them in the future?
Dr. Vasan: These are the only two functioning sites as of right now. The site in East Harlem opened at the beginning of COVID. And so, as you can imagine, referrals were challenging, getting that site up and going was challenging. It's now up and going and we're collecting data and learning about it. Between that data and this data here, we'll have a better understanding of its effectiveness, our ability to grow it, and then of course get additional resources to expand it. We've been talking actively with our partners at the state for those resources as well. And I know the federal government is also talking about expanding mental health block grant funding for programs just like this. So we're starting here, we'll collect the data, we'll evaluate it and then move on.
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Mayor Adams: Thank you. Thank you. Thank you.
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Question: Mr. Mayor, there was an article reported today in Politico about an undisclosed location, which I guess is not undisclosed anymore, in the Verizon building downtown that you use as a secondary workspace. Can you talk about why the need to have this other workspace? What you do there that you can't do at City Hall?
Mayor Adams: I'm sorry that we're getting a spike in COVID because I have to wear my mask and I can't give you my signature smile right now. How do you have a city location as an undisclosed location? This just doesn't make any sense. Some of this stuff we have to ask ourselves, are we just being creative here? This is a city location. I move around to different city office spaces. Sometimes I need to do a Zoom and I can't get back to City Hall right away, so I would stop someplace to go. Sometimes I want to do a meeting in that area, it could be an elderly across the street in the NYCHA and she can't come all the way to City Hall. This is a city building.
Mayor Adams: All city buildings are places... OEM, Office of Emergency Management, they have an office there for me with a shower in case there's an emergency. Every space in this city is part of what I utilize to assist the city. So if someone feels as though there's a location that staff but employees that couldn't fit in this little small space in City Hall, which they would rather be in, because everybody likes to be in the City Hall, that we now have this secret undisclosed location. That's just not making any sense. I've been in that building three times in the last... It couldn't have been more than four, because if I say three, y'all going to do the math and say, oh, you said another time.
Mayor Adams: So I've been there to look at the space, make sure it was safe for my team that's there, that's assigned there, so they could be all in one place. It was a smart way of using government resources. My team there is doing real work. I'm not there. I'm at City Hall. So I'm not sure with this undisclosed location... You know what I figured out? I figured out whenever you have Eric Adams' name in the story, you get a lot of clicks. So people just find ways, Hey, he ate fish. Clicks. Hey, he did this. I'm just a popular guy to write about, you know what I'm saying? So I got it. So I got to go with it. We got this secret location. It's not secret location. It is a space that we utilize to do work.
Question: But how's it different from the work that's done at City... It's so close by.
Mayor Adams: Yeah, yeah, yeah. When we go back to City Hall, I'm going to walk you through the space where I am located. I don't know if you've been there before, but we going to break the rules and I'm going to bring you into the space. It's a small space and my scheduling team, my other team, they can't fit into that small space. So we have City Hall staffers in all of these different locations. Many of them. That is one of the locations. And so I'm just really curious on why it's an undisclosed location because it's not.
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Question: I have a monkey pox question, I want to bring the Health Commissioner back on.
Mayor Adams: Yeah, yeah, yeah, yeah.
Question: You have to imagine frustration is boiling over for folks that are trying to get a vaccine. The website crashed for, I believe the third time yesterday with more vaccine appointments coming out. We had a previous infrastructure to give vaccines out to millions of people, but this infrastructure seems to not be functioning as well as it should. What can you tell these folks that are just at their wits end trying to get a vaccine?
Dr. Vasan: We apologize for the problems yesterday. We apologize for the problems last week. Shouldn't happen. Take responsibility for it. We're building more stable vaccine appointment infrastructure as we speak and we'll be announcing developments in the coming days about how New Yorkers can make appointments over a longer period of time. As you know, that's all a function of the amount of vaccine that we have. So I don't want to detract too much from the fact that New York has led on this issue. It's because of New York City that we're even having this conversation about a national vaccination strategy. There was nothing until we did our pilot in Chelsea in June. There wasn't a plan in place. And so we pushed that conversation forward. But we own it, those mistakes shouldn't happen. And so we're working to correct those and do better for New Yorkers in the future.
Question: When you had that previous infrastructure, why wasn't that used versus this new unproven infrastructure that clearly is not working?
Dr. Vasan: It's a different endeavor. That's a mass vaccination program, citywide, which has a massive infrastructure associated with it. And it's doing just about all it can to handle all the vaccination sites around the city, the Vax4NYC app and site. And we're building a similar thing, but it required more space, more infrastructure and a separate build at this time. And so we're working closely with our partners at Matt Fraser and the Chief Technology Officer's office and DoITT to build that out as we speak.
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Question: This goes back to Bobby's question, Mr. Mayor, but with regard to the offices at 375 Pearl Street, did you ever have those offices renovated for your use?
Mayor Adams: When you say renovated, what take down walls, build out spaces?
Question: Yeah. Like outfitted-
Mayor Adams: We built more cubicles, we built more cubicles. What did we do? You move into a space, you modify to fit. The way it was laid out that there were very few cubicle spaces for people to sit in. There was a huge conference room. We said, we don't need this fancy conference room. We need desks for people to do real work. So we built out more cubicle spaces for employees to have more desks. It was a brilliant, smart idea, and it just continues to show the brilliance of my administration.
Question: Cool. Thank you. Appreciate it.
Mayor Adams: Okay. Thank you.