No Cost Solutions to Improve NYC's Emotional Health

The City's mandate to hire mental health professionals for all families living in homeless shelters is long overdue.

But I worry the vision will fail because of political inertia or budget battles or both. After all, the City has yet to fully hire other needed caregivers such as school social workers and early childcare teachers that we've needed for years.

But rather than give up hope, I suggest the City listen to the social workers and case managers to find out what can be done and what promising practices are happening. Because even if the City found $9.2 million to hire at least 1 full time social worker in every family shelter, that wouldn't be enough.

My team recently held a series of focus groups with 40 front line staff and managers of community-based social service organizations throughout the City. We wanted to hear what workers have been dealing with since the COVID19 pandemic. We also wanted to know how staff were coping with stressors and traumas in their jobs of helping others. We asked them what they've noticed, what they needed more of and what strategies they were utilizing to address participants' and staff mental health needs.

The backdrop to these focus groups was to find out what the City could or should be doing without burdening the budget. Conversations were held on behalf of a City agency looking for strategies and promising practices to support clients and staff without incurring more costs.

In addition to the need for more qualified staff, we learned about major burn-out among staff; and staff who are seeing children struggle more than ever with emotional regulation and anger management. We heard them witness frustration, anxiety and sadness from children more frequently than ever before. And with burn-out, they've seen higher turnover and the need to increase awareness and crisis management skills among staff.

In addition to listening to providers, our research surfaced resources and suggestions that, with good leadership and strategic thinking can be implemented at little to no cost. Because hiring more staff is only part of ensuring that attention is paid to the emotional and mental health needs of our City's most vulnerable.

Train all staff

Make sure all all staff are aware of basic mental health triggers and symptoms. This sounds pretty obvious but the reality is that training isn't always accessible with flexible locations and times to accomodate job schedules. Relevant training exists at little to no cost. The City and their contractors need to remove barriers to training so that more staff become comfortable handling emotional and mental health issues.

Develop a triage checklist or info graphic

So that staff know who to call, when and for what, if emergencies or non-emergencies occur; ensure that all staff have access to the protocols - post them in communal areas and update them at least annually. The checklist or infographic should be created in collaboration with frontline staff and case managers. They should be tailored to each program and community organization.

Strengthen community linkages

Identify brick and mortar locations where residents can be referred for specialized care that isn't accessible on site; make use of schools, afterschool and neighboring community based programs. Create and share a simple, easy to access directory that staff can access any time to advise clients or participants during their program hours.

Pay attention to staff's mental health needs

We cannot forget the stress and vicarious trauma experienced by staff in jobs that focus on supporting the most vulnerable and high risk populations. They also need support from employers and colleagues to do their jobs, avoid burn-out and be in good mental and emotional shape to help others.

Finally, I want to add that mental health care can sometimes be as simple as knowing how to manage human emotions such as stress, grief, anger or sadness. This isn't to downplay the need for more intense clinical services when needed. But as we've learned from the pandemic, some days can be extra difficult. We can wake up feeling anxious or get set off easily or feeling sad. When money and housing worries prevail, especially for families with young children, basic emotions may get magnified, making it harder to focus on the things that keep us healthy, productive and safe.

I hope these suggestions that came out of our conversations with social workers and case managers at several dozen CBOs will be considered by the NY City Mayoral agencies and all its community partners who help to take care of our city's most vulnerable.