Urbanisation has moved at a staggering pace. “In 2016, an estimated 54.5 percent of the world’s population lived in urban settlements. By 2030, urban areas are projected to house 60percent of people globally and one in every three people will live in cities with at least half a million inhabitants.” (UN: The Word’s Cities in 2016)
Cities are quite alien environments for any animal (us included) and research shows that, “The physical and social environments of urban life can contribute both positively and negatively to mental health and wellbeing. Cities are associated with higher rates of most mental health problems compared to rural areas… in addition to more loneliness, isolation and stress.” (The Centre for Urban Design and Mental Health).
One of our world’s great metropolises is New York City where one in five New Yorkers are likely to experience a mental health disorder in a given year. This is not a unique problem- the vast majority of our world’s cities are facing mental health crises, without a corresponding sense of urgency from the public or private sector. What is unique however, is how New York City is dealing with this.
In 2015, New York City announced an unprecedented commitment to create a mental health system that works for all the city’s residents, and a commitment to empower citizens’ mental health and well-being. This initiative was titled to match its desired outcome: ThriveNYC.
To learn more about how New York City is empowering the mental health of its citizens, and becoming an international leader in creating a mental health friendly city, I spoke with theFirst Lady of New York City, Chirlane McCray.
Q: Where did you find your passion for mental health?
[Chirlane McCray] My passion for mental health issues is personal; I am someone who has experienced mental illness and substance misuse in my family, my extended family and friends. These are issues that have touched my life very deeply and personally over the years- and issues that have been the root cause of so many people not being able to have success in their lives.
It shocks me that our society has not caught up with the fact that mental illnesses should be treated like any other disease, and not relegated to the justice system. We have so many different therapies and medicines, and people can make significant recoveries. I had to do something!
Q: How is culture playing a role in the state of mental health?
[Chirlane McCray] The first and most important part of tackling mental health challenges is to drive cultural change. If you don’t change the culture around mental health- people will continue to be stigmatised, people will continue to stay silent, people will not seek the help they need.
In New York, we’re doing a number of things to change the culture around mental health, and I’d like to give you just a few examples.
One is mental health first aid. Our goal is to train a quarter of a million New Yorkers in mental health first aid so that people actually have a greater understanding of what mental illness is, what substance misuse is, ensuring that people are comfortable talking about it and more confident if they’re touched by these issues. Our hope is that by training so many New Yorkers, it will go a long way to changing the culture.
We’re also working very closely with clergy here in the city, and across the country – Like our police officers, our teachers, and paramedics- our clergy are often first responders in mental health crises. People go to them because they trust them, they know that they will keep their confidence, give advice, and listen. The truth is that many in the clergy don’t know what to do when people come to them with something that can’t be prayed away! They need the right training, support and signposting skills to help- and that’s why we’ve set up the online Thrive Learning Center, and we’re teaching them mental health first aid. We want to give clergy to the tools to learn about psychosis, schizophrenia, anxiety, depression and all the other spectrum of conditions they may encounter. We also want them to get expert advice on how to refer people to appropriate care, and how to help people get through their days.
We’re also engaging a lot of advertising capacity throughout our city, in our subway stations, on billboards, turnstiles and more. We showcase personal stories and testimonials of people who are overcoming anxiety, depression, and the challenges of mental health; they tell them their personal story, and also give the phone number 1-888- NYC-Well which anyone can call if they’re going through something similar- it’s free, it’s confidential, and callers will be put straight through to a trained counsellor. If they need longer-term care, the counsellor will connect them, stay on the line, call them back and make sure it worked, because people fall through the cracks so often and we don’t want that to happen.
My hope is that more people will share their stories and feel like they can do that openly and honestly without being demonised or shunned; that’s essential and necessary to change the culture.
Q: How are you connecting agencies, communities and stakeholders around mental health in the city?
[Chirlane McCray] We have a council within government where 20 agencies sit down quarterly to talk about what they can do to improve mental health in their area. Thrive is part of everything that every agency is doing; police, fire, small business, children’s services, housing, everyone.
One of our more recent initiatives, launched separately from ThriveNYC, was created to expand resources to the LGBTQ community. Through the NYC Unity project we’re training over 500 physicians to more competently and sensitively handle the mental health challenges faced by people in transition, and by the transgender community.
We are providing more support for Gender Sexuality Alliances in schools, giving students a voice to speak to each other authentically and accurately about the issues they’re facing.
For young people, we’re also offering text support allowing them to talk through their mental health issues and challenges online, in an environment they’re comfortable with.
Nobody should ever feel isolated, or like they have nowhere to turn. Whether it’s at school, home, or in the workplace. Nobody should ever feel a cultural burden of silence around mental health challenges.
In New York, we have a ‘Connections to Care’ program, currently it’s serving more than 7,000 people (so it’s not a tiny pilot) and brings together 15 different organisations in all boroughs, different communities- training their staff in mental health first aid, and giving additional training, so that they can deal with their clients who come in for different reasons. These organisations are diverse, ranging from those working with young people identifying as LGBTQ to those working with unemployed or underemployed young adults, families facing childcare challenges and more.
Across many of the service delivery areas in our city, our staff have found that one of the biggest obstacles to their clients being successful in getting through whatever they’re going through is mental health. Our training is giving these organisations front-line capabilities, whilst also providing them partnerships with clinical care, hospitals, clinics and professionals where higher-level care is needed.
I remember one real example that has really stuck with me. A young woman reported to one of our services with suicide ideation; she had five children, was widowed, and a staff member identified her as someone who needed urgent mental health help. They made sure she got it, and quite literally saved her life. She’s a completely different person now, was able to finish her training, work through many issues, and provide a sustainable life for herself and her family. She may have taken her life, and her children would have suffered immensely but the staff in the neighbourhood where this woman lived were able to identify her problems- and because they were local she trusted them, and felt comfortable enough with them. They were also close meaning she didn’t have to travel to get services- and that’s important.
People need to have access to mental health services right on their doorstep; where they live, where they learn, where they go to work, where they go to worship.
Q: What has been the role of arts and city design in mental health?
[Chirlane McCray] Building healthy space, and green spaces is something that we’re working very hard on within the administration through the Mayor’s Fund– It’s really important, and we’re making sure that our schools have recreation spaces, and that urban planners realise
We’re also working closely with organisations in the community who are using arts to create change. MCC Theatre for example, have been around for 30 years. They put on theatre programs for communities and with people who are not usually portrayed on the stage. For example, Charmed is the play that they’re featuring right now. Most of the cast are members of the transgender community, and it tells the personal story of a transwoman who is roughly 65 years old and This is something we’re supporting through our funds, and one of the ways that we are uplifting this community through the arts.
Q: What keeps you hopeful about creating lasting change in mental health?
[Chirlane McCray] I know that New York can be a model for programming around mental health, I believe that we can change, and I know that we can change the culture.
Just take a look for example, at NFL players with pink socks, bringing their babies on the field. You would never have seen that just 10 years ago. My husband is a big baseball fan and just recently he was talking with a major star who was telling him about his anxiety – this was just part of the newscast, it was normalised, it was no big deal. The culture is changing as we speak, and I think that our efforts will only help it change even faster.
People are very hungry for change because everyone is touched by it. There are so many people suffering.
Q: How are businesses playing a role in mental health activism?
[Chirlane McCray] In our hyper masculine environment I find it’s really difficult to get people to share their stories and actually speak openly and honestly about something that’s so counter to the culture.
We have our Businesses Thrive taskforce, that’s part of Thrive and they’re working on that.
Also we’ve been reviewing a manual that we’re putting together for all of our agencies. Like, how to make sure promoting mental health is integrated in the practice. No matter which agency it is. Wherever people are, mental health services have to be available and must be part of your life. Right now, we don’t have it in our schools, we don’t have it in our workplace, we don’t have it where people worship, and that means that people can fall through the cracks. It’s got to be part of our everyday lives.
As First Lady of New York City, Chirlane McCray has redefined the role of First Lady, managing a robust portfolio to advance an ambitious agenda in support of all New Yorkers.
Ms. McCray created ThriveNYC, the most comprehensive mental health plan of any city or state in the nation, and she is recognized nationally as a powerful champion for mental health reform.
Additionally, Ms. McCray spearheads the Cities Thrive Coalition of mayors, with representation from more than 150 cities from all 50 states, advocating for a more integrated and better-funded behavioral health system.
As Chair of the Mayor’s Fund to Advance New York City, she brings together government, philanthropy and the private sector to work on some of the most pressing issues of our time, including mental health, youth employment and immigration.
Ms. McCray’s other duties are extensive.
In 2015, with her signature, New York City became the first city in the country to join the United Nations Women’s Safe Cities Global Initiative.
She is passionate about public service and leverages her platform in innovative ways to bring change where it is needed.
The First Lady oversees the Gracie Mansion Conservancy and is intent on making sure that the programming, installations and exhibits are more accessible to the public, and better reflect the rich history and many cultures that make up New York City.
She is the first in her position to address a U.S. Conference of Mayors annual meeting; lobby Capitol Hill, fighting for progressive issues that affect the quality of life of New Yorkers; testify before the New York City Council; and serve as commencement speaker for a major college or university.
Ms. McCray is a graduate of Wellesley College and recently received an Honorary Doctor of Science degree from the CUNY Graduate School of Public Health and Health Policy. She and Mayor Bill de Blasio live in Gracie Mansion, the official residence, and are proud parents of Chiara and Dante.