CM Epstein Q&A: Chokshi on homelessness, supportive housing, and involuntary commitment

You're also joined by Council Member Epstein, who also has a few questions.

Thank you for your time.

I want to just turn our attention to the homeless crisis that we experience in New York City and kind of the role that the hospital system plays in helping people move into housing and supportive housing.

Do you see the hospital system as a key infrastructure for people with mental health issues, Bridge to Home, which is at Bellevue?

And what do you think your role is to ensure we get people from the streets into supportive housing in more organized settings?

Thank you for the thoughtful question.

I'll again start by just sort of checking my own responsibility as a potential Board of Health member.

It's limited with respect to the role of the hospital system, you know, particularly health and hospitals.

With that said, Councilmember, this is something that I'm personally very passionate about.

As you may have heard, I practice at Bellevue, and my practice focuses on people experiencing homelessness.

I've taken care of several patients who have benefited from Bridge to Home.

I think it's an excellent model, and I believe that what H&H has done, particularly over the last several years, to

advance both health care for people experiencing homelessness and then connect people to housing is unequivocally something that benefits their health.

So I'm supportive of that, and I think that as we...

continue to elaborate additional interventions of that type of category, it will benefit New Yorkers who are homeless.

And the second question just around, like, I understand, you know, since you've practiced at Bellevue, there's a large conversation about whether someone should be involuntarily committed or not, the changes in the state law from two years ago.

Do you think that our H&H system and your role, are we doing a good enough job identifying people with serious mental health issues,

using the changes in the law that talk about people being able to take care of their basic needs and ensuring that those people are getting the support they need?

Because we've seen this cycle of people going in and out of specifically Bellevue and other H&H facilities and then unfortunately doing harm to themselves or to others, even though they're well known to the H&H system.

Yeah, thank you for the question.

This is a challenging issue, and I can say clinically it's something that you have to use very judiciously, you know, to ensure that

people's rights are protected, even as you are trying to protect their health, you know, at the same time.

My perspective is that the major sort of intervention, the solution, is actually on the other end, what we were talking about earlier, ensuring that there are pathways for transitional housing,

ensuring that barriers to supportive housing and the supply of supportive housing

are sufficient.

Making sure that people with serious mental illness have access to the ACT and IMT and other intensive mobile treatment teams in the community.

So I think those are where I think the greatest focus should be placed.

I said I didn't have one more question, but I do have one more if I can.

So you would expand programs like SHOW or other mobile-based programs to get people to have access to services?

The short answer is yes, but I have to acknowledge my conflict of interest.

I practice on the show vans myself, and so it would be difficult for me to say anything other than that.

Okay, thank you.

Thank you, Chair.

Thank you.

And seeing no other members who have questions, Dr.

Chakshi, you are excused.

Thank you.