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Mental Health Association of New York City
Mental Health Association of New York City (MHA of NYC), primary investigator: MHA of NYC was created in
1969 to enable individuals with mental illnesses to live full, productive lives and to contribute to their communities.
A major part of MHA of NYC's work is devoted to advancing public policy issues that are related to mental illness, such
as the availability of a full continuum of community-based mental health services; affordable, accessible mental health
care; and parity in health insurance. MHA of NYC also provides innovative mental health services. With 28 programs assisting
more than 2,500 individuals and families in 2003, MHA of NYC often has been on the forefront of identifying new needs for
children, adults, and families with mental illnesses and developing model programs to meet those needs. MHA of NYC has received
local, State, and national recognition for innovative and best practice programs.
MHA of NYC's experience with crisis center management is grounded largely in its primary vehicle for
New York-area behavioral health public education, the LifeNet Multicultural Hotline Network. Since the inception of this
24-7 crisis, information, and referral program in 1996, MHA of NYC's LifeNet has received awards for excellence in programming
from city and State government officials as well as from consumer groups. The hotline is staffed by multilingual mental health
professionals. While all staff members provide callers with crisis counseling and support as needed, the network's primary
mission is to listen to the concerns of the callers, to assess the severity and risk of the presenting problem(s), and to help
the callers link to whatever support resources are most appropriate among the more than 4,000 services listed in the LifeNet
referral database. LifeNet reaches out to callers in the New York area using a variety of print and broadcast media. Its behavioral
health public education campaigns have won awards for nonprofit advertising in international competitions and have received
official recognition from U.S. Senators Hillary Clinton (D-NY) and Jon Corzine (D-NJ), as well as the World Health Organization.
MHA of NYC's LifeNet and its related public education work includes:
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Experience in developing state-of-the-art hotline technology systems. LifeNet's hotline network infrastructure was
developed with the fundamental goal of optimizing the interface between hotline staff and user-friendly information management
systems. Intensive training and supervision practices maximize the worker's effective listening and engagement skills in
combination with an efficient assessment, referral, and data recording instrument. LifeNet's customized software program
allows staff to track relevant demographic data about callers, to conduct severity and risk assessments, to document problems
and services requested, to search for and record referrals provided, and to conduct followup surveys for callers who were linked
to crisis or emergency services. The software is capable of instantaneously producing scores of reports relating to call
information or system activity. The phone system operates on a T-1 line (that can handle 47 calls at once) and is backed up
by another T-1 line and 6 analog lines (in case of electricity failure). The lines for Asian and Spanish calls ring on the same
phones as regular LifeNet calls but are distinguished by a different ring and a separate light that illuminates on the phone
panel. Caller identification capability is present at each of LifeNet's 19 workstations.
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Scaleable capacity and ability to reach persons in crisis. Due to LifeNet's experience and scaleability, it became the
central communications infrastructure for the Federal Emergency Management Agency-funded Project Liberty program and the American
Red Cross/September 11th Fund Behavioral Health Benefit Program, one of the largest postdisaster community mental health outreach
initiatives ever seen. Nearly overnight, LifeNet's program doubled in staff size (to 50 full- and part-time workers) as the service
expanded its scope to respond to an exponential increase in demand for services from 9/11-affected callers. Joining Federal, State,
and local governments, along with the two largest 9/11 charities, LifeNet has been able to facilitate access to services for more
than 210,000 distressed callers in less than 3 years, a quarter of whom have been 9/11-affected callers seeking help from Manhattan
to Brazil. Since the disaster, LifeNet has become a national service, receiving more than 2,000 calls a year from beyond the New
York-New Jersey area (via Internet, print, and broadcast news and national dissemination of 9/11 brochures). Currently, LifeNet
receives approximately 6,000 calls a month from agencies and persons in various communities seeking behavioral health information
and assistance.
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LifeNet's experience in suicide prevention. Since 1996, LifeNet is the only hotline to have New York City-authorized linkages
with their 23 mobile crisis teams (MCTs) and emergency medical services (EMS). LifeNet has been authorized not only to make referrals
to local crisis and emergency systems when needed but also to follow up with EMS and the MCTs to determine call outcomes. However, as
the public has become more aware of this hotline over the years and as calls have increased dramatically, we have not seen a proportionate
increase in the need to dispatch crisis outreach or emergency teams to callers' homes. LifeNet is serving more persons with a history
of suicide than ever before (approximately 600 callers per month), yet these callers appear to be reaching us more often at precrisis,
presuicidal stages of their presenting problem, suggesting that prevention is occurring. LifeNet not only has been reaching more
persons with some history of suicide but also has been successful in reaching individuals who have never before sought mental health
care. For more than 5 years, at least 40 percent of LifeNet callers report no prior treatment history.
LifeNet was asked to join the 1-800-SUICIDE network first in late summer of 2003 and subsequently was certified by the American Association of Suicidology
in the spring of 2004. LifeNet has not been connected to the network routing system since. In addition, LifeNet has been one of eight
call centers involved in a SAMHSA-funded efficacy study of suicide hotlines. This hotline provided the highest number of participants
to the study, largely due to engaging callers with crisis and suicide issues, resulting in an exceptionally high "consent to participate
in followup rate" of 85 percent.
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Other public education and suicide prevention activities. Aside from the numerous public education campaigns targeting
at-risk populations in multiple languages, MHA of NYC has been a regional leader in suicide prevention and screenings for
depression, anxiety, and other mental health problems in youth, adults, and seniors. MHA of NYC's public education division
employs five multilingual clinicians (including two bilingual Spanish professionals and one Cantonese/Mandarin trilingual
professional) to conduct outreach and education activities. In the past 3 years, MHA of NYC has concentrated its suicide
prevention workshops, trainings, and screenings on youth and senior populations, working directly with the target populations
and those that serve them (teachers, counselors, and health care and social service workers) to identify persons in need and to
better refer them to services. In this timeframe, MHA of NYC has conducted more than 250 workshops and trainings related to
depression, suicide, and mental health and has screened more than 3,300 youth and nearly 1,000 seniors for depression and other
mental health problems. MHA of NYC and LifeNet also have worked with several area colleges and universities to raise awareness
about depression and suicide prevention. Most recently, New York University (NYU) sought LifeNet's expertise in campus suicide
prevention following a series of suicides that occurred during the past school year. Through an agreement with NYU, LifeNet is
now providing backup hotline assistance for the university and will be assisting in campus-related outreach, education, training,
and screening activities during the coming year.
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Cultural competence. By establishing separate network hotlines for Spanish (1-877-AYUDESE) and Asian (1-877-990-8585)
languages, and employing culturally competent clinical personnel to conduct related outreach within these ethnic communities,
LifeNet has been able to reach the two largest non-English speaking cultures (Spanish and Chinese) in New York City. The Asian
service is the first professional, trilingual (Cantonese, Mandarin, and Korean) mental health hotline of its kind. MHA of NYC's
skills in these languages allow for all of its public education materials (e.g., posters, brochures, and radio and television ads)
to be translated readily in a culturally competent fashion. The multicultural hotlines currently are receiving more than 4,000
Spanish and 3,200 mostly Chinese—Cantonese and Mandarin dialects—calls per year. Interestingly, approximately 50
percent of Spanish callers report no prior treatment history, and up to 70 percent of Chinese callers report the same,
underscoring the power of this network to reach persons who might not have otherwise sought help.
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Experience in hotline network coordination and systems collaborations. While MHA of NYC and LifeNet's work has been
concentrated mostly in the New York area, this organization is accustomed to playing the role of "convener," acting to coordinate
systems of providers to enhance area service coordination and delivery. Regarding local hotline networks, in 1995, MHA of NYC
established the "Helping Alliance"—a consortium of 12 helplines with expertise ranging from health and mental health to
gay and lesbian issues—aimed at preventing suicide and providing more information and support to youth in distress. MHA
of NYC's coordination of the alliance enabled ongoing regional public education activities to youth and the adults that work
with them, including print campaigns, site trainings, and presentations. To coordinate local suicide prevention activities more
effectively, MHA of NYC developed the city's Depression Screening Coalition in 1995 (now called the Mental Health Coalition),
and as cochair of the coalition since its inception, has overseen all targeted and regionwide depression screening events.
Following 9/11, LifeNet became the central network entry point for facilitating linkages to other local hotlines and federally
funded crisis counseling services throughout New York and to some parts of New Jersey and Connecticut. As previously noted, the
American Red Cross and the September 11th Fund designated LifeNet as the network entry point for persons seeking 9/11-related
assistance throughout the Nation in 2002. In September 2001, MHA of NYC established and has continued to chair the Trauma Resource
Network, a group of Federal, State, and local agencies—both public and private—and assembled to coordinate collaborative
efforts toward short-and long-term disaster mental health response and recovery.
The National Suicide Prevention Network project director, John Draper, Ph.D., has experience in suicide prevention, crisis center
management, and systems coordination. Dr. Draper, a counseling psychologist, worked in the homes of hundreds of persons at risk for
suicide as a Brooklyn mobile crisis professional for 7 years, where he eventually served as clinical director and consultant to the
city's Department of Mental Health. Dr. Draper continues to work as a consultant to the city, training mobile crisis professionals
in risk assessment. Since his tenure at MHA of NYC began in 1996, Dr. Draper has been responsible for all aspects of the LifeNet
hotline network's development, including staff hiring and training, customized software program design and implementation, data
management and reporting, and all network-related multicultural outreach and education activities. Under his stewardship, MHA of
NYC's public education and hotline capacity has grown exponentially, from serving 10,000 persons in its first year to serving more
than 120,000 persons through its hotline and other outreach initiatives in its seventh year. Dr. Draper's training as a family systems
therapist also has aided him in his work to facilitate collaborations between major systems of human services, law enforcement, and
emergency services in the area. He has engineered major behavioral health public education and outreach initiatives through the city's
police, fire, education, aging, health, and mental health departments, and he currently chairs three city behavioral health committees
to ensure ongoing systems collaborations.
Dr. Draper will oversee the operational entity that will administrate and provide a range of services for this network of hotlines,
an entity that is a separate subsidiary of the Mental Health Association of New York City. At the time of this writing, the name of
this separate subsidiary of MHA of NYC is awaiting the approval of government authority.
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