Building Up the Mental Health Care Capacity of Community-Based Organizations (Phase 1 & 2)

Grantee Name

Fund for the City of New York

Funding Area

Special Projects Fund

Publication Date

January 2019

Grant Amount

2016: $300,000
2017: $200,000

Grant Date:

October 2016–December 2018

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At least one in five New Yorkers will experience a mental health disorder in any given year. Frontline staff at community-based organizations (CBOs) report that many clients often appear depressed or anxious, which they suspect may interfere with clients’ ability to succeed in programs.

However, with limited mental health training, staff members at these organizations are unprepared to deal with clients’ emotional and/or behavioral problems.

In response, New York City unveiled its ThriveNYC initiative, with a plan to overhaul mental health services. A key component is Connections To Care (C2C), a public-private partnership that aims to build the mental illness prevention and treatment capacity of CBOs that work in the areas of workforce development, education, and early childhood services.

New York City received a $10 million grant (over 5 years) from the federal Social Innovation Fund (SIF) to advance parts of the ThriveNYC initiative. $6 million of the SIF funds would support C2C as it tested the integration of evidence-based mental health services into CBOs serving at-risk populations, which included low-income expectant mothers and parents of children up to four years old; out-of-work, out-of-school young adults ages 16–24; and unemployed and underemployed adults age 18 and older. Through the SIF grant, each CBO would receive between $100,000 and $200,000 per year over five years. Per a SIF grant requirement, the CBOs (and the City itself) were required to raise 1:1 matching funds each year.

Phase 1: Given the importance of mental health services and because many of the CBOs were current or former grantees, NYHealth was interested in supporting their efforts in fulfilling the 1:1 match. However, doing so raised a dilemma: the SIF grant’s 1:1 fundraising requirement created potentially competing interests between the Mayor’s Fund to Advance New York City and the CBOs. Awarding 15 separate grants to each of the participating CBOs would pose a challenge in accountability and grants management. At the same time, making a grant directly to the Mayor’s Fund posed different challenges—mainly, tracking one relatively small grant within a $6 million government initiative and one where NYHealth would have little oversight ability.

After much consideration, a novel idea was developed: NYHealth would identify an independent entity that could serve as a fiscal agent. This organization would be responsible for disseminating grant funds to each of the 15 CBOs and overseeing the performance of the subrecipients. Furthermore, establishing a centralized funding mechanism made it much easier for us to attract funding partners.

The Fund for the City of New York, an entity independent of New York City government, was selected by NYHealth for its experience playing this type of role. The Fund established a C2C funding pool, which would streamline the funding mechanism and administer any grants coming from NYHealth and others. The Altman Foundation joined us as a funding partner and contributed directly to the C2C pool to support CBOs.

Phase 2: Building on the success of Phase 1, NYHealth awarded the Fund for the City of New York a second grant in 2017 to continue this initiative. The Altman Foundation also continued its support, and the van Ameringen Foundation came on board as an additional funding partner.

Outcomes and Lessons Learned

Successfully trained more than 1,700 staff (1,000 in Phase 1 and 700 in Phase 2) in at least one of the four C2C evidence-based mental health skills: screenings, motivational interviewing, mental health first aid, and psychoeducation.
Provided services to more than 26,000 individuals through C2C mental health skills or referrals.
Screened 14,651 program participants, of whom about 1 in 3 screened positive for a mental health condition.
In Phase 1, referred 85% of patients who screened positive for a mental health condition for treatment by the end of the first year. In Phase 2, C2C ceased tracking the percent of participants who screen positive and are offered a referral; instead, providers focused on developing protocols to ensure that all participants, regardless of screening results, receive the services they need.
In Phase 1, 62% of individuals who received a mental health referral completed it within the first 6 months of program services. In Phase 2, 73% of participants completed a mental health referral.
Worked with the RAND Corporation and New York University’s McSilver Institute for Poverty Policy and Research to evaluate job placement and retention, educational attainment, and housing stability in C2C participants identified with a mental health condition.
Collaborated with the Mayor’s Office for Economic Opportunity to collect impact and cost evaluation data and identify similar sites for impact evaluation comparison.

Under Phase 1, C2C paired mental health providers with CBOs to screen clients for mental health conditions. The 15 CBOs represent organizations that serve children, youth, families, LBGTQ New Yorkers, Latinos, African Americans, Arab Americans, and immigrants, and provide services that address early childhood development, workforce/employment, re-entry from incarceration, homelessness, and domestic violence. Clients who screened positive for a mental health condition were then referred for treatment or clinical care. C2C instructed CBO staff members on four core evidence-based mental health skills: mental health first aid, motivational interviewing, screenings, and psychoeducation. The Mayor’s Fund to Advance New York City and technical assistance partners ensured that trainings delivered to the CBOs met industry quality standards. C2C worked with the CBOs to ensure practices and techniques are integrated into existing services and the organizational culture at these agencies.

Under Phase 2, the Fund for the City of New York found that positive screening rates were higher for the C2C program (1 in 3 screened positive for a mental health need) than the citywide rate (1 in 5 screened positive), suggesting that C2C may be successfully engaging participants who have not been previously reached by the existing mental health system. The Fund for the City of New York is conducting a C2C impact study, which will include measures of identification of mental illness, engagement with services, symptom management, mental health status, hospitalization rates, and quality-adjusted life-years. The study will available in late 2020.

Co-Funding and Additional Funds Leveraged: For Phase 1, the Altman Foundation provided $200,000 in co-funding. NYHealth’s support also provided the matching funds needed for participating CBOs to meet grant requirements from the federal Social Innovation Fund (SIF). SIF awarded C2C a $6 million grant in 2015, helping CBOs to continue serving low-income New Yorkers. For Phase 2, the Altman Foundation provided $200,000 and the van Ameringen Foundation provided $100,000 in co-funding; New York City committed $4 million to fund the remaining 2 years.

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