At the northern tip of Manhattan, hundreds of blocks from the skyscrapers and tourist attractions downtown, you’ll find the Allen Hospital. It was built as a community hospital, meant to serve the residents of Inwood, Washington Heights, and the Bronx. In addition to general medical floors, the Allen has a 30-bed psychiatric unit, which serves about 600 patients each year. Most patients at Allen Psych are black or brown, many are on Medicaid, and most are from the immediate community.
NewYork-Presbyterian (NYP), a New York City hospital empire and one of the city’s largest landowners, runs the Allen Hospital. In 2015, NYP placed a specialty spine surgery center in our community hospital, hoping to raise revenue by attracting affluent patients from around the world. Now, NYP plans to close the Allen’s less profitable psych unit in order to expand its more profitable spine center. To cater to the rich, NYP will abandon the poor, the working class, and hundreds of patients with dual diagnoses: severe mental illness and substance use disorders.
Where would that leave our neighbors? Amid a citywide shortage of psychiatric beds, an opioid epidemic, and the rise of Rikers Island as the city’s largest provider of psychiatric care, NYP says they will send patients in crisis to White Plains, about two hours away from Inwood by bus or train.
But Inwood knows better. For more than a year, the Save Allen Psych campaign has organized with community members who know that Rikers – not Westchester – will likely be the next stop for our neighbors in crisis. NYC’s Department of Corrections locks away 82% of people on Rikers for either pre-trial detention or technical parole violations. About 90% of people on Rikers are black or brown, and about 40% have a diagnosed mental health condition.
This is not justice.
On Thursday, May 16, we hosted a town hall about saving Allen Psych. Our conversation connected mental healthcare in NYC with racial and immigrant justice, housing, health insurance, and the prison industrial complex. We featured testimonials from community members, including Hancy, a South Bronxite and mental health advocate, who reflected on his interactions with the police during a mental health crisis and how hard it was to be sent all the way to White Plains for treatment.
Karina Aybar Jacobs, a local psychotherapist and a member of the Democratic Socialists of America, then posed questions to a panel of leaders from Physicians for a National Health Program, Northern Manhattan is Not for Sale, the Washington Heights CORNER Project, and the National Alliance on Mental Illness’s NYC-Metro Chapter. From their different vantage points, these panelists shed light on how their causes related to one another — and to the campaign to Save Allen Psych.
For example, Dr. Roona Ray showed how our current health insurance system doesn’t adequately pay for psychiatric care. This leads to a shortage of providers, particularly in poor and immigrant communities. Dr. Ray also outlined how a single payer system, like the New York Health Act or a nationwide Medicare for All plan, could fund mental healthcare more equitably and expand access to a broader range of psychiatric care providers, many of whom do not currently take insurance.
Paloma, a Northern Manhattan community activist, drew on her experience organizing for housing justice to explain how developers and landowners use rezonings and rent hikes to force out longtime residents. Quoting Dr. Mindy Fullilove, she described how housing insecurity, eviction, and displacement exacerbate the mental health conditions that people cannot, under our current health insurance system, afford to treat. Paloma noted the correlation between eviction and suicide.
Furthermore, Kailin from the Washington Heights CORNER Project described her organization’s vital work on harm reduction and overdose prevention. Allen Psych, she explained, is more than just one of the few facilities in the city that treats patients who have both severe mental illness and substance use disorders. It’s also a resource that the people she helps have personally requested in times of crisis. Kailin spoke forcefully about the need to protect all members of the community by treating people with these stigmatized illnesses with compassion.
In addition, Jamil from the National Alliance on Mental Illness’s NYC-Metro Chapter discussed the need for people with mental illness, their caregivers, and neighbors to learn from each other, organize together, and raise their voices. When asked how New York could afford the comprehensive care the NAMI-NYC advocates for, Jamil responded with a reflection on the economic reality of life in NYC. We live in the richest city in the richest country in the world, so no one should have to go without the care they need.
Our town hall conversation revealed the many layers of damage and danger that working-class communities of color face under capitalism. Our community can’t afford to lose Allen Psych, yet our conversation also made clear that saving Allen Psych is the least we can do. In the face of structural violence, our communities deserve more — and better — than private institutions like NewYork-Presbyterian provide.
At the bare minimum, our hospitals must put people over profit.
But what does it mean to put people over profit? And what does it mean, really, to support mental health?
Supporting mental health means ending a private insurance industry that pumps our minds and bodies for profit. It means rejecting an industry that precludes our ability — through prohibitive costs, copays, and deductibles, and through discrimination on the basis of employment, immigration status, and race — to get the mental healthcare we deserve.
Supporting mental health means taking the police, the jails, and the prisons out of mental healthcare. It means rejecting Bill de Blasio’s $10 billion jail expansion plan, rejecting police involvement in crisis response, and rejecting the colonization of the hospital by the carceral state. It means divesting from jails and investing in healthcare, housing, and education.
Supporting mental health means ending — forever — the indignity and distress of eviction. It means comprehensive, safe, and compassionate harm reduction. And as Karina said at our town hall, it means seeing mental healthcare as a human right — not just something you can access if you can afford it, or if your neighborhood’s private, nominally nonprofit hospital deigns to offer it.
A better world is possible, and the 80 people who participated in our town hall emerged with a clearer view of how to build that better world. Saving Allen Psych is just the beginning.
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Karina said at our town hall, it means seeing mental healthcare as a human right not just something you can access if you can afford it, or if your neighborhood’s private, nominally nonprofit hospital deigns to offer it.