Supportive Housing in Brooklyn

March-April 2005


Ms. Burke is director of communications, St. Mary's Hospital, Brooklyn, NY.

A New York City System Provides Special Housing for Patients with Mental Illness or HIV/AIDS

Since 1977, Saint Vincent Catholic Medical Centers of New York City has been creating and maintaining supportive housing offerings for at-risk populations, such as individuals with HIV/AIDS, those with substance abuse challenges, and the mentally ill. By providing a continuum of medical and social services, the organization aims to help residents stabilize and rebuild their lives.

Saint Vincent sees empowerment as a key step toward helping individuals maintain their health, re-enter the community, seek employment, and pursue other goals.

Some of the supportive services Saint Vincent offers in its housing communities are care coordination, counseling, peer support networks, self-help groups, leisure activities, help with finances, and referrals to community agencies offering other resources. Recognizing the importance of job training and assistance, the system also offers a unique program in which mentally ill individuals are able to work in a recycling center or office cleaning business, both of which are owned by Saint Vincent.

Saint Vincent Catholic Medical Centers (SVCMC), a seven-hospital system in metropolitan New York City, has been operating and developing residential and supportive housing programs for people with mental illness since 1977. It currently operates 12 residential/supportive housing programs serving 388 people, including single adults, children, and adolescents.

"Supportive housing" is safe, affordable housing that is linked to a continuum of medical and social services. Designed for at-risk persons and families, it blends housing with health care, social supports, employment resources, and other services, depending on the specific needs. The options vary widely in terms of size, cost, services, and facilities, but what all supportive housing facilities have in common is the goal of enabling residents to stabilize and rebuild their lives, thereby experiencing community, self-reliance, dignity, and hope. The combination of permanent, affordable housing and available services works well for people who face complex challenges—who often are, for example, not only homeless but also have very low incomes and such serious, persistent issues as mental illness and HIV/AIDS.

In this article, I will, first, give an overall picture of SVCMC's supportive housing services, and, then, focus on a particular program, St. Mary's Prospect Place in Brooklyn, NY.

Saint Vincent and Supportive Housing
SVCMC is one of New York City's most comprehensive health care systems, serving nearly 600,000 people annually. The system was established in 2000 as a result of the merger of Catholic Medical Centers of Brooklyn and Queens, Saint Vincents Hospital and Medical Center of New York, and Sisters of Charity Healthcare on Staten Island.

SVCMC developed and provides supportive services and property management for all of its properties. Funding for these housing programs has come predominantly from the state Office of Mental Health and the city departments of Health and Mental Hygiene and Housing Preservation and Development. Through its capacity as a service provider and property manager, SVCMC has very rarely needed to evict anyone from its housing programs, maintaining a 98 percent occupancy rate for its facilities. The system sustains this high occupancy rate by maintaining a strong referral network, including effective linkages with the NYC Continuum of Care Coalition, a local not-for-profit group; centralizing outreach for all of its housing programs; quickly processing referrals through a centralized agency committee approach; and maintaining a waiting list of potential residents.

SVCMC operates its housing programs through its Department of Residential Services (which is, in turn, part of the system's Behavioral Health Services Division). The residential programs comprise 232 units of permanent supportive housing (both single-site and scattered-site); 84 beds for transitional supervised community residences (group homes with intensive rehabilitation services) with around-the-clock staff coverage; 15 beds for adult family care; 34 units of licensed apartment beds; 20 family-based treatment program beds for children and adolescents (temporary foster homes in which the foster parents are trained to deal with emotionally disturbed kids); and two beds for adult respite care.

These programs target people who have been diagnosed with serious and persistent mental illness (often considered among those hardest to house); mentally ill drug abusers; HIV/AIDS patients; and the geriatric mental health population. SVCMC views residents' training for and achievement of meaningful, gainful employment a critical component of any successful supportive housing program. In addressing this goal, SVCMC has created two businesses for people with psychiatric disabilities, Rainbow Recycling and Rainbow Brite, which provide recycling and office-cleaning services, respectively. The system also offers training and placement for "companions," people who provide respite care for families with a mentally ill member in residence.

Supportive Services
The residential services program provides supportive services geared towards meeting tenants' individual needs and providing them with a flexible array of support. These services enable residents to re-enter the community; maintain physical and psychiatric health; participate in therapeutic and rehabilitative programs; pursue employment, education, or other productive activities; sustain healthy relationships; and improve the quality of their lives. A major objective of the program is "recipient empowerment"-enabling a resident to retain his or her housing and obtain meaningful, gainful employment.

The specific services provided for residents are:

  • Development of a comprehensive individualized service plan and functional assessment
  • Supportive housing case management
  • Coordination of medical care for those with HIV/AIDS
  • Supportive counseling
  • Crisis intervention
  • Assistance in establishing a household
  • Instruction and/or support in carrying out daily living tasks
  • Access to and knowledge of necessary community supports
  • Assistance in establishing natural support networks
  • Assistance in establishing and maintaining entitlement to benefits
  • Assistance with money and medication management
  • Assistance in gaining employment
  • Coordination of psychiatric services
  • Transportation to and from day treatment and psychiatric, medical, and dental appointments when necessary
  • Recreation, socialization, and leisure activities

Some residents in the supportive housing program carry the dual diagnoses of mental illness and substance abuse. Given the nature of their illnesses, they may at times relapse into drug use. Supportive housing residents who relapse are given additional substance-abuse counseling and support, such as:

  • Relapse intervention and relapse prevention groups
  • Behavioral de-escalation techniques (anger management, for example)
  • Modified therapeutic-community techniques (for people receiving treatment for both mental illness and substance abuse)
  • Peer support through the creation of social support networks
  • Linkage with self-help groups, including transportation to groups if necessary

In addition, residents are taught life-safety skills: how to evacuate a burning building, for example, and use of fire extinguishers and equipment maintenance.

St. Mary's Prospect Place
In July 2004, SVCMC began constructing a new supportive housing facility, located across the street from St. Mary's Hospital, a 269-bed acute care facility in Brooklyn. On completion in December 2005, the new facility-to be called St. Mary's Prospect Place-will be a permanent supportive housing program. The program will comprise 78 efficiency apartments: 50 for adults with serious and persistent mental illness with high service needs and 28 for adults with HIV/AIDS. Besides the apartments, the facility will also contain common areas-a large community room with kitchen, a library, a fitness room, and laundry facilities-and on-site supportive service offices.

St. Mary's Prospect Place will provide numerous benefits to the general community. Among these are:

  • An attractive, modern, fully landscaped building that will help beautify the community
  • Safe, affordable, permanent, supportive housing for its residents, many of whom are currently living in transitional residences in the community
  • Employment opportunities for qualified applicants from the community, including positions for case managers, vocational and employment counselors, an entitlement counselor, clerical and secretarial workers, a building superintendent, a maintenance and porter staff, and a security staff

To ensure the safety of both St. Mary's Prospect Place residents and the surrounding community, the management will provide 24-hour security in and around the building. In addition, the facility will have large common areas that can be used for community events, such as health fairs, arts and crafts fairs, and meetings.

St. Mary's Prospect Place is intended to provide extended-stay housing with on-site services for persons with either mental illness or HIV/AIDS who want permanent, private housing but lack self-maintenance and socialization skills, and, because they lack such skills, have a tendency toward homelessness.

St. Mary's Prospect Place will be accepting referrals from community residences, psychiatric centers, hospitals, shelters, outreach programs, transitional living programs, community support programs, and other sources serving the target population. Residents will be offered access to St. Mary's Hospital's comprehensive network of mental health and substance abuse programs and medical services (including HIV/AIDS services); if they prefer, they will be linked to the services of other community providers. Residents will also be encouraged to accept linkages with community-based mental health and medical treatment (e.g., day treatment programs, medical clinics, and vocational programs).

Saint Vincent Catholic Medical Centers
Cosponsored by the Diocese of Brooklyn and Sisters of Charity of New York, SVCMC serves as the academic medical center of New York Medical College in New York City. The system comprises seven hospitals: Mary Immaculate Hospital, Queens; St. John's Queens Hospital; St. Mary's Hospital, Brooklyn; St. Vincent's Hospital Manhattan; St. Vincent's Hospital Staten Island; Bayley Seton Hospital, Staten Island; and St. Vincent's Hospital Westchester.

SVCMC's resources include more than 3,000 physicians; four skilled nursing facilities; a systemwide home care service; a hospice; and more than 60 ambulatory care sites, which provide a broad array of medical, psychiatric, and substance-abuse services.

In 2002, SVCMC recorded 100,000 inpatient discharges; 1,920,000 outpatient visits; and 524,000 home care visits. Its emergency rooms, which include three trauma centers, received 285,000 visits that year. SVCMC is the largest private provider of emergency medical services in the New York City Fire Department's 911 service.


Copyright © 2005 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Supportive Housing in Brooklyn

Copyright © 2005 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.