In the litany of mental health initiatives being tested to solve one of the city’s most persistent issues, at least one is showing early signs of success.
A pilot program focused on transitioning homeless people from intensive street outreach programs into more stable community-based services is producing promising results, according to data shared with Crain’s.
Known by its acronym, STEPS, which stands for Step-down Treatment Ensures Personal Success, and run by the Institute for Community Living, a Financial District-based nonprofit, the program offers a range of health and social services for people who require a lighter touch after having passed through one of two street-based treatment programs aimed at the most dire cases of people experiencing chronic homelessness and untreated mental illness. STEPS accepts participants after they’ve obtained transitional or supportive housing, employment and other measures of independence.
In its first year up and running the program, backed by a $2.3 million private grant, has shown remarkable success in keeping participants in treatment and out of hospitals and jail. All of the 77 participants enrolled in 2024 maintained housing during the program, 98% adhered to their prescribed medication and nearly all avoided arrest, incarceration and hospitalization, the data show. Only one client returned to the more hands-on treatment programs, known as Assertive Community Treatment and Intensive Mobile Treatment, after decompensating.
The latest numbers show the model – of intensive treatment on street corners and park benches ceding to more independent and self-directed care – can be effective, according to Dr. Troy Boyle, the chief operating officer at the Institute for Community Living. But so far relatively few resources have been poured into the approach compared to the money Mayor Eric Adams and Gov. Kathy Hochul have spent on police responses to street homelessness, with only several dozen slots for more than a thousand people waiting for treatment.
The program has caught the eye of Speaker Adrienne Adams who is calling for more resources for STEPS heading into budget negotiations with the mayor as she mounts a campaign to replace him in this year’s city elections.
One of the program’s biggest values is alleviating a backlog of the two street-based programs, known as ACT and IMT, which together serve fewer than 100 individuals with a waitlist of roughly 1,300, said Boyle, who led the creation of the program.
“When you go to the hospital, you don’t stay in the ICU forever. You stay there until you stabilize and then you’re stepped down to a regular hospital room,” said Boyle.
In her State of the City earlier this month, widely seen as a proxy of her mayoral campaign platform, Adrienne Adams identified the backlog as a critical roadblock in getting more individuals off the street and into housing, a perennial issue that has dominated the tenure of both Eric Adams and Hochul. The mayor and governor have each unrolled a series of their own outreach programs, that have included both mobile social workers and clinicians and a greater emphasis on involuntary hospitalization and treatment.
In one of nine policy proposals highlighted in her speech, the speaker called for funding for a pilot program along the lines of STEPS without mentioning the model by name. Adams’ office confirmed that the Council is backing the Institute for Community Living’s program, seeking $1.5 million for it in the city budget, which will be negotiated with the mayor’s office over the coming months, though these types of one-off pilot programs are often ultimately funded through Council discretionary dollars.
The Institute for Community Living also operates some of the city’s ACT and IMT teams. The company, which brought in $189 million in revenue in 2023, received $65 million from city contracts in the current fiscal year, according to data kept by the city comptroller.
