To address the sharp rise in mental health challenges in the wake of the COVID-19 pandemic, an innovative community-based behavioral health program is bringing novel peer-to-peer counseling, telehealth, advanced psychiatric care, and early intervention programs for youth and young adults to Southeast Brooklyn.

The new EnTRy program, named for Enhanced Treatment and Recovery, is part of the outpatient psychiatry program at the Family Health Centers at NYU Langone and made possible by an unprecedented $5 million federal grant from the Substance Abuse and Mental Health Services Administration (SAMSHA).

We are working with a population that has been especially hard hit by the pandemic, and will be reaching out directly to people to connect them to the clinic and community organizations. EnTRy will focus on patients with severe mental illnesses, such as bipolar disorders, psychosis, and schizophrenia. The program will pay special attention to problems of joblessness, unstable housing, and a lack of digital literacy that can keep patients in a spiral of poor mental health."

Hunter L. McQuistion, MD, medical director of EnTRy and clinical professor of psychiatry at NYU Grossman School of Medicine

Dr. McQuistion's long career as a psychiatrist at academic medical centers and in the public health system includes a scholarly focus on community behavioral health, homelessness, social disparities, and social determinants of mental health.

He recently joined the Family Health Centers at NYU Langone to clinically oversee the program, having previously treated patients at NYU Langone locations in Manhattan. He has also previously held leadership roles in psychiatry at NYC Health + Hospitals/Gotham Health, Gouverneur, and in the Mount Sinai Health System.

Forging unique connections between clinic and patient

Essential to the program are community navigators who share cultural and language backgrounds with the Sunset Park area residents in need of services, many of them Hispanic, Asian, and Arabic. Peer specialists, who have themselves received treatment for similar mental health issues, will receive special training to be part of the care team. Both roles help establish trust and ensure continuity of care—often barriers to success for this patient group.

The Family Health Centers at NYU Langone is also adding clinical and administrative staff and peer specialists to treat individuals ages 12 and older who have serious forms of mental illness. Three additional psychiatrists will enable more care in Spanish, Mandarin, and Cantonese, and expand services for patients in middle and high school.

"Early intervention is critical for adolescents, when the earliest signs of mental illness can emerge," says Jon J. Marrelli, PsyD, manager of EnTRy and manager of behavioral health and primary care integration for the Family Heath Centers at NYU Langone. The EnTRy program will offer young people a recovery coach to assist with educational and employment guidance. "Focused support to stay in school or maintain employment is a critical part of a young person's mental health recovery," he explains.

Mental illness, treatment demand, and substance abuse growing in Brooklyn

While the Family Health Centers at NYU Langone outpatient psychiatric clinic has been in operation for 5 decades, experts there have seen patient demand for services grow by nearly 30 percent over the past 2 years as a result of the pandemic. Increased acceptance of telehealth has helped meet demand for mental healthcare, but those without access to digital tools and skills have struggled. In-person check-ins and outreach with smart tablets will be part of the EnTRy approach to maintain patient contact.

"There's been an influx of people in mental health crisis who have turned to drugs and alcohol, which only exacerbate underlying health conditions," says Dr. Marrelli. "People also are experiencing higher levels of grief, trauma, anxiety, and social isolation, prompting them to lapse into more serious psychiatric illnesses."

To address this intensifying need, last year the Family Health Centers at NYU Langone applied for the SAMSHA grant, offered nationally to Federally Qualified Community Health Centers that operate in minority and economically disadvantaged communities severely impacted by COVID-19 and are handling more cases of serious mental illness. This $5 million grant awarded to the Family Health Centers at NYU Langone is 20 times greater than previous SAMSHA funding.

"Trust is so important to the success of his program, which is why this program is a perfect fit for the Family Health Centers," says Larry K. McReynolds, executive director of the Family Health Centers at NYU Langone. "The SAMSHA grant and new EnTRy program syncs with and expands our role as a community health center, and it enables us to do more where need is great and where we already are making a difference for patients."

Patients will include those already engaged in care through the Family Health Centers at NYU Langone, as well as an additional 150 individuals, reaching a 1,000-person caseload over the next 2 years.