NEW YORK, November 18. 2025 — Today, the Collaborative on Housing for Health (CH4H) released a new, first-of-its-kind roadmap with concrete recommendations to end homelessness among New Yorkers with the most complex behavioral health needs, including serious mental illness and trauma-induced personality, mood and substance use disorders.
The roadmap is the result of a unique collaboration between leaders of major homeless service and supportive housing providers and the New York City Department of Social Services, convened and supported by The Leona M. and Harry B. Helmsley Charitable Trust. A novel data analysis of single adults in New York City shelters and hospitals conducted for the Collaborative found that “high-acuity” New Yorkers with complex behavioral health needs represent a small slice of New York City’s homeless population: approximately just 1% of adults experiencing homelessness.
Each year, this small but highly visible group of New Yorkers is trapped in a cycle of repeated crises — bouncing between siloed, costly public services such as hospital emergency rooms, jails, shelters, and the street or subway due to recurring, unmanaged behavioral health challenges. Despite the variety of effective programs and interventions available across the city, this specific group continues to fall through the cracks, and their needs put a disproportionately large strain on the system. Serving high-acuity New Yorkers more effectively improves outcomes for everyone experiencing homelessness in the city.
The Collaborative’s new roadmap lays out a plan to break that cycle and bring these New Yorkers into stable, permanent housing. In particular, the roadmap calls for better tools to identify people in the most need at discovery points and key moments like hospital discharge, jail release and street outreach; new ways of contracting and delivering existing services that support coordinated, accountable engagement pathways that keep people on track towards entering stable housing; and actionable insights for policymakers to address key bottlenecks that prevent access to care.
The partners in the Collaborative will work to advance the roadmap’s recommendations and make strategic investments in collaborating with city agencies, funding specialized providers, modeling system dynamics and conducting policy analysis. The roadmap, which is accompanied by a new website (HousingForHealthNYC.org), comes at a pivotal moment, as the next Mayoral administration and city leaders face mounting pressure to respond to the most complex and costly cases of homelessness.
“Every day, we see the toll that untreated mental illness takes on New Yorkers experiencing housing instability,” said Dr. Van Yu, Chief Medical officer from the Center for Urban Community Services. “By bringing together health care, housing, and policy expertise, this Collaborative offers a unique opportunity to finally break the cycle of crisis and instability for so many New Yorkers. This effort can transform lives and create a more humane, effective system of care.”
Through a first-of-its kind data analysis, more than 100 interviews and focus groups with practitioners, experts, and people with lived experience, the Collaborative has outlined concrete steps that can be implemented with existing public resources over the next two to three years, while building toward lasting system transformation. The group will share with New York’s next Mayoral Administration their recommendations for creating a coordinated system that transforms outcomes for the most vulnerable homeless New Yorkers.
Over the next few years, the Collaborative will be working to advance the roadmap’s recommendations and has secured the institutional commitments and resources required to succeed, including:
“At Helmsley, we believe that stable housing and coordinated, consistent care towards health stability are essential to addressing high-acuity homelessness,” said Tracy Perrizo, Program Officer for Helmsley’s New York City Program. “The Collaborative on Housing for Health demonstrates what’s possible when philanthropy, government, and service providers come together with a shared vision. We are proud to support this work and its promise to improve outcomes for the most vulnerable New Yorkers.” Over the next two years, the Collaborative will focus on this smaller, high-acuity segment of the homeless population, anticipating that the program’s success can then be replicated for other high-needs groups.”
Molly Wasow Park, Commissioner, New York City Department of Social Services: “At a City agency level, we see every day how housing, mental health, and economic insecurity intersect. The Collaborative’s roadmap aligns with our commitment to break down silos, use data to identify New Yorkers cycling through crises, and build clear pathways from street and shelter to permanent homes. We look forward to partnering with providers across the city to scale what is working—from outreach and stabilization to supportive housing and rental assistance like CityFHEPS—so the highest-need New Yorkers can move into housing and stay housed.”
“We see every day that when you pair a permanent home with the right care, people stabilize and thrive. This roadmap is not about building a brand-new system—it’s about aligning the one we have so outreach, safe havens, transitional options, and supportive housing actually connect for people who’ve been cycling through crisis. If we fix the handoffs and fund successful pathways, New Yorkers with the most complex needs can move from the street or subway into lasting homes,” Frederick Shack, Chief Executive Officer, Urban Pathways.
“New York doesn’t have a scarcity of programs—we have a scarcity of programs built for people with the highest needs. By using cross-system data to flag people stuck in repeated crises and by building new clinical approaches, we can get people out of shelters, off the streets, and into permanent housing,” said Dr. Jeffrey Brenner Chief Executive Officer, The Jewish Board of Family and Children’s Services.
“The Collaborative’s roadmap is a bold and necessary step toward addressing one of the most entrenched challenges in our city,” said Jody Rudin, President and CEO of ICL. “For too long, New Yorkers with the most complex behavioral health needs have cycled through crisis after crisis without getting the consistent, coordinated care and housing support they need. This roadmap offers a clear, data-driven path forward that prioritizes compassion, coordination, and accountability. At ICL, we see every day that when people have stable housing and the right whole-health supports that address both physical and behavioral health needs, recovery and wellness are possible. This effort represents hope for a more humane and effective system that finally meets people where they are.”
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About the Collaborative on Housing for Health
The Collaborative on Housing for Health is a NYC-based coalition of senior leaders from the nonprofit, government, and health sectors, convened with funding from The Leona M. and Harry B. Helmsley Charitable Trust. The Collaborative is working to expand the impact and scale of housing-for-health solutions for people experiencing homelessness with complex needs by testing and advancing practical tools, coordinated provider networks, targeted innovation, and data-driven policy to realign the existing system for better outcomes.
