Tackling New York City’s toughest challenges: Mental health and homelessness

Cal Hedigan is tackling one of New York City’s most difficult challenges: housing for those living with mental health concerns. As the CEO of Community Access, an organization that provides housing, training, advocacy and healing-focused services, she leads the organization in its mission to help individuals recovering from trauma and mental health conditions. The organization is also celebrating its 50th year anniversary this year.

Hedigan came to Community Access in 1999 and pursued her passion for helping people with mental health conditions to steadily grow into leadership roles and eventually becoming CEO of Community Access in 2019. Under her leadership, the nonprofit has been able to develop affordable housing across the city and build homes for 8,000 people. Hedigan is working on scaling mental health services, education, and other programs to keep up with the demand that the city is facing. Community Access most recently invested $120 million to create 245 units of affordable and supportive housing in the Bronx.

New York Nonprofit Media spoke with Hedigan on how she became CEO, Community Access’ response to the homelessness crisis, and what she hopes her legacy will be. 

This interview has been edited for length and clarity. 

How did you get to where you are now?

When I was in college in the 1980s, I wanted to take time off and do some meaningful work, and by that I mean work with a social purpose. I'm an Irish citizen, but I’ve lived in the U.S. from the age of nine. Before that, I lived in England. I went back to England in 1985 and I applied to a group called the Community Service Volunteers, and I expressed that mental health is an area of interest and domestic violence. It so happened that they placed me as a volunteer in a house for people living with schizophrenia, in the north of England. I lived and worked in that house for a year and a half. It was really an amazing experience. It was what's called a therapeutic community, but not in the way that therapeutic communities evolved in the U.S. related to substance use, but a therapeutic community in its original form, which is sort of people living and working together in a non-hierarchical way. And by that, and through that, living and working together helping people move forward in their lives. So that was the way this house worked. We had morning meetings, we had afternoon meetings, and we had a lot of meetings. Morning meetings and afternoon meetings were workgroups, and it was all about living and working together. And I just really loved the sort of lack of divisions between staff and participants, sometimes there can be this sort of us versus them conception as if there are fundamental differences between the people providing services and the people receiving them, which never made any sense to me. So it was like just a lovely way of seeing how things could work. It was just a great experience for me as a young person. Then I went back to college, and I graduated with a degree in religious studies at Brown University in Providence, I moved to New York City shortly thereafter. It was right at the beginning that all the attention was being paid to create housing for people who had experienced homelessness, and were also living with mental health concerns. I got a job as a case manager in the Brooklyn women's shelter in 1989, and I've been doing this work ever since. For 10 years, I worked for another organization called the Bowery Residents Committee, where I did all sorts of jobs from being an intake worker to a program supervisor, and then a program director. I have the great experience of often being hired at the very beginning of a program when it was just opening, or just about to open in many of those roles. It was a really great experience to really understand all the regulations that govern these programs and an opportunity to shape how they ran. It was really informed by my experience in England trying to really build community and really see how connections between human beings can really make a difference in people's trajectories. All that time, I heard about Community Access because of its approach, its belief in self-determination and its approach to the work. So I was really excited in 1999 when I saw a job advertised. In those years, you looked in the New York Times, the actual paper, on Sundays for jobs in Human Services. There was a job opportunity there and I jumped at the chance to apply for it because of the human rights approach to the work and the understanding that people don't lose their agency just by being labeled with a mental health concern. I didn't see a lot of that in the mental health community, in my experience in those 10 years, so I was excited to come to a place that was really grounded in a strong set of values that believes in individual dignity and human potential.

What does a typical day look like for you?

I try and begin my day with two things, one of them is meditation, and the second is some kind of movement, which for me is usually yoga. Those are two things that really help me keep my balance as a human being so that I'm able to be more thoughtful. So I'm able to approach it with the right perspective and not get thrown around by things that may come up during the day that I need to respond to. I'm also a bicycle commuter. One of my favorite parts of each day is taking the 25-minute ride to work, our offices are down by South Ferry, and I live in the East Village. It's an opportunity to take it as a sort of respite before I go into the day. 

I don't know that there's a typical day, I have a team, a senior team of people here that partner with me in leading the organization. On a fairly routine schedule, I have one on ones with each of those people. It's one of my goals to actually create some space in my schedule for thinking and moving things forward. And that's part of what I hope to do in my leadership of community access, is ensure that people really have an opportunity to have a real balance between the demands of the work and being able to take care of themselves. I think one thing that we know very well here at Community Access, because this work is hard, is that you really need to be able to bring your best selves to work so that you can really intentionally engage with the people that we exist to serve. I also try to be a great ambassador for the organization and be able to talk thoughtfully in various public forums about our values and the need for them to be more of what happens across the public mental health sector, where we really understand that people are experts in their own lives. Our job as providers is fundamentally to listen to them, to listen deeply to people, to understand what helps them, and what doesn't help them, and really be guided by their preferences and needs. You can never say that too often, because it's just not the way our system has been set up, historically. And so, really trying to be a voice wherever I can, for the need for us to be guided by the people we serve in how we deliver services, and how we make corrections when we may make some missteps.

I understand that one of the main values of Community Access is the right of all individuals to create lives of their own choosing and to know what they need most in life. How does this value impact your thoughts regarding supportive housing?

As an organization, we are a housing-first organization, and what that means is that we're trying to make sure that there are very few, if any, barriers to having a stable place to live. Services are voluntary, in supportive housing, we have staff on-site, but people don't need to use those services in order to have a right to have a home of their own. It's our job really, as a provider of services to make sure that we're providing services that are helpful, that are guided by tenant choice. And that changes as people's needs change. We're both a landlord and a supportive service provider because we develop and then operate supportive and affordable housing. So we really make sure that we have clear role definitions between those roles, and that the service staff are supporting people in reaching their life goals.

What is Community Access doing to address the homelessness crisis?

I think the answer to the crisis, which is really a lack of affordable housing in our city, is to develop more affordable housing. And that takes time. I was somewhere recently where people were engaging in a conversation about mental health and homelessness, and in all these public dialogues, people are really looking for this immediate solution. But we didn't come to the problem that we have in a heartbeat. It's been building for decades, there has been less and less affordable housing within the city. What we're trying to do is really accelerate the resources that we put into the development of supportive and affordable housing to be able to double the impact that we have on each one of these projects. 

It is Mental Health Awareness Month. Can you tell me about some of the work outside of housing that Community Access does surrounding mental health? For example, at your workforce training program, Howie the Harp, or the Crisis Respite Center. 

We started in 1974, purely as housing. One of the beautiful things about housing is that you really have this opportunity to get to know people deeply and get to know their needs, and get to understand the gaps in the services in the system. So it's because of that that we have expanded what we do, outside of housing. One of our oldest programs outside of housing is a program called Howie the Harp Peer Advocacy Center which we began in 1995. That is a program that trains people who have lived experience of living with mental health concerns to become service providers in the Human Services community. It's a classroom training program where people are in class for 12 to 14 weeks, and then do an internship, and then find employment in the human services sector, often as peer specialists, but really in any role in programs that serve people living with mental health concerns. That's an important part of changing the landscape of services within New York City. The more people you have with lived experience in roles as providers of services, the more that we can transform the system into a system that is more responsive to individual needs. Another one that is really central to our vision of the public mental health sector is our crisis respite center, which has been renamed as a residential crisis support program. It is an alternative to psychiatric hospitalization, it opened its doors in 2013. We have over 10 years of operating this service in New York City now. When it started, it was the first program of its kind in New York City. The model is entirely peer-staffed. All of the respite workers have had their own experiences as users of service within the mental health system. And it's intended to be a place where people can stay for between seven days and 28 days, and really receive peer support, and access to other wellness tools. They can move through their crisis, without being locked up in an institution where they can still have access to other community resources that support their health and well-being. We also have a really active advocacy department, where we really try and increase our voice and our leadership in, in changing the service system and having it be more community-based voluntary services that are accessible to people when they need them, and also calling out some of the harms that happen to people because of some of the gaps in our services. One of the things that we've been focusing on, again, in the last decade, is we were the founder of a coalition called Correct Crisis Intervention Today, or CCIT NYC, which is really calling on New York City to move away from the New York City Police Department as being the first responders in mental health crises because we've seen how people can be harmed and in worst cases killed in those police encounters, and really adopt a model where peers and Emergency Medical Technicians could replace the police as those first responders. We've spent a lot of time building a coalition and trying to influence policy within New York City in that area. We also have five intensive mobile treatment teams, which are working with people who are unhoused. And for the most part, unsheltered and who have been really disconnected from services for a long time. These teams are interdisciplinary and include social workers, nurse practitioners, nurses, peers, and harm reduction specialists, and work very intensively. Each team works with up to 27 people, so they can spend an awful lot of time building trust and engaging people and having people sort of move from being disconnected and not really trusting the service system to have their interests at heart to really re-engaging with people over time and connecting people to the various disciplines on that team to help the people become more stabilized and identify some goals for their own life's journey.

Why do you think Community Access has lasted 50 years? What makes it stand apart from other organizations that do similar work?

Part of it is staying true to our roots. We started off as an organization that was grappling with the need for affordable housing and support for people who are being discharged from state psychiatric centers. Really understanding that housing has to be in place for people if they're able to really make changes in any other part of their lives. We have stuck with our original purpose and grown. We understand how important housing is and we're committed to growing in that area to meet ever-increasing needs. We are so rooted in Human rights and self-determination, harm reduction, healing and recovery, and racial equity, and other values that underpin our work. Being rooted in those values and committed to living them in the day-to-day, I think is part of our success as an organization, it means that we are also able to attract people who share those values to work here and to stick around with us, even when things get hard. 

How do you think the current administration is handling the homelessness crisis right now, especially for those with mental health concerns? Do you feel the administration has given you enough support to create that pipeline?

They have a tough job. There needs to be more investment, both in the workers in the agencies in the city that are part of developing this pipeline and more investment in the workforce that works within the housing once it's operating. We always need more resources. But for me, I would think that we need to really prioritize investment in housing, and figure out how to meet short-term shelter needs, but not have there be. Let's stop building a shelter system and start really creating a plan for there to be enough supportive and affordable housing for everyone.

What do you hope your legacy at Community Access will look like?

I would hope that my legacy is that we continue to be really rooted in our values and that we continue to learn from our successes and our failures so that we can be the best organization that we can be in serving this critical need.