Frigid NYC needs supportive crisis stabilization

2026 is already pushing New York’s health and safety infrastructure to its limits. Days after a historic winter storm, at least 14 people lost their lives, many of whom were struggling with homelessness and showing signs of hypothermia. As families continue to make their way out of the snow, thousands of people are still looking for a warm place to sleep and eat.

For people facing mental health and substance use challenges, extreme cold and limited supportive housing options will continue to snowball, with deadly consequences.

Yet we focus on developing a response plan rather than executing a solid strategy – and it will cost many more lives if we don’t act.

As healthcare providers, our responsibility does not end when temperatures drop. This is why we advocate for a proven solution: Crisis Stabilization Support Centers (CSSC). They offer us a way to protect residents struggling with addictions, mental health issues and housing insecurity, during times of distress.

Last summer, the Adams administration proposed encampment sweeps and involuntary placement for people struggling with homelessness, substance abuse and serious mental illness. This approach was misguided and, like other city advocates, we opposed the initiative.

At Phoenix House, many of our clients struggle with both acute addiction and homelessness. We know for a fact that coercive interventions can actually increase the risk of substance use relapse and overdose, and that displacing people from encampments only worsens instability.

But the former administration’s plan also brought new resources and focused attention on a systemic problem: How to get homeless New Yorkers inside and into treatment?

So we were optimistic when Mayor Mamdani promised the same level of attention, but with a more strategic approach that did not include extensive mop-up operations. But the coldest January in decades makes it clear we still need a replacement plan. Without investing in stabilizing the crisis on the treatment side, we will only see more New Yorkers succumb to addiction and exposure – just steps away from reaching a hospital bed or finally getting off a shelter waitlist.

With homelessness on the rise and tens of thousands of people forgoing drug treatment, new crisis centers can create a stronger continuum of care. Long neglected, they provide voluntary, non-clinical 24/7 assistance to people in crisis. Not only are nurses, counselors and certified peer specialists prepared to stabilize a person’s symptoms in the short term, but the staff also serves as a bridge to long-term recovery services.

According to the New York Department of Health and Mental Hygiene, up to 90,000 residents already report unmet needs for substance abuse treatment. Simultaneously, homelessness has more than doubled statewide, while Black and Latino New Yorkers continue to be disproportionately impacted.

According to the state comptroller, nearly 160,000 New Yorkers are homeless, or 8 out of every 1,000 people. Just as troubling: up to 10% of unhoused people also suffer from serious mental illness or substance abuse. Nonetheless, nearly four years after Governor Hochul launched efforts to build nine new Crisis Stabilization Centers across the state, New York still does not have enough locations to ease the burden on our overcrowded shelters.

When it comes to health and safety, even as New Yorkers prepare for extreme conditions, our response to the crisis remains ill-equipped. What’s more: We narrowly avoided a full-blown emergency less than two weeks ago, after federal officials reversed a last-minute $2 billion budget cut for vital health programs.

While taking steps to resolve these intertwined crises, it is irresponsible to spend any more time circumventing what works – especially in this chaotic federal climate. New York needs more supportive crisis stabilization centers now, not in a few years or when it becomes appropriate to turn back the clock. We will either save more people the sooner we start, or we will lose more lives to freezing temperatures.

The Mayor and his team should implement this strategy now to prevent more unnecessary deaths on our streets.

Foster is president and CEO of Phoenix House of New York and Long Island, which provides clinical services, residential and outpatient treatment to individuals suffering from substance abuse and co-occurring mental health disorders.