Luis Rojas Marcos was born in Seville, Spain (1943). He was a hyperactive child, but thanks to the insistence of his mother he applied his excess of energy to playing drums in a rock music quartet. From a very young age he had the vocation to be a doctor encouraged by the stories that his mother told him about his maternal grandfather, a rural doctor in Santander, Spain.
Immediately after graduating from Seville University Medical School (1967), he immigrated to New York City where he completed his residency training in Psychiatry at New York University (NYU) and Bellevue Hospital Center (1972).
That same year, he was granted by the United States’ National Institute of Health a three-year Fellowship Research Award to study the effects of the language barrier on mentally ill immigrants who had difficulty expressing themselves in English. His studies resulted in several ground breaking publications and demonstrated that the language barrier often distorts the communication of non-English speaking immigrants to the point that the evaluations performed by psychiatrists without trained interpreters are unreliable and may give rise to inaccurate diagnoses.1 2 3
His advocacy work and efforts to raise awareness among lawmakers of
the distorting effects of the language barrier contributed to the City of
New York enactment of the Emergency Room Interpreters Act, which
requires all hospitals to have trained interpreters available in the
emergency rooms so that doctors can communicate effectively with
immigrant patients who do not speak English. 4
Board certified in Psychiatry (1974), in 1975 Dr. Marcos became Chief of the NYU/Bellevue Psychiatric Research Unit. In 1977 he was conferred the degree of Doctor of Medical Science by the State University of New York, at Downstate Health Sciences Center. And from 1977 to 1981, he was Director of Psychiatry at Gouverneur Hospital in New York.
In January 1981, New York City Mayor Edward I. Koch appointed Dr. Rojas Marcos Director of psychiatric and prison health services of the New York City Health and Hospitals Corporation, the largest public general hospital system in the United States. In those years, many American and European cities were suffering the harsh consequences of the hasty and massive closure of state psychiatric centers as a result of the policies of deinstitutionalization, and he published extensively about the impact of these policies on general hospitals. 5 6
While serving in this position, Dr. Marcos was instrumental in the creation of Project HELP (Homeless Emergency Liaison Project), the first mobile medical/psychiatric unit with the mission of evaluating and hospitalizing seriously mentally ill homeless persons, living in the streets, who by reason of their mental illness were at risk of serious harm.
Psychiatrists, nurses and social workers were part of the mobile unit. In the first year alone, Project HELP provided care to more than 500 homeless people and hospitalized 298 seriously ill patients who received much needed medical and psychiatric care. Project HELP served as a model crisis intervention for other urban centers both in the United States and in other countries.7 8 9
In 1992, Mayor David N. Dinkins named Dr. Rojas Marcos Commissioner of the New York City Department of Mental Health, Mental Retardation and Alcoholism Services.10
His public advocacy and interventions on behalf of creating community mental health services contributed decisively to New York state legislature enacting the Community Mental Health Reinvestment Act in 1993. This law established the legal commitment of the government to create mental health services in the community. Another important initiative promoted by Dr. Marcos was the Assisted Outpatient Treatment program to help the mentally ill who due to their illness do not accept treatment. This initiative recognizes that mental illness, unlike other physical ailments, is often characterized by the inability of the patient to recognize and seek help.
Subsequently, the New York State Legislature added to this community based program the provisions of the Kendra Act, which requires severely ill psychiatric patients unlikely to survive safely in the community and who are repeatedly hospitalized for noncompliance with treatment, to accept help in community outpatient clinics. 11 12 13
During his tenure, the Department of mental Health created the first culturally competent mental health centers for the Hispanic, Asian, Caribbean and Russian immigrant populations of the City. Under his leadership, the Department also developed the successful youth violence prevention program Choose to de-fuse. 14
In 1995, Mayor Rudolph W. Giuliani appointed Dr. Luis Rojas Marcos for President and Chief Executive of the New York City Health and Hospitals Corporation.15 The Corporation is responsible for providing comprehensive medical and mental health services to all New Yorkers, regardless of their ability to pay. It operates eleven general hospitals, six long-term care facilities and multiple ambulatory care centers throughout the City. At that time, the system served about two million patients annually, had a workforce of 43,000 employees, and an annual budget of $5 billion. From 1996 through 2000 it achieved financial stability and showed positive balances for the first time in its 27-year history. As a result, Wall Street investment companies improved the Corporation’s ratings, and several hospitals –Bellevue, Kings County, Queens, Jacobi and Coney Island- were rebuilt or extensively renovated. 16 17 18 Dr. Marcos was the longest serving President of the Corporation of his time (1995-2002).
Member of the City’s Emergency Management, Dr. Marcos was on the front line during the tragic terrorist events of September 11, 2001.19 As President and CEO of the Health and Hospitals Corporation, he played a key role in the emergency response and the organization of the delivery of medical and psychological care to the victims and their families. Later he wrote his personal experience in the book in Spanish Beyond the 11 of September (Espasa, 2002). As he explains, these events solidified his conviction that it is not enough to cure diseases, but it is essential to identify and strengthen the natural human qualities that help overcome adversities and contribute to a healthy and complete life.
From 2003 to 2013, he served as Medical Director for Affiliations of NYU School of Medicine where since 1986 had been a tenured Professor of Psychiatry. 20 He was also appointed member of the Board of Directors of Dignity Healthcare West and Chair of its Quality Committee (2003-2007). DHW is a 23-hospital system in California, Nevada and Arizona.
From March 2013 to April 2021 21 he served as Chief Executive Officer of the Physician Affiliate Group of New York (PAGNY), one of the largest physician group in New York State. PAGNY’s 3,900 health professionals provide comprehensive health services at seven New York City public hospitals, and the NYC Correctional Facilities, including Rikers Island. 22
Dr. Marcos is an Associate Member of the New York State Education Department Board for Medicine, a Fellow of the New York Academy of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association. In March 2008 he was appointed by the State legislature to the New York State Palliative Care Education and Training Council, where he served until 2016.
In 2010 the Spanish Government awarded Dr. Marcos the ‘Medal of the Arts and Literature of Spain “In recognition of the international projection of his medical and literary trajectory”. And in 2016, he received the Foundation MAPFRE International Award for Best Initiative in Health Promotion, to the program ‘Abandoned on the streets of the city: Project Help’.23
Dr. Rojas Marcos has been conferred Doctor Honoris Causa degrees by Ramon Llull University (2013), Basque Country University (2014), and Burgos University (2015), Spain. He has published extensively in English and Spanish in the areas of public health and cultural psychiatry. He has contributed to the study of the language and cultural barriers of mentally ill immigrants, the special needs of the urban homeless population, and the development of public health policy (see scientific publications).
He regularly collaborates with institutions devoted to social and public health issues. In Spanish, he has published several bestseller books on current psychosocial subjects e.g., The Seeds of Violence, Our Happiness, Beyond September 11th, Self esteem, Overcoming adversity, You Are Your Memory, Heart and Mind with Dr. Valentín Fuster, head of cardiology at New York’s Mount Sinai Medical Center, We Are what We Speak, and most recently Optimism and Health (Penguin Random House, 2020).
Luis Rojas Marcos has four children (Laura, Bruno, Joseph and Carolena), and three grandchildren (Luis, Belen and Rafael). His hobbies include playing the piano, the guitar and drums; writing essays in Spanish; riding his motorcycle, and running the New York City Marathon (he has run it 26 consecutive times).
21 John E. Morris: A History of PAGNY 2010—2019, PAGNY Health and Research Foundation Inc. New York, 2019