Experts: State's mental health care system failing those in need, especially kids

The mental health care system in New York State often fails both adults and children, with long waits for treatment or no care coming at all, experts testified on Wednesday at a public hearing convened by State Attorney General Letitia James.

Advocates, doctors and public officials said at the hourslong hearing that with insufficient services, people suffering mental health issues frequently are ending up homeless, in jail or living in isolation at home instead of getting the treatment they need.

“It’s a revolving door of short-term Band-Aid solutions,” James said, adding that “mental illness is not a crime” and people suffering from it deserve proper treatment.

James said she convened the forum both to explore possible ways to reform the mental health care system, and to pinpoint areas of potential legal investigation of facilities that are violating the law by failing to provide required care.

“Children are not immune” to the shortcomings of the mental health care system, James said, noting that the number of beds providing residential treatment for them in the state has been cut in half in the last decade, from 545 to 274.

She also said that in 2018 there were 12,738 visits to emergency rooms by people who had harmed themselves. Some 4,500 of them were under 19 years old, according to the state Department of Health.

While current data is not yet available, James said “that number has undoubtedly grown since the pandemic.”

Some experts said many people experiencing mental health crises, including children, are going to ER rooms — their only option — because they can't get appointments with psychologists or psychiatrists.

“If you talk to families or you talk to health care providers … they all say the same story: Things are desperate out there,” said Alice Bufkin, associate executive director of policy and advocacy for the Manhattan-based Citizens’ Committee for Children of New York. “Children are presenting at younger and younger ages with serious mental illness. Families are blocked at every stage from finding care. Young people are cycling in and out of ERs and hospitals because they can’t get the care they need early.”

Most of the testimony came from New York City-based providers and experts, with none from Long Island. But a Northwell Health psychiatrist, in a telephone interview, echoed many of the same concerns.

Dr. Scott Krakower, a child/adolescent psychiatrist at Northwell Health, said that children with severe mental health issues typically wait two to six months just to get a full evaluation. Then they wait months more to start receiving treatment.

“I don’t think we are” meeting the needs of children, he said, though health care systems are trying their best.

One root of the problem is that there simply are not enough psychologists and psychiatrists who treat children, he said. “That was always the case even before the pandemic. It’s just more now” as cases of depression, anxiety and other issues increase.

Ron Richter, CEO of New York City-based JCCA, formerly known as Jewish Child Care Association, said improving the mental health care system is critical to helping prevent more tragedies.

“Things like Buffalo and Texas with children getting killed are happening when we had the warnings about young people who are struggling mightily and end up harming others. We don’t want to see that happen ever again.”

“And we know the warning signs,” he added. “We just are not affording the treatment.”