New York State budget adds more than $400M to bolster mental health services

ALBANY — The new state budget increased funding for mental health services by more than $400 million to better serve kids in schools, veterans and the mentally ill charged with crimes — as well as addressing a shortage of care workers — amid a growing state and national mental health crisis.

The budget provides funding across state agencies for mental health clinics in schools, more inpatient psychiatric beds at state facilities and for the continuing mental health needs of veterans, first responders and law enforcement and correction officers. 

The state Office of Mental Health will receive an additional $118 million, bringing its budget to $4.9 billion. That compares with $3.3 billion in 2022 when the state began a multiyear plan to bolster mental health services, according to the state Division of Budget. The budget division said it couldn't provide an all-inclusive figure for total spending across all state agencies on mental health services.

The state's priority to fund mental health services comes as more than 1 in 5 New Yorkers have symptoms of mental illness and 1 in 10 adults and children face challenges serious enough to impact work, family and school life, according to the state Health Department. Left untreated, the results include school failure, teen pregnancies, unemployment, divorce, suicide and violence.

Nationally, the U.S. Surgeon General determined the country is in a youth mental health crisis, including increases in schizophrenia and bipolar disorder, all exacerbated by a closely related addiction to drugs, including oxycontin and fentanyl.

“It is a crisis,” said Ramesh Raghavan, a professor at the New York University Silver School of Social Work and co-author of “Investing in Children’s Mental Health.” “The area of need is particularly acute in youth.”

The crisis has prompted more funding by states, including California, and the federal government. New York’s effort ramped up beginning with Hochul’s 2023 State of the State address. She called for a $1 billion, multiyear investment after “years of underinvestment, even before the pandemic.”

“Given that we seem to have such enormous underinvestment in this country, any increase is very, very positive,” Raghaven told Newsday.

However, Raghaven and mental health leaders providing care in the state also said a better balance in how the funding is spent is needed. For example, the state has focused on increasing the number of psychiatric beds in hospitals and psychiatric centers, when community-based care works best for most patients.

“A psychiatric bed is a venue of care, it is not a type of care,” he said. “And we should be investing in more types of care.”

He said the state could better balance preventive measures, such as more early intervention with youths.

Half of all mental illnesses begin at age 14, with three-quarters starting by 24, according to the state Health Department, citing national figures.

Mental health spending under the Office of Mental Health, which provides services and administers most mental health spending, as well as under the judicial, education, health and veterans affairs departments in the budget adopted last Saturday include:

• $33 million to expand mental health services for people with mental illness who are arrested. That includes $10 million to expand Mental Health Courts, which specialize in handling such cases. There are now 41 mental health courts in cities, boroughs and counties around the state, including in Nassau and Suffolk counties. Hochul said Wednesday at a Manhattan news conference that the goal is to have the special courts in all 62 counties.
• $20 million toward school-based mental health clinics statewide and $19 million for additional services for school-age youths. Another $9.6 million will be used to continue serving youths within their community when possible. There are now more than 1,100 school-based mental health clinic satellites operating or planned in the state’s 4,771 public schools now.
• $55 million to add 200 more inpatient psychiatric beds at state facilities, including 15 beds for youths.
• A doubling of funding to $2 million for suicide prevention by first responders, veterans, law enforcement and correction officers.
• $1.25 million to hire more staff in the Department of Veterans Affairs to process more claims, including those stemming from post-traumatic stress disorder.

“By enhancing mental health supports, we're not just helping people find stability and peace, we're making our community safer,” Hochul said.

The budget also provides $244 million in funding to confront a workforce shortage that has reduced the capacity for care at nonprofit service providers funded by the state, and delayed patient contact with psychologists and psychiatrists sometimes for months. The budget includes funding for a 2.84% adjustment in the cost of living for most mental health care workers. The nonprofit agencies had called for a 3.2% increase.

The budget also includes $4 million to forgive student loans for licensed mental health clinicians serving children and families, and who qualify for the program.

Most of the state’s front-line care workers are making between $25,000 and $35,000 a year, with slightly higher pay on Long Island and in New York City, said Glenn Liebman, CEO of the Mental Health Association in New York State, whose members provide the services under state contracts. That wage has been mostly stagnant without a cost-of-living increase for more than 15 years, Liebman told Newsday. That has led to staff shortages, including at one Albany nonprofit which he said has 1,500 workers and 200 vacancies.

“They work with challenging people at times and their thanks is a salary you can get at McDonald’s,” Liebman said.

“It’s hard to stay in the job without rising up in the ranks or working three or four jobs,” said Jihoon Kim, CEO of the InUnity Alliance mental health care organization and former staffer for Hochul. “But it’s really just the start … but I’m a realist.”

By Michael Gormley

michael.gormley@newsday.com@GormleyAlbany

Michael Gormley has worked for Newsday since 2013, covering state government, politics and issues. He has covered Albany since 2001.