State undertaking $1B 'transformation' to address mental health crisis
Gov. Kathy Hochul speaks at Westchester Community College in Valhalla on May 10. Credit: AP/Evan Vucci
ALBANY — The state has begun a $1 billion effort to confront a mental health crisis exacerbated by the isolation of the COVID-19 pandemic in what experts say is the biggest transformation in mental health care since massive psychiatric hospitals were shuttered in the 1970s.
The effort funds all steps in mental health care, including adding mobile crisis teams in the streets, more professional care in schools and more space for psychiatric patients in hospitals, as well as bolstering the “988 hotline” and providing extensive care and support after people are discharged. Measures also include making sure private insurance companies provide mental health coverage on equal basis to physical health coverage, as already required in law.
The mental health crisis hits nearly half of adults at some point in their lives, while others suffer chronic cases of depression and other mental illness, according to experts. The state’s effort also increases funding for in-hospital care as part of a public safety element to stem homelessness and street crime.
“The era of ignoring the needs of these individuals is over,” Gov. Kathy Hochul declared in her State of the State address this year. “Today marks a reversal in our state’s approach to mental health care. This is a monumental shift to make sure no one falls through the cracks … the most significant change since the deinstitutionalization era of the 1970s.”
The influx of spending, the second in two years under Hochul, falls short, however, in what mental health advocates said is an important piece: compensation for workers who carry out the services.
Hochul and the State Legislature provided 4% increases in the cost of living for health care workers, including those in the mental health field. That’s half of what advocates sought, who say it only starts to make up for stagnant funding since Gov. Eliot Spitzer required cost-of-living increases nearly 16 years ago. The fallout from the pay issue is unfilled jobs and a high turnover rate, mental health advocates said.
Still, the advocates say the efforts to combat the growing mental health crisis are extraordinary.
“It’s a panoply of greatest hits in many ways,” said Glenn Liebman, CEO of the Mental Health Association of New York State. “COVID has had a real impact … there has been a festering mental health crisis, but COVID escalated it.”
“Everyone is going to be affected directly or indirectly by the mental health crisis,” Liebman told Newsday.
Others in the field agreed.
“We’ve never seen such a commitment to mental health,” said Matthew Shapiro, senior director of government affairs at the National Alliance on Mental Illness in New York State, a grassroots organization for people with mental illness and their families.
Several trends prompted the state response.
The Pew Charitable Trusts recently said 1 in 4 adults had mental illness nationwide and more than 12 million adults had “serious thoughts of suicide,” according to a 2021 survey. Other studies found more than 40% of Americans suffered mental illness at some point in their lives.
Advocates note that most mentally ill people don't commit crimes; the ones who do often are homeless and have a history of violence in their backgrounds.
New York City Mayor Eric Adams said subway crimes are “driven by people with mental health issues” and he’s ordered that they be committed to psychiatric facilities when accused of crimes. High-profile cases include the 2022 incident in which a person with a history of mental illness and violence pushed a passenger into the side of a moving subway train in Times Square.
Hochul and the Legislature approved $1 billion for mental health care in the 2023-24 state budget. The funding will add 1,000 beds and add 3,500 housing units for people suffering mental illness. These and other services are aimed in part at the 3,200 people living on the streets and in subways.
Much of the effort is aimed at helping youths facing mental illness and trauma through more screening and services.
“We see a lot of students in crisis or having mental health issues or behaviors,” said Bob Schneider, executive director of the New York State School Boards Association. “They aren’t going to be able to learn when they have these issues.”
“You have children come into school districts and many have some trauma at home, and they bring that into the school building,” Schneider said. “Emotional issues including depression are big issues.”
A 2022 survey by the Council of School Superintendents found that 90% of superintendents said schools are taking a larger role in providing nonacademic services, including mental health and physical health care, meals and recreation. Eighty-one percent said schools are the first and most readily available mental health services for young people in their communities.
Hochul plans a Youth Mental Health Summit in June to highlight the crisis and seek solutions.
Although school shootings are driving the conversation for some to increase mental health services in schools, only about 5% of mass shootings are related to severe mental illness. However, 25% are associated with depression and other psychiatric and neurological diseases, according to Columbia University Department of Psychiatry in 2022 report by Dr. Ragy Girgis, associate professor of clinical psychiatry.
Shapiro of the National Alliance on Mental Illness said the state’s effort, along with President Joe Biden who used his State of the Union address to focus on the “national mental health crisis,” will impact a long intractable problem.
“We’ve never heard mental health in the State of the State or the State of the Union and both the president and governor normalized that conversation and showed the importance of mental health care,” Shapiro said. “I think it goes a long way to cutting through the stigma.”
ALBANY — The state has begun a $1 billion effort to confront a mental health crisis exacerbated by the isolation of the COVID-19 pandemic in what experts say is the biggest transformation in mental health care since massive psychiatric hospitals were shuttered in the 1970s.
The effort funds all steps in mental health care, including adding mobile crisis teams in the streets, more professional care in schools and more space for psychiatric patients in hospitals, as well as bolstering the “988 hotline” and providing extensive care and support after people are discharged. Measures also include making sure private insurance companies provide mental health coverage on equal basis to physical health coverage, as already required in law.
The mental health crisis hits nearly half of adults at some point in their lives, while others suffer chronic cases of depression and other mental illness, according to experts. The state’s effort also increases funding for in-hospital care as part of a public safety element to stem homelessness and street crime.
“The era of ignoring the needs of these individuals is over,” Gov. Kathy Hochul declared in her State of the State address this year. “Today marks a reversal in our state’s approach to mental health care. This is a monumental shift to make sure no one falls through the cracks … the most significant change since the deinstitutionalization era of the 1970s.”
ADDRESSING MENTAL HEALTH
The state’s new Mental Health Care Plan includes:
- Housing for severely mentally ill people, many of whom are homeless.
- Providing more mental health services in schools.
- Significantly expanding outpatient services.
- Closing gaps in some health insurance coverage that doesn’t include mental health and substance abuse care.
- 150 new adult psychiatric beds in state psychiatric hospitals.
- 12 new comprehensive psychiatric emergency programs.
- Tripling the number of state behavioral health clinics statewide to 39 for walk-in, immediate mental health and substance abuse care.
- 42 more assertive community treatment mobile teams for children and adults.
- Eight more “safe options support teams” to support mental health professionals, five of which will be in New York City
- 50 new “critical time intervention care coordination teams” to provide “wraparound services,” including housing, job support and tuition assistance for children and adults discharged from hospitals and emergency rooms.
- More funding for crisis intervention in homes.
- More funding to address eating disorders.
- Expanded peer-based outreach and engagement to adults.
- Expanding a mental health student loan repayment program to include licensed mental health professionals.
- More funding for the “988 Suicide and Crisis Lifeline,” which is now in its second year
The influx of spending, the second in two years under Hochul, falls short, however, in what mental health advocates said is an important piece: compensation for workers who carry out the services.
Hochul and the State Legislature provided 4% increases in the cost of living for health care workers, including those in the mental health field. That’s half of what advocates sought, who say it only starts to make up for stagnant funding since Gov. Eliot Spitzer required cost-of-living increases nearly 16 years ago. The fallout from the pay issue is unfilled jobs and a high turnover rate, mental health advocates said.
Still, the advocates say the efforts to combat the growing mental health crisis are extraordinary.
“It’s a panoply of greatest hits in many ways,” said Glenn Liebman, CEO of the Mental Health Association of New York State. “COVID has had a real impact … there has been a festering mental health crisis, but COVID escalated it.”
“Everyone is going to be affected directly or indirectly by the mental health crisis,” Liebman told Newsday.
Others in the field agreed.
“We’ve never seen such a commitment to mental health,” said Matthew Shapiro, senior director of government affairs at the National Alliance on Mental Illness in New York State, a grassroots organization for people with mental illness and their families.
Several trends prompted the state response.
The Pew Charitable Trusts recently said 1 in 4 adults had mental illness nationwide and more than 12 million adults had “serious thoughts of suicide,” according to a 2021 survey. Other studies found more than 40% of Americans suffered mental illness at some point in their lives.
Advocates note that most mentally ill people don't commit crimes; the ones who do often are homeless and have a history of violence in their backgrounds.
New York City Mayor Eric Adams said subway crimes are “driven by people with mental health issues” and he’s ordered that they be committed to psychiatric facilities when accused of crimes. High-profile cases include the 2022 incident in which a person with a history of mental illness and violence pushed a passenger into the side of a moving subway train in Times Square.
Hochul and the Legislature approved $1 billion for mental health care in the 2023-24 state budget. The funding will add 1,000 beds and add 3,500 housing units for people suffering mental illness. These and other services are aimed in part at the 3,200 people living on the streets and in subways.
Much of the effort is aimed at helping youths facing mental illness and trauma through more screening and services.
“We see a lot of students in crisis or having mental health issues or behaviors,” said Bob Schneider, executive director of the New York State School Boards Association. “They aren’t going to be able to learn when they have these issues.”
“You have children come into school districts and many have some trauma at home, and they bring that into the school building,” Schneider said. “Emotional issues including depression are big issues.”
A 2022 survey by the Council of School Superintendents found that 90% of superintendents said schools are taking a larger role in providing nonacademic services, including mental health and physical health care, meals and recreation. Eighty-one percent said schools are the first and most readily available mental health services for young people in their communities.
Hochul plans a Youth Mental Health Summit in June to highlight the crisis and seek solutions.
Although school shootings are driving the conversation for some to increase mental health services in schools, only about 5% of mass shootings are related to severe mental illness. However, 25% are associated with depression and other psychiatric and neurological diseases, according to Columbia University Department of Psychiatry in 2022 report by Dr. Ragy Girgis, associate professor of clinical psychiatry.
Shapiro of the National Alliance on Mental Illness said the state’s effort, along with President Joe Biden who used his State of the Union address to focus on the “national mental health crisis,” will impact a long intractable problem.
“We’ve never heard mental health in the State of the State or the State of the Union and both the president and governor normalized that conversation and showed the importance of mental health care,” Shapiro said. “I think it goes a long way to cutting through the stigma.”
Michael Gormley has worked for Newsday since 2013, covering state government, politics and issues. He has covered Albany since 2001.
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