ALBANY, NY – Governor Kathy Hochul will unveil a sweeping billion-dollar plan Tuesday to close some of the many gaps in the care system for New Yorkers with mental illness.
Ms. Hochul, a Democrat, pledges to drastically change the state’s approach to mental health in the wake of the pandemic and its effects on public safety and on children’s behavior and school performance.
The governor’s plan will force state-licensed hospitals to reopen more than 800 psychiatric inpatient beds lost during the pandemic, build 3,500 units of housing with supportive services, and expand mental health services in schools that have seen large increases in children with psychological problems.
The plan aims to help hundreds, perhaps thousands, of serious mentally ill people who cycle in and out of hospitals, prisons, shelters and streets. Hospitals often discharge them after just a few days without coordination with outside caregivers.
The government will require hospitals to meet stricter standards for assessing and accepting patients, and will create teams of dozens of outpatient care coordinators so hospitals can deliver these patients and ensure continuity of care.
“We have under-invested in mental health services for so long and allowed the situation to get so dire that it has also become a public safety crisis,” Ms. Hochul said. “This proposal marks a tremendous shift in making sure no one falls through the cracks and finally and fully meeting the mental health needs of all New Yorkers.”
Ms. Hochul will make the announcement at her State address in Albany on Tuesday for the first time since she was elected to a full four-year term in November. The governor’s agenda is expected to focus largely on improving public safety and tackling housing affordability by expanding home construction across the state – pressing issues that defined his choice.
New York’s Mental Illness Policy
After a series of high-profile crimes involving homeless New Yorkers, the city said it would take aggressive action.
- A New Policy : Mayor Eric Adams announced efforts to remove people with serious, untreated mental illness from the city’s streets and subways. Here’s what you need to know about the plan.
- Behind the Shift:Brian Stettin, the mayor’s counselor for serious mental illness, has worked with a psychiatrist for more than a decade calling for mandatory outpatient treatment for people with a history of refusing medication.
- Involving the Police :The policy will test an already strained relationship between mentally ill people and the NYPD.
- Repel:Advocates for the homeless and the mentally ill, and other politicians, said the policy would face legal challenges and would not address the root causes of the problems, including the lack of housing.
Various elements of the governor’s mental health plan were requested by New York City Mayor Eric Adams in November when he announced his policy of assisting people with serious, untreated mental illness by force, if necessary. Mr. Adams had requested the government to consider the long-term histories of patients and their ability to comply with outpatient care when deciding how long to hold patients, and to improve coordination between hospitals and community caregivers.
The Adams administration warmly welcomed Ms. Hochul’s plan. “We applaud this bold list of proposals and look forward to continuing to improve our progress and address these issues in partnership with the governor,” said Kate Smart, spokesperson for Mr Adams.
One of the key components of Ms. Hochul’s plan is trying to reverse the dire shortage of available hospital beds to treat people with the most acute cases of mental illness.
Since 2014, the number of inpatient psychiatric hospital beds that are expensive to operate in New York City, both in private and government institutions, in New York City and across the state, has decreased by nearly 20 percent. In 2014, there were approximately 6,200 psychiatric beds in state-licensed community-based hospitals; In 2022, there were about 5,000, about 1,200 drops.
The reduction has led to a congested system with not enough beds for anyone seeking care, which means nervous emergency rooms still coping with a pandemic have to pick them up frequently.
Ms. Hochul plans to order hospitals to reopen 850 beds that have gone offline, in part because government officials say it is more profitable for hospitals to divert resources. The governor will also follow through with legislation that will increase the state’s authority to fine hospitals that do not comply with the order, up to $2,000 per day per violation.
Micah Lasher, the governor’s director of policy, said the proposals “are aimed at addressing the economics of the issue for hospitals” after the state failed to persuade hospitals to make beds with other incentives last year.
Additionally, the state plans to build 150 new psychiatric beds in state-run hospitals, 100 of which will be in New York City; this is a significant increase in the treatment of vulnerable patients who sometimes require months of care before being discharged. (The new beds are in addition to the 50 beds that Ms. Hochul announced last year.)
Kenneth E. Raske, president of the Greater New York Hospital Association, said the hospitals “share the governor’s goal of increasing the number of inpatient psychiatric beds available.”
He added that hospitals look forward to working with the government “on the challenges posed by this effort, including hiring the workforce needed to equip beds and the need for additional investment in mental health services.”
For years, the operators of shelters for the mentally ill and advocates for the homeless have complained that overflowing hospitals provide only minimal assistance to people with severe mental illness and do not connect them to the tools they need to work outside the hospital setting. . Homeless Martial Simon, a schizophrenic patient who has been hospitalized at least 20 times, pushed a woman in front of a train last year.
To address this issue, Ms. Hochul’s plan was to fund the creation of a team of approximately 100 clinicians and counselors who would provide outpatient services to more than 5,000 people with serious mental illness throughout the state, about half of them in New York City. Such teams already exist, but they are insufficient, and many programs have waiting lists.
“If they need shelter, they help them, if they need groceries, they help them, and they give them mental health treatment,” Ann Marie T. Sullivan, commissioner for the state’s Office of Mental Health, said in an interview Monday.
Sullivan said the state will require hospitals to carefully coordinate with outpatient teams and follow checklists when they discharge patients under threat of losing their license.
“It’s going to be pretty specific,” he said: “‘Have you contacted the provider who works with this client? Have you spoken to his mother?”
With much of the attention recently focused on the mental health crisis on the streets of New York, Hochul officials presented their plan as a statewide effort to bolster years of underinvestment in a frayed system plagued by shortcomings at every step. .
For example, the government is trying to help vulnerable youth by increasing the number of school-based clinics. The aim of the movement is to fill the gap in mental health programs for schoolchildren whose struggles with anxiety and severe depression have been exacerbated by the pandemic school closures.
The state is seeking to triple the capacity of outpatient community behavior centers from 13 to 39 to target people with milder mental illnesses, such as depression, who may have trouble accessing care.
Hochul officials estimate that his plans will cost at least $1 billion, parts of which must be approved by the Democrat-controlled State Legislature. Most of the funding, approximately $900 million over five years, would go towards building more housing for people with mental illness; The remainder will be spent on recurring operating expenses of at least $130 million per year, officials said.
Jody Rudin, CEO of the Community Living Institute, a nonprofit that provides services and housing to people with severe mental illness in New York City, praised Ms. Hochul’s coordinated approach as “the best prescription a doctor could ever write.”
“This is a transformation plan that has the power to move us from a fragmented system to an inclusive one by building on community-based, trauma-informed programs that help people heal,” said Ms. Rudin.
However, Cal Hedigan, CEO of Community Access, a nonprofit housing and mental health services provider, said in a statement that while she applauded Ms. Hochul’s investment in outpatient services, she was “disturbed” by the fact that most of the housing was not there. The governorship plan, which includes 500 one-room occupancy units and 900 units of medium-term housing, is temporary or transitive.
“We know experimentally that permanent, supportive housing is what is needed and most effective,” he said.