NY faces a mental health crisis. Hochul plans to invest $1B to fix it

New York Gov. Kathy Hochul on Tuesday revealed a $1 billion plan to tackle mental health crises connected to rising crime and inequality in housing and health, as well as mounting concerns about pandemic-related trauma suffered by children.

The Democratic governor’s sweeping proposal to create thousands of housing units for New Yorkers with mental illnesses and reverse decades of disinvestment in inpatient mental health care is part of her State of the State address being delivered in Albany.

The fate of Hochul’s mental health plan will be debated during the state budget process, which will unfold in coming months before the April 1 budget deadline.

FILE – New York Police Department officers wake up sleeping passengers and direct them to the exits at the 207th Street station on the A train, Thursday, April 30, 2020, in the Manhattan borough of New York. In New York City’s latest effort to address a mental health crisis on its streets and subways, Mayor Eric Adams announced Tuesday, Nov. 29, 2022, that authorities would more aggressively intervene to help people in need of treatment.

Among Hochul’s mental health plans:

  • Increasing capacity for inpatient psychiatric treatment by 1,000 beds: During the COVID-19 public health emergency, the state allowed hospitals to take inpatient psychiatric beds offline. Hochul’s plan directs community hospitals to immediately bring 850 currently offline inpatient psychiatric beds online.

  • Hospitals will face fines of up to $2,000 per violation, per day for failing to comply with the number of psychiatric beds outlined in their operating certificate.

  • The state will also open 150 new adult beds in state-operated psychiatric hospitals, including 100 in New York City alone. That is in addition to 50 beds announced last November.

  • Creating 3,500 new housing units for individuals with mental illness. That includes 1,500 supportive units split between rental units that can be opened quickly and new construction or renovated units completed over the next five years. Hundreds of other units will serve people with varying levels of need and homelessness risks.

Why is Hochul’s $1 billion mental health plan needed now?

New York Gov. Kathy Hochul, delivers her address during her inauguration ceremony, Sunday, Jan. 1, 2023, in Albany, N.Y. (AP Photo/Hans Pennink)

As New York emerged from the pandemic, concerns surrounding mentally ill people driving spikes in violent crime in New York City became a key issue during November’s elections, and contributed to several downstate Republicans victories.

Hochul won a historically close race against Republican Rep. Lee Zeldin. Since then, New York City Mayor Eric Adams, a Democrat, has urged state lawmakers to make mental health reforms, including support for a New York City measure that allows authorities to pursue more involuntary psychiatric inpatient care.

CDC study: Abuse, violence, other events linked to poor mental health in teens during COVID pandemic

One reason for the need is that New York’s health system has closed hundreds of inpatient psychiatric beds in recent decades, in part, due to national industry trends away from the costly care in favor of more profitable health services.

In 2000, for example, New York had 6,055 certified inpatient psychiatric beds. By 2018 that number had dropped 12% to 5,419, with most of the decline involving New York City and Long Island, a nurses’ union report shows.

“We have underinvested in mental health care for so long, and allowed the situation to become so dire, that it has become a public safety crisis, as well,” Hochul said Tuesday.

Advocates for people with mental illnesses protest New York City Mayor Eric Adams’ plan to force people from the streets and into mental health treatment, on Wednesday, Dec. 7, 2022, in New York.

The plan will also expand a range of outpatient services to expand mental health care access, reduce wait times, and ensure appropriate levels of care, she added. It will also close gaps in insurance coverage for mental health services.

Insurance companies would be barred from denying access to medically necessary, high-need, acute and crisis mental health services for both adults and children under the plan. Commercial and Medicaid coverage of mental health services would also be expanded.

How Hochul’s $1B mental health plan addresses kids

While inpatient psychiatric bed needs are most dire in New York City, concerns about mental health declines in children are mounting statewide and nationally.

Experts warn more kids are reporting rises in traumatic experiences, anxiety and other mental health issues in recent years, as earlier problems linked to pandemic lockdowns remained an issue.

Hochul’s plan will expand access to mental health services in schools by increasing Medicaid payment rates for school-based satellite clinics and school-based wraparound services.

The proposal will also introduce legislation requiring commercial insurance providers to pay for school-based services at a level equal to the higher paying Medicaid rate, to ensure timely access for all children, she said.

The plan also outlines an annual investment to provide the start-up funding necessary to get new and expanded school services in operation quickly.

This article originally appeared on New York State Team: Mental health in NY targeted with $1B plan to fix crises