NY Governor Unveils Far-Reaching Plan to Address Mental Illness

ALBANY, N.Y. — New York Gov. Kathy Hochul used her first State of the State address since being elected to a full four-year term in November 2022 to vow to dramatically change the state’s approach to dealing with mental health issues.

The governor’s plan focuses on state-licensed hospitals, which she plans to compel to reopen more than 800 inpatient psychiatric beds that disappeared during the coronavirus pandemic. 

She also wants them to create 3,500 units of housing with supportive services and to expand mental health services in schools, which have seen steep increases in children with mental health concerns since the pandemic.

“When it comes to keeping people safe and protecting their well-being, fixing New York’s mental health care system is essential — and long overdue,” she said on Tuesday. “Even before COVID, rates of mental illness had been on the rise. 

“And since the onset of the pandemic, more than one in three New Yorkers have sought mental health care or know someone who has,” Hochul added.

The plan takes particular aim at helping the hundreds or perhaps thousands of people with serious mental illness who cycle in and out of hospitals, jails and shelters and wind up back on the streets. 

According to the governor, too many people who need serious mental health care can’t get it, and even where such care is marginally available, “the barriers are seemingly endless.”

“No appointments are available close to home. Insurance won’t cover care. There are long waits for psychiatric beds in hospitals,” she said.

“As a result, people have been forced to suffer in silence. Illness grows when it isn’t treated. And the number of people suffering from mental illness continues to grow,” Hochul added.

The net result is a situation that has “become so dire, that it has become a public safety crisis,” she said.

Declaring “the era of ignoring the needs” of those with mental illness is over, Hochul called her plan — which comes with a price tag of $1 billion — “a monumental shift to make sure no one falls through the cracks.”

She also called it “the most significant change since the deinstitutionalization era of the 1970s.”

Over the past decade, the number of inpatient psychiatric hospital beds has fallen by about 20% in New York.

In 2014, there were about 6,200 psychiatric beds in community-based hospitals licensed by the state; by last year, the number had dropped to just 5,000.

The reduction has led to a system unable to serve all those seeking care. As a result, and much like the health care system as a whole, that means emergency rooms still grappling with COVID-19 have become the care provider of last resort.

In addition to the 850 inpatient psychiatric beds she plans to bring back on line, Hochul said the state will add an additional 1,000 inpatient psychiatric beds on top of that, and fund 150 new beds in state facilities.

“This is more than half of the beds we have lost since 2014,” she said. “These actions are overdue.

“Last year, we were asked to increase hospital reimbursement rates to enable psychiatric beds to be financially viable,” the governor said. “We did that, and provided $27.5 million in funding and higher reimbursements. Yet, hundreds of these beds still remain offline. And that’s not acceptable.

“So we will now insist that these beds be brought on line, and seek greater authority for the Office of Mental Health to ensure full cooperation in meeting these objectives. This is a moral imperative, and it is a public safety imperative,” she said.

Hochul also committed the state to investing in services that allow patients to begin reintegrating in a way that is safe for them and for the community.

“We know that supportive housing is a tool for both prevention and recovery. That’s why my plan includes building more than 3,500 residential units, supported by intensive mental health services. … And we’ll make sure that as patients move from one kind of treatment to another, no one gets left behind. Our plan requires facilities to discharge high-risk patients into intensive wraparound services,” she said.

Hochul also announced that she will soon propose legislation that will prohibit insurance companies from denying access to “critical” mental health services.

“Finally, we’re going to focus on our children. Because too many schools provide no mental health support. Our children need preventive services now to stop them from needing intensive services in the future,” she said, adding, “We aim to reduce unmet mental health needs among children by at least half in the next five years.”

Dan can be reached at [email protected] and @DanMcCue