This approach has changed dramatically since the 1950s, with public psychiatric beds reduced by over 90%. The effects were mixed. Some individuals found improved care through community-based outpatient services. Yet, this also resulted in others facing homelessness, imprisonment, or engaging in violent behaviors.
The good news is that tax evasion issues in New York are being addressed. Since Governor Kathy Hochul took office in August 2021, there’s been a push to enhance the availability of psychiatric beds, with over 300 new ones added.
Hochul’s actions have included investing in state psychiatric facilities, increasing Medicaid rebates for psychiatric beds in general hospitals, and replenishing facilities that had been reduced during the COVID-19 pandemic. These initiatives aim to benefit individuals with serious mental disorders, their families, and the wider urban community.
In contrast, former Governor Andrew Cuomo had a reputation for slashing bed numbers. He argued that reallocating resources from institutional care to community programs would lead to better care and lower costs. However, his cuts coincided with a rise in emergency calls to the NYPD for “emotionally disturbed” individuals, while expenditures on mental health shelters increased and more people were imprisoned.
Essentially, what was framed as a cost-effective shift turned into a burden on local city resources. Thankfully, Hochul’s administration appears to be reversing some of this trend.
While mental health pressures on shelters and police services still loom large, they are not escalating at the same pace as they did during Cuomo’s era of deinstitutionalization. Yet, experts highlight that New York still has significantly fewer public mental hospital beds than what is recommended.
Advocates for increased national investment in inpatient psychiatric care face hurdles. For one, Hochul had to allocate substantial funds to secure additional beds through the state legislature, favoring community programs that some critics believe undermine the integrity of institutional care services. Future budgets are anticipated to be more restrictive, according to state fiscal watchdogs.
Moreover, with the focus on serious mental illness, a targeted approach is essential, but it’s often easier said than done politically.
Additionally, Mayor Eric Adams has been a vital proponent of sound mental health policies. His potential loss in the upcoming election could pose a significant setback for reform, especially as he addresses the most resistant cases.
Adams and Hochul have worked well together, but recent disagreements hint at the political turbulence between city and state leadership, particularly concerning mental health issues.
New York state needs to take charge. With its regulatory authority and oversight of Medicaid and the institutional framework, it holds a prime position for advancing substantial mental health reforms.
At the federal level, congressional action is needed to enhance Medicaid funding for inpatient care in specialized mental health facilities. A recent positive development came when Brooklyn Democrat Dan Goldman introduced legislation aimed at this goal.
Goldman’s bill, named the Michelle Alyssa Go Act after a subway victim with mental health challenges, is a step forward.
The mayor’s role is critical as the primary communicator. While state authorities can exert influence, citizens often look to the mayor for guidance on pressing issues, like the mental health crisis.
Adams has moved away from the narrative that the current state of mental health services has failed those with serious conditions, putting both them and the community at risk.
It’s a perspective the average subway commuter can identify with. The upcoming election on November 4th could shape the future of mental health reforms initiated by Adams and Hochul.
