PEF members and staff pose for a photo before the hearing. Left to right: PEF Field Representative Anthony Rios, Leticia Rivera, Michele Rosello, PEF Council Leader Tamara Martin (NYC AG’s office), and Carl Ankrah.
June 27, 2022 — PEF leaders testified on June 22 in New York City about the strained state of New York mental health services at a hearing held by Attorney General Letitia (Tish) James.
James was already very concerned about the gap between the need for mental health services and the availability of those services when she called the hearing.
“There is no doubt that New York is in the midst of a mental health crisis that has only worsened during the COVID-19 pandemic,” James said. “For decades, New York has seen a decline of short-term inpatient psychiatric beds, which are critical to providing consistent and thorough mental health care in our communities. With this hearing, I intend to spotlight this crucial issue, explore potential areas of reform, and inform my office for future investigations into allegations of inadequate mental health treatment.”
Three PEF leaders from the state Office of Mental Health testified in person and PEF President Wayne Spence submitted written testimony. The local leaders were: PEF Executive Board member Carl Ankrah, a nurse practitioner at PEF Council Leader at Rockland Psychiatric Center; Council Leader Michele Rosello of Division 241 at Creedmoor Psychiatric Center in Queens where she is a licensed master social worker 2; and Division 213 Council Leader and Executive Board member Leticia Rivera, who is an intensive case manager at Bronx Psychiatric Center. They were among many witnesses testifying, including state Senate Healthcare Committee Chair Gustavo Rivera.
No state agency commissioners spoke, but James received a brief written statement from the Office of Mental Health during the hearing and read it into the record.
Both James and numerous witnesses praised Gov. Kathy Hochul and the state Legislature for increasing funding for mental health services in the current budget, but they noted that it is just a start that will need many more years of support to bridge the existing gap.
James said since the pandemic began, approximately 400 inpatient psychiatric beds have been eliminated, converted to COVID-related or general medical use, or been completely taken out of commission. This year, it is estimated that there are fewer than 5,000 adult, short-term, inpatient psychiatric beds in hospitals across the state.
James also cited reports from ProPublica, that New York has just 274 psychiatric beds for children and adolescents.
The attorney general expressed concern that the lack of access to inpatient psychiatric care leads to increased homelessness, incarceration, and more frequent hospital visits. As COVID-related hospital visits decline, emergency departments are overwhelmed by individuals who require more intensive psychiatric services, but are unable to access necessary psychiatric inpatient beds or services in the community, which can exacerbate their illness.
The testimony of the many witnesses only corroborated James’ concerns.
In her testimony, Leticia Rivera cited the Cuomo administration’s “Transformation Agenda” as a key factor in the diminishment of services. She cited the “steep rise in suicides, crime and homelessness in every community across the state” as evidence of the damage that has resulted. She said the term transformation equated to privatization of services.
OMH has shed more than 25,000 positions since 1990, causing the agency’s reliance on overtime to explode, Rivera said. Since 2011, OT has shot up 65 percent at OMH and cost state taxpayers $157 million in 2020. She added the agency has reduced its patient bed capacity by 2,000 since 2016.
Not only is the state’s capacity to treat inpatients greatly reduced, but critical programs such as state-operated Assertive Community Treatment (ACT) teams that provide immediate triage for persons in crisis have suffered funding cuts.
“Even with the state ‘reinvesting’ savings from these reductions to critical state programs into privately operated providers, the state’s overall inpatient bed capacity still doesn’t meet the basic minimum standards prescribed by the Treatment Advocacy Center that recommends 50 beds per 10,000 residents,” Rivera said. New York is short of that standard by 1,700 inpatient beds.
That’s why PEF “continues to advocate that New York ‘Fund Our Future’ by expanding public services for mentally ill and other at-risk individuals to ensure appropriate and continuous access to quality care for all New Yorkers” with the goal of keeping them close to their families and other support systems, Rivera said.
Ankrah also called for the state to stop privatizing its mental health safety net system. He said the state should take four steps to improve that system:
- Reject consolidating the Children’s Psychiatric Unit at Hutchings Psychiatric Center in Syracuse into SUNY Upstate Medical Center;
- Re-establish the planned 15 private Youth Assertive Community Treatment Teams as public entities and reallocate the $21 million in taxpayer funding for the teams accordingly;
- Establish 14 public ACT teams for adults, instead of the 14 private teams that are planned. The $14 million in funding should be switched to support the state-operated teams; and
- Expand state staffing and inpatient stabilization capacity to treat the mentally ill and those suffering from co-occurring disorders such as addiction or developmental disabilities.
Rosello added that New York must dedicate more funding to support its state-operated mental health services, and she noted that although the state-operated programs treat the most difficult cases, they still have fewer clients seeking hospital emergency room services than the privately operated programs.
“In sum,” Ankrah said, “the continuing outsourcing, consolidation and closure of programs and services operated by the Office of Mental Health, coupled with the reduction of staff and the physical beds dedicated to serving the mentally ill, have been disproportionally harming low-income, uninsured, underinsured, undocumented and severely handicapped New Yorkers.
“It needs to end.”
WATCH: PEF members testify before AG James on mental health services (PEF testimony starts at about 3:03:00)
READ: PEF President Wayne Spence’s written testimony on mental health services