In addition, the state would open 150 new adult beds in state psychiatric hospitals—including 100 in the city alone—in addition to the 50 open beds Hochul announced in November 2022.
The governor would also make a capital investment to fund 3,500 new residential units for New Yorkers living with mental illness. Those would include 500 community residence single-room occupancy units to house and provide services to people with serious mental illness, 900 transitional units for people moving into community-based living, 600 licensed apartment units for people who need some services to live in their communities and 1,500 supportive housing units for people with serious mental illness. The supportive housing units would include scattered-site rentals and new construction or renovation that would be completed in the next five years.
Hochul’s plan includes measures designed to increase accountability for admissions and discharges. Hospitals would be required to “responsibly admit patients in need of care” with new evaluation standards and increased state oversight. Emergency departments and inpatient providers would be required to discharge high-risk, high-need New Yorkers into immediately available services, such as housing or job support. Outpatient programs would be required to provide immediate and ongoing appointments for high-risk patients during the discharge process.
According to Hochul’s office, 50 new Critical Time Intervention teams of workers would be created to help patients transition into services after discharge.
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These proposed policy changes and investments address the continuum of care issues that were highlighted by a Crain’s investigation that found many hospitals do not admit seriously mentally ill patients, instead bouncing them out of emergency rooms with prescriptions in a cycle referred to as the institutional circuit.
Crain’s, moreover, has found that more than 1,000 New Yorkers are on waiting lists for community programs for serious mental illness, highlighting a need for better connection between inpatient and outpatient services and increased capacity.
Hochul’s plan comes into play after Mayor Eric Adams announced his own plan to address mental health in November. His plan includes a directive that re-emphasizes that police, emergency medical professionals and outreach workers are authorized under existing state law to involuntarily transport patients to hospitals who seem to be unable to meet their own basic needs.
Advocates have called Adams’ plan unconstitutional and unacceptable; the mayor has responded by saying his plan is tailored and will not violate laws.
Meanwhile, Hochul’s plan involves expanded outpatient services that seek to widen care access. The plan would add 12 comprehensive psychiatric emergency programs throughout the state; 42 Assertive Community Treatment teams (22 in the city) that will offer high-intensity mobile services; 26 Certified Community Behavioral Health Clinics for walk-in behavioral health care, including substance use disorder treatment; eight Safe Options Support teams (five in the city) to do outreach work; 20 expanded-capacity Article 31 mental health clinics; and Health Home Plus care management.
The governor also plans to prohibit insurance companies from denying adult and child patients access to medically necessary high-need, acute and crisis mental health services.
The governor’s State of the State address began at 1 p.m. today.
This story first appeared in Crain's New York Business.