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EDITORIAL: Hochul's ambitious plan to address mental health is desperately needed

Buffalo News - 1/14/2023

Jan. 14—It can't be brushed aside any longer.

New York state is in the midst of a mental health crisis. It has been building for decades and has rapidly escalated since the onset of the pandemic, which saw substantial increases in every category of psychological disorder — from anxiety to obsessive/compulsive to severe mental illness. Between March 2020 and now, more than one in three New Yorkers has either sought mental health care or knows someone who has.

The state's top leaders are finally paying serious attention.

Mental health formed a centerpiece of Gov. Kathy Hochul's State of the State address on Tuesday. In it, she announced a $1 billion initiative that will restore as many as 1,000 psychiatric hospital beds throughout New York and add nearly 50 teams of clinicians and counselors able to deliver outpatient services to people with serious mental illness statewide.

Attorney General Letitia James is coming to Buffalo's downtown library this week (Wed, Jan. 18, 11 a.m.) for a public hearing about this crisis — and she'll get an earful from local health care advocates and others about just how desperate the situation is. Members of the public, advocacy groups and health care providers are encouraged to attend and testify.

The insights and action plans that come out of James' listening tour — this is the second such hearing — should augment and inform Hochul's expansion of the insufficient mental health care resources available in Western New York and elsewhere in the state.

Mental health is a nationwide issue, but Buffalonians can be forgiven for thinking they've been singled out for special attention by the stress gods: The city is coming off a months-long stretch of misfortune that includes a racist massacre that killed 10 residents, a historic blizzard that killed at least 44 and the shocking collapse of Buffalo Bills player Damar Hamlin during a "Monday Night Football" game. Hamlin, now back in Buffalo, seems to be well on the way to recovery.

Aside from the specific circumstances that have led to extra anxiety and stress, New York's ability to deal with mental illness is already handicapped by factors such as these:

—One third of psychiatric beds for children in New York have been lost since 2014. The outpatient and community-based mental health services that were supposed to take the place of inpatient psychiatric care are not adequately funded and can't hire or retain enough qualified staff members. This is why the immediate addition of new beds is a critical element in the new plan.

—Private insurers are notorious for underpaying mental health providers and not covering preventative care, despite the fact that both state and federal law require health insurance plans to cover mental health and substance use disorder treatment in the same way they cover physical health treatment. That's why Hochul wants to close critical gaps in such coverage and prohibit its denial.

—Although hospitals are legally required to evaluate and stabilize anyone who presents at the emergency room with a medical crisis, emergency rooms throughout the state are increasingly less able to handle the demand. Buffalo's single behavioral health emergency room at Erie County Medical Center has recently been reported as overcrowded and overwhelmed, with days-long waits for psychiatric evaluations.

In addition to what's already been cited, Hochul's new plan would add 12 mental health emergency centers throughout the state to ease the pressure on hospitals; triple the number of community behavioral centers — which provide walk-in services — from 13 to 39; and add 3,500 housing units to serve those in crisis and those recovering. It would increase Medicaid payment rates for school-based clinics. It would install requirements that immediately connect high-need patients to wrap-around services, closing the gaps that often occur between emergency visits and follow-up care.

Health care professionals around the state have expressed optimism, especially regarding a commission that will study staffing problems and more within the industry. Educational professionals, too, are heartened by the promise of new resources, including Hamburg School Superintendent Mike Cornell, who cites the need for a mental health counselor in every school, mental health first aid training for all who work in schools and — at best — a dedicated family support center in every district. All that takes money, annual costs that will still be there when a one-time cash infusion has dried up.

"We can't mistake the take-off for the landing," Cornell cautions, adding that sustaining any new initiatives over decades will be key.

What's missing from Hochul's plan? It's probably too early to tell. Unlike many other diseases, mental illness is rarely cured, and its symptoms seldom disappear completely.

If mentally ill New Yorkers are able to get emergency treatment in a timely manner, that's one thing. If in 10 years, most of those people are still receiving effective follow-up care, have safe living conditions, are engaging in various types of meaningful occupations and are able to enjoy appropriate social interactions, let's call that a good measure of success.

We're not there yet. But now, there is new hope.

...

Here are three resources for those in immediate need:

—Crisis services, 716-834-3131, crisisservices.org: Crisis Services is a proven resource for its 24/7 hotline and more. This help is always free of charge.

—Mental Health Advocates of WNY, 716-886-1242, mhawny.org: Non-clinical services that promote mental well-being and provide assistance with navigating the mental health delivery system.

—Suicide and Crisis Lifeline: dial/text 998

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