Transformative Plan to Increase Inpatient Psychiatric Treatment Capacity, Boost Insurance Coverage and Dramatically Expand Outpatient Services
Investments will Create Transitional and Supportive Housing to Serve New Yorkers with Mental Illness; Create Systemic Accountability for Hospital Admissions and Discharges
Governor Hochul: "That's why I was proud to announce a $1 billion commitment to improve access to mental healthcare here in the State of New York. And this is, the most significant change since the deinstitutionalization of the 1970s. It starts with getting more patient beds, more psychiatric beds back online, because right now we have 3,200 New Yorkers struggling with mental illness or addiction who are living on our streets and in the subways."
Hochul: "All this because we care about our people. It's that simple. I don't need a big flashy slogan. We just care about people because that's who we are as New Yorkers. We've always had that in our hearts. That's why the rest of the nation looks to us for all of our policies."
Earlier today, Governor Kathy Hochul announced details of her comprehensive $1 billion multi-year plan to overhaul the continuum of mental health care and drastically reduce the number of individuals with unmet mental health needs throughout the state. First outlined during the 2023 State of the State last month, the plan aims to dramatically expand access to mental health care, reduce wait times and ensure appropriate levels of care to correct a mental health care system that has suffered from chronic underinvestment.
VIDEO of the event is available on YouTube here and in TV quality (h.264, mp4) format here.
AUDIO of the event is available here.
PHOTOS of the event are available on the Governor's Flickr page.
A rush transcript of the Governor's remarks is available below:
Hello. Good morning. Good morning. Buenos dias. It's great to be back here in the Bronx. Oh, thank you. Thank you. All right, first stop after we announced our record-setting transformative budget. Where else would I go but the Bronx, right? Here we are. Here we are.
And we are joined by so many outstanding leaders that you have here in the Bronx. And I want to just acknowledge some of them right now. You'll be hearing from your Senadora, your new Assemblymember turned into a Senator because of all of you, and that is Nathalia Fernandez. Let's get for a big round of applause. Our Senator also from this region is Luis Sepúlveda. Let's recognize him as well.
Dear, dear friend of mine who seems like she's been on the job a really long time, but it hasn't been much more than a year, is your Bronx Borough President, Vanessa Gibson. Let's give her round applause. Our Assemblymember, YudelkaTapia. My good friend is where? Where's Yudelka? All right, save her a seat. Save her a seat. Also, Marjorie Velazquez, our City Councilmember, has joined us. Our OMH Commissioner, Dr. Ann Marie Sullivan is here. Dr. Sullivan. Our OASAS Commissioner, Dr. Chinazo Cunningham is here. Thank you.
The Dean of the Albert Einstein School of Medicine, where we are today. Thank you for hosting us, is Dr. Gordon Tomaselli. Dr. Tomaselli. And everybody knows Dr. Philip Ozuah, our President of Montefiore needs no introduction. Dr. Ozuah. And you'll be hearing also from Yvette Brissett-Andre, the Executive Director of Unique People Services about the services that she provides. Let's give her a round of applause.
And I never forget the formers because you know, they still have to be recognized. You know, you have to - you never forget the contributions we had of our former Bronx Borough President, our great friend, Rubén Díaz Jr. Thank you. And former Assemblymember, Marcos Crespo. Let's give them a round applause as well.
Here we are to talk about something that people haven't talked enough about, and that is mental health. In fact, the mental health crisis that too many New Yorkers are having to endure and for far too long in silence. Today, we break the silence. We say that their voices matter, and that's exactly what we talked about as we set forth our priorities for the State of New York in our budget just released less than 24 hours ago. Mental health will continue to be front and center because that is the core of wellness for our people that they have the services they need if they're falling through the cracks, compassionate care, wraparound services, a place to stay and heal. And that, from this day forward, it'll be a priority of the State of New York because that's what our people deserve.
And I wanted to make this statement of my values and our values as a society here in New York, in the Bronx. I have been here many, many times. We were just here last month at the Bronx Children's Museum, and you think about what a wonderful, uplifting place for children to feel carefree and natural, and sometimes get out of some really tough circumstances they may be going through at home. That's the beginning of good mental health for children. Nurturing places, caring places, letting them know they're loved. And for too long, there have been kids falling behind. And a lot of it happened because of the pandemic, but there was always this quiet underpinning of families not sure what to do with the child that seemed troubled, seemed to be more depressed, seemed to not get along with people, especially as they're growing into those really rough teenage years.
As the first mother Governor in the State of New York, I know all about those teenage years. I survived them. My kids will tell you how they feel, but I think they're doing okay. But I know how hard it is. I know how hard it is at a deeply personal level. There's nothing you want more than your kids to just be okay. And we're here to help. We're here to help to say that that is a commitment from all of us in the State of New York.
And so, mental health has been a form of health care. We think about health care in a beautiful place, and this is an extraordinary place. We're educating the people who will be the ones who save our lives, save societies, help all of us recover from whatever health challenges come our way. This is a place I want to talk about this because in the umbrella of health, we have to elevate mental health and that is what we're doing here today. And this is an area that's been overlooked, underinvested in, and as I mentioned, the pandemic, what it did to people, and I saw this in my own young nieces and that senior year in high school, when you're supposed to be with your friends and going to proms and just feeling fun and like a kid again before you head off into the world. Perhaps going to college, perhaps going to your job, and that was robbed from a lot of kids and their younger siblings saw this. And the paralysis of just being so isolated and all you have to connect you with the outside world is social media. And I don't think there's a single person other than those kids, maybe, who think that's a healthy outlet for them.
So, think about what happened for two solid years, compounding in a pre-existing program problem, making it worse, and now three years later, we haven't regained our footing. We haven't solved the problem. And since the pandemic, more than one in three New Yorkers have sought mental health services or know someone who has. That's a lot of people. Made them our young kids. But people find endless barriers. Even someone who steps up and says, "I have a problem. My child has a problem. I'm ready to get help." Is it easy? They just make a phone call and there's somebody there? Gosh, no. They can't find appointments available, insurance doesn't cover the services, there's long waits if they really need serious services and psychiatric beds. And again, I use the word disinvestment.
I'm old enough to remember the 1970s when the decision was made that the best thing for people receiving care in institutions that did not - they weren't a place of pride for a lot of us. They were not the places that people were getting all the support they need, but they were literally just - the doors were open, and people were like, "Go ahead. You're on your own. Good luck to you. Survive on your own." And for me, at a personal level, my parents were very much social justice activists. They had us involved in everything. We always were either protesting the Vietnam War, marching in civil rights marches. My parents started a home for Puerto Rican kids whose parents were working in the fields.
And they also saw that there was a place called the West Seneca Developmental Center, where hundreds, if not thousands of people, that's where they lived. That was their home, and they were told they're going to be now out on the streets. So, my parents joined a program where young people, in particular, teenagers who'd be let out, 17-18-year-olds, could at least spend time with families and learn how to do basic things. They'd never been in society. They didn't know how to go grocery shopping, I didn't know how to go to a drugstore and buy a tube of toothpaste, and yet, they're going to be on their own. So, I was probably 13, 14. My parents say, "Roger and Melanie are going to come live with us for a while. You're going to take them into town, teach them how to shop, take them to the movie theater. Just help them feel like they're going to be okay." So that was my early exposure to what it was like when all these - I don't know how many Melanie's and Roger's were out there getting up all this support, but I bet a lot weren't. And they ended up on our streets. Many are still there, but they've been joined by so many more because society just turned their eye away and says, "No, we're not going to look any longer. You're on your own." Except, we are looking in the face of these individuals.
Many of them are the people we see on our streets, in our subways. Just trying to figure out how to survive with all the challenges going on that most of us don't have to endure. They're left on their own. And so, it's become a public safety crisis in this sense. A mental health crisis has evolved into a public safety crisis and fear has been generated because some of them really can't control their impulses. They need help. They need to be somewhere getting real help. Not abandoned on our streets. So, New Yorkers are anxious now about what's going on in the subways. It's a natural feeling. You feel this sense of compassion for someone. But you also know I can't let someone hurt my kids. I don't want to get hurt on my way to work. So, there's this tension because New Yorkers have good hearts. They really do. They want to do the right thing. And so, you see people unable to take care of themselves who could harm themselves or harm others, who also are at risk of being victimized.
So, that's why I put mental health front and center. First issue I spoke about, now that the budget has been released, I talked about my State of the State, talk about it non-stop because the era of ignoring mental health needs is over. It is over. We are fundamentally rebuilding from the bottom up our continuum of care. Continuum care means we take care of everybody in the mental health system. It's a monumental shift to make sure that no one else falls through the cracks. And that's why I can talk all day long, but people are going to say, show me the money. Show me the money. That's how we talk in the Bronx, right? Yeah. Okay. Okay. A lot of talk. Show me the money. I know the Bronx.
That's why I was proud to announce a $1 billion commitment to improve access to mental healthcare here in the State of New York. And this is, the most significant change since the deinstitutionalization of the 1970s. It starts with getting more patient beds, more psychiatric beds back online, because right now we have 3,200 New Yorkers struggling with mental illness or addiction who are living on our streets and in the subways. At the same time, we have the need going up - the number of psychiatric beds declined by 20 percent since 2014, doesn't work. And as a result of bed reductions, a large, large number of beds also remain offline in our community hospitals. And there's also a lack of step-down services. I mean, someone comes in, okay, where are you going to go afterward? Are you completely healed, and all done? No, it doesn't work that way. Anybody knows it doesn't work that way. People need constant care, supervision until someday when they don't. So, the lack of step-down services means occupancy rates, sometimes people need to stay longer, and they should be going somewhere. Some are being let out too soon. So, people who are in severe psychological distress are increasingly more visible on our streets and are falling through what we called a broken system.
We can and we must, and we will do better. Our plan is to add 1,000 inpatient beds by funding 150 beds at state facilities and bring 850 psych beds back online in hospitals. That's more than half the beds we lost since 2014, and we'll serve over 10,000 New Yorkers annually, and I wanted to come to this place. Because I want to give a special shout out to Montefiore. They never, they never, they never closed any of their 103 beds, 55 of which are in the Bronx, even at the height of the pandemic. And I thank you for that. I thank you Dr. Ozuah. I thank you.
And even when times are tough, you said people still need care and I shared that philosophy. But we have to also go beyond patient beds. We're investing in transitional and longer-term supportive housing because that's a tool for prevention and recovery. And we have to make sure that people don't get backed up in hospitals and when it's time to be able to go, they have to have a place to go. So, our plan includes 3,500 residential units supported by intensive mental health services. That's how you help these people and make sure that people don't get left behind.
So, facilities that just charge high risk individuals have to put them into intensive wraparound services and we're going to help. The state will help you. We have tolook after them. We have to check in on them. We have to connect them with resources, perhaps a job. Whatever they're going to need, we're going to have to give it. Or else they cycle right back to where they started. That's what we have tostop from happening again. And we want to provide those services in the least restrictive setting. And so, our plan expands outpatient services well, assertive community treatment, safe option support, and intensive and sustained treatment and engagement.
So, that's what we're going to do. But how you're going to pay for it? Yes, we have our billion dollars, but I also think insurance companies should treat this as a health issue. So, we are going to - as part of my budget package, we are proposing legislation to ensure that insurance companies are prohibited from denying access to mental health services. Because if you can't have insurance and you're supposed to pay for it out of your pocket, it's not going to happen. And cost insurance barriers should never be a reason people don't get the help they need. Also, employment. Employment is an important part of the recovery process. My plan will expand individual support, connecting people to jobs and opportunities, job training, and help adults with mental illness.
Find a job that makes them feel like they have dignity, that their lives matter, that they're contributing, that they have value. Because right now, when they're layingon a street corner, they don't feel that, and my God, they're still God's children and we can never forget that. And we have the power. All these services and the leadership team that I've assembled, and all the people here, the elected leaders, community leaders, the providers, our doctors, nurses, we are all joined in this common pursuit of just doing what's right for these people. So, giving them a job is so important.
But what about the young ones who aren't old enough to have a job? The ones I talked about at the outset. Too many schools have no mental health support. In fact, in New York City, the Comptroller's audit determined that 37 percent of schools in New York City have no services for mental health whatsoever. Now I'd like to see the school that can say to me that not a single one of their students doesn't have a problem at all. They're all just doing just fine. I have yet to see that school. Until that time, I believe that our schools are also part of this continuum of care, because that's where kids are going to spend most of their day. That's where they're going to have adults who are trained to know when something's not quite right and they need mental health services. And kids who don't get help, it puts them in a disadvantage in the classroom and beyond and it sets them up for failure. So, our children need preventative services now to stop them from needing intensive services later.
That's why we do this preemptively. And we will make sure that we stop ignoring this, because we know teenage emergency room visits are way up. There's been a 40 percent increase in the last few years of teens reporting to sadness and depression. Again, I have a lot of young people in my family. I observe everybody, and I'm not going to just blame social media, but I'm so glad my kids weren't exposed to that because you just don't feel good. You're always being compared to others, and you always have this sense of inferiority that adults weren't subjected to. Yeah, there's bullying around everybody, but this is sustained when that is your connection to the rest of the world and that pervasive negativity just eats at your soul and you don't feel you have value. We have to counter that.
Parents need to know that's what's going on in their houses, so we've got to help these kids too. You know, a teenager, think about a teenager starting off as a sophomore in high school, having to finish remotely, finishing middle school remotely. A lot of them have anxiety. They need these services. And that's why I'm investing money into the system - $10 million to expand school-based mental health services across the state, and $10 million to strengthen suicide prevention programs for at-risk youth.
We'll also have $12 million in what we call the Healthy Steps Program and Home-Based Crisis intervention teams, to go out where the kids are. And my goal is to reduce the unmet mental health needs of our children by half in the next five years. That's ambitious, that's bold, but we have no choice. And you think about the ripple effects of all this - anxiety, depression. Deaths from overdose drugs rose 58 percent from 2018 to 2021. And I've been studying this a long time, probably 15 years when I was back, actually longer, when I was back on my town board, local councilmember. We started seeing teenagers overdosing from heroin in my hometown. And everybody's like, "Where's this coming from? And where'd the addictions start?" Well, a lot of it was prescribed by a doctor at the time.
I remember my kids were in middle school when this was going on, and both my kids had their wisdom teeth out, and they're given a 60-day supply of Hydrocodone to deal with one day surgery on their mouth. I knew about the danger of this because I was already seeing the police data in my town of the overdoses. So, I didn't feel very - they, they thought I was kind of heartless, but I said, "Take an aspirin and suck it up. You'll be fine." But a lot of parents didn't know this. And my own nephew had a workplace injury as a teenager, working at a delicatessen, cut his hand. And they prescribed the drugs to make him feel better, get over the pain. But after 17 days, your brain chemistry changes, and addiction starts to develop. That happened to my nephew, led to a decade of in and out of services. Can't find services - jail. The stress on the family was immeasurable, and that's just one family out of millions. So, I know what this can do. Opioid addiction, and often now fentanyl, can literally grab you by the throat and strangle you. It doesn't let you go.
So, we're going to work with our state and federal partners, with our local partners. We have to stop the flow of these drugs from coming into our state, but we also have to deal with the impact of the addiction that exists now. And this is something we are laser-focused on. We're going to keep focusing on life-saving initiatives, expanding access to critical harm reduction tools like fentanyl test strips - literally allowing people to come into a facility and have it tested whether or not the drug they want to use is laced with fentanyl. Now that seems pretty extreme, but I believe it'll save lives. I believe we have to take that step to let them test. We have to spend the money, get the test kits out, make sure that that happens. And I'm going to have a new interagency task force to examine every aspect of this.
So, we're going to be transformative in the mental health space. Also, a billion dollars and not the same, another billion dollars, for the health care system overall to help with capital because we have to continue to help our hospitals expand, grow, meet the needs they have to. Expand Medicaid coverage for 7.7 million more low-income New Yorkers, increase more access to aging services for our seniors in long-term care. And all this because we care about our people. It's that simple. I don't need a big flashy slogan. We just care about people because that's who we are as New Yorkers. We've always had that in our hearts. That's why the rest of the nation looks to us for all of our policies. "What is New York doing? They always do it best. They're so smart. They're so innovative, and they're so compassionate." And that's what this is all about.
Am I bragging like a New Yorker? That's okay. I think a really smart guy like Albert Einstein would agree with what I just said too. So, thank you. Thank you for being part of our team, people who do care and all of you have a different role to play. I know my role, all of you have a role to play to help lift up our people. So, when our time on this earth is over, when people say - the maker's going to say to you, "What did you do? Did you make a difference? Did you make someone's life just a little bit better because of what you did?" I believe that every single person in this room will be able to answer with a resounding yes. Yes, because I cared and I made a difference.
That's how I judge myself. That's how I expect to be judged. And today we're going forth to show some of our most vulnerable residents that we care. Thank you very much, and with that - thank you. Thank you, thank you. Let me bring up - thank you. Thank you, thank you. Let me bring up our extraordinary Senator, Nathalia Fernandez.
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