Gov Cuomo, Legislature Can Be Heroes for Children with Mental Illness

By Andrea Smyth | March 11, 2021

Buried but no less important in the heap of human conditions made worse by the pandemic is the incredible impact on children’s behavioral health.

Incidents of depression, anxiety, drug abuse, inability to regulate emotions, self-destructive behaviors like cutting, and heart-wrenching outbursts – they’re up. They’re up in ways that impede the lives not only of the children and adolescents, but their families, friends and neighbors.

Centers for Disease Control data show emergency room visits by Americans under age 18 have increased dramatically since the shutdowns began a year ago.

Know what’s down? Not only available space in New York’s residential treatment programs, but investment in the type of intensive community mental health services kids need to lead happier, safer, more productive lives.

Over the last two years, the Cuomo administration has ignored the warning signs that intensive residential mental health programs operated by nonprofits and serving youth ages 9-21 were at risk of closing. But more troubling, the administration never invested into the community-based programs to which those New Yorkers turn when the residential opportunities are shut down.

In other words, the Cuomo administration kicked countless young people with mental health issues off the island but never gave them boats to get ashore. These kids and their families have been left adrift in the rough waters of despair, depression, self-damage and ideas of suicide.

And yet, despite this darkness, there’s hope. With the passage of President Biden’s stimulus package this week, Gov. Cuomo, the Senate and the Assembly have an opportunity to help these youth and their families rise out of the depths.

Between the December stimulus package and the American Rescue Plan, New York State will receive some $300 million for mental health. Since another $40 million is being saved by residential treatment facility closures, the State Budget agreement could make a $100 million investment in intensive children’s mental health community services.

Investments like that would reverse a dangerous trend in our state and a precarious situation for children with debilitating mental and behavioral illnesses and their and families

Since 2019, the number of residential treatment beds for children who need the most intensive mental health treatment is down 40 percent. Not long ago, a non-profit announced it would close three children’s residential treatment facilities, about 28% of the state’s capacity.

Moving children out of residential facilities may be the right policy – but only if there is a well-designed plan that invests the resources saved by downsizing into intensive, accessible community-based services that match the very complex needs of the children and families where they live and go to school.

The latest downsizing announcement and downward trend in residential is not a dog whistle to save residential services. It’s a desperate cry for help to significantly invest in and strengthen community services. How bad is the system struggling?

• Only about one in five public schools have school-based mental health clinics.

• Forty-six children’s community service providers have closed since November 2020 – that is, since Election Day — resulting in 49 out of 56 counties with fewer, not more, home and community-based services.

• There are 12 intensive residential facilities left to serve the entire state. Meanwhile, the Cuomo administration has yet to modernize the process for approving children for admission, despite a statutory requirement that it do so.

While the expansion of services would require investment in the short-term, mental health experts believed that it would ultimately save taxpayers many millions of dollars, preventing expensive—and traumatic—events like emergency room visits, foster care placements, and juvenile arrests, not to mention life-long health and mental health problems in adulthood.

Vaccinations, collaborative public health measures and respect for our fellow human beings are hopefully leading us out of the worst of the pandemic. One day life will return to some semblance of normal.

While that may be so for many of us, our children with behavioral health problems will suffer long after. In fact, the problems manifested by the last year will probably worsen unless something is done now.

Gov. Cuomo and the Legislature have an opportunity to make a tremendous difference. They should grab it.

Andrea Smyth is Executive Director of New York State Coalition for Children’s Behavioral Health, which advocates for non-profit children’s behavioral health service agencies and the families they serve.