Shared from the 6/28/2019 Albany Times Union eEdition


A matter of mental health

Since the 1950s, New York has been moving people with serious mental illness out of institutions. The effort had two commendable goals: to integrate these people as much as possible into society, and to reduce the huge cost of institutionalization.

There’s every indication, though, that in the state’s view, it’s no longer enough to save money on institutionalization. There seems to be a new threshold: saving money on deinstitutionalization.

Where that has left the mental health system depends on whom you ask. Gov. Andrew Cuomo’s administration no doubt wants the public to believe it’s doing a good job of managing care while working within the governor’s spending caps. And mental health advocates say care is suffering.

We all need to know who’s right.

The numbers suggest the system is under increasing strain. Over the past decade, state spending on mental health has declined from just under $2 billion to $1.3 billion. If spending had kept up with inflation, it would need to be $2.4 billion today. And that doesn’t factor in the growth in the population in the mental health system — more than 770,000, compared with 717,000 in 2011, according to the state’s own estimates.

Mental health advocates note that the needs of people entering the system have changed. They’re no longer formerly institutionalized patients somewhat used to rules and routines, who were taking only a couple of medications to control their illnesses. Now they tend to come off the streets, require more intensive management and rely on a whole range of drugs. All this is run largely by workers who earn around minimum wage — which, incidentally, is rising under state law, even as state funding doesn’t keep up.

Seeking a window onto this situation, the Legislature this year passed a bill — unanimously in both chambers — to have a commission examine one piece of the system: housing for people with mental illness. The state Office of Mental Health contracts with local governments and nonprofits to provide about 40,000 units of supportive housing and services for adults with severe psychiatric disabilities.

Now advocates worry that the governor will veto the bill. Much as he may be reluctant to have an impartial look at consequences of his budget choices, though, Mr. Cuomo should sign it. This is an issue that could affect all New Yorkers, with all sorts of fiscal and social implications — pressure on local governments and taxpayers to make up for state funding cuts, greater pressure on institutions, hospitals, jails, shelters, police and courts, and the danger posed by having severely mentally ill people untreated and on the streets.

It’s a matter of human dignity to allow and enable mentally ill people to live in the least restrictive environment possible. And it’s a matter of public interest and safety that it be done right, which includes adequate funding. A half-century into this experiment, it’s worth knowing if New York is still on that noble track.

THE ISSUE: State lawmakers want a commission to look at whether certain programs for mentally ill people are adequately funded.

THE STAKES: Shortchanging these programs affects not just clients, but all New Yorkers.


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