The state’s recent investments in mental health care have been commendable, but there is still a need for targeted investments to support children with significant behavioral health needs.
New York has been at the forefront of child welfare reform with a substantial decrease in the use of out-of-home care over the past 30 years. The state’s focus on preventive services has positively impacted the lives of numerous young individuals, enabling them to thrive with community-based support. Whenever possible, it is preferable to keep children in their homes and communities, both for their well-being and fiscal prudence.
However, what about the children who require care beyond what the home environment can provide? The savings from the reduction in out-of-home care have not been reinvested in quality children’s services, resulting in the closure of more than half of New York’s residential treatment beds for children with significant mental health challenges. In 2012, there were 554 beds available, but by 2022, there are only 274 remaining.
The lack of appropriate placement options has forced residential treatment centers to admit children whose needs surpass the level of care these programs are designed and licensed to provide. This has resulted in severe consequences, including increased violence on residential campuses and in surrounding communities, as well as a rise in self-harm and suicide attempts among young people. Furthermore, these improper placements divert resources away from children who should be appropriately placed at the centers. This crisis is not limited to New York, but is being experienced by providers across the country.
New York’s young people need comprehensive solutions to address these issues.
We must establish placements for the small number of critically ill children whose complex mental health needs cannot be adequately met in a residential treatment center. This will ensure the safety of all children by providing them with appropriate care in suitable settings. Additionally, the state-set foster care rates should be adjusted to account for the significant expenses incurred by providers when caring for high-acuity youth. Capital funding from the Office of Mental Health should be utilized to strengthen the capacity of residential treatment centers.
In the long run, New York should approve and invest in “intensive services models” that would equip providers with the necessary tools and resources to properly care for high-acuity youth.
Lastly, the state needs to invest in the child welfare and children’s behavioral health workforce. All programs are facing significant challenges in recruiting and retaining staff due to chronically low wages set by government contracts.
New York urgently needs to expand its continuum of care by providing enough placement options for children with the greatest levels of need. The children and youth being served, as well as our communities, deserve better.
Assemblyman Andrew Hevesi, D-Queens, represents the 28th Assembly District. Kathleen Brady-Stepien is president and CEO of the Council of Family and Child Caring Agencies, representing the state’s child welfare nonprofit organizations.
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