With the pandemic fueling a crisis in children’s mental health in New York City and beyond, a new team of community workers is now providing around-the-clock support to young people who might otherwise end up in psychiatric hospitals or contemplating suicide.
The urgent mission is being launched this month by one of the state’s oldest nonprofit social service groups, which goes by the acronym JCCA. The effort has begun in Brooklyn, serving youth ages 10 to 21 and providing mental and behavioral health support.
The first of 15 teams envisioned citywide, clinicians will work directly with families in their neighborhood to help stabilize troubled young people and avoid the need for hospitalization, school disruption, arrest and other negative outcomes.
“We not only want to address their day-to-day struggles, but also help them learn how to navigate the day-to-day challenges of life with mental illness,” said JCCA’s CEO Ronald Richter.
Young people who have undergone multiple hospitalizations, those who haven’t adapted well to traditional treatments and those who are in need of emergency psychiatric services will be eligible to receive the team’s assistance.
The $21 million initiative is funded by the New York Office of Mental Health, and will involve psychiatric nurse practitioners and other licensed mental health professionals, an educational and a clinical support specialist, among others.
Team members will meet twice weekly in the communities where the participants live — at schools, homes or community centers. Their direct services will include case management, support with school-related issues and coordination of care providers.
As in a hospital, “we all go through every single case every morning, and stay in constant communication with each other in order to provide the care that is needed,” said Ricardo Bermudez, JCCA program director and team leader.
The work could not be more timely, he added, and is a necessary response to the “very intense need” for expansive mental health services in the state. Bermudez has been troubled to see an increase in suicidality among young people he serves.
According to a 2021 report by New York’s Coalition for Behavioral Health, the pandemic brought on a 77% increase in demand for state behavioral health services, and 35%of parents reported negative impacts on their child’s emotional and behavioral health.
These statistics mirror national trends during the pandemic.
Yet mental health advocates in New York say the problem emerged well before COVID-19, in 2014, when former Gov. Andrew Cuomo (D) approved shifting state funding from inpatient hospital-based services to outpatient, community-based programs. Millions of dollars were subsequently spent redesigning statewide mental health care, and reducing the number of beds at psychiatric facilities.
The shift eliminated nearly one-third of all pediatric psychiatric hospital beds in the state. At the same time, due to innovations in the child welfare field, the number of residential treatment beds for children over the last 10 years has also been cut in half. Without proper community-based support for mental health care, vulnerable children have been left in jeopardy, advocates say.
To better serve them, Gov. Kathy Hochul (D) has approved $4.7 billion in spending for New York’s Office of Mental Health for the coming fiscal year, an $800 million boost over last year’s spending. The new investment will fund a range of programs that serve children — from residential treatment centers to the newly created crisis intervention team. Out of these funds, a $27.5 million annual investment will go toward increasing the number of psychiatric beds available for children across the state.
Leaders of child welfare agencies say the funds, while welcome, still fall short of the need, given how many years the youth mental health crisis in the state has been growing.
In March, a lawsuit was filed in federal court claiming New York hasn’t addressed the “well-known and longstanding failure” to provide critical mental health services to children on Medicaid. The legal action brought against commissioners of the state’s department of health and office of mental health claims the state continues to violate marginalized groups including young people from low-income families, children of color and LGBTQIA+ youth.
Children who experience mental health crises too often end up confronted by law enforcement officers rather than clinicians able to respond to emergencies — confrontations that can be particularly hazardous for Black and brown youth perceived as a threat.
One of the plaintiffs in the ongoing suit, a 13-year-old Black girl referred to as C.W., was diagnosed with attention-deficit/hyperactivity disorder, anxiety, chronic stress, schizophrenia and other mental health disorders. The conditions have caused her to struggle in school and with her family, and have made it difficult for her to engage in youthful activities.
C.W.’s doctor prescribed intensive home-based mental health services, and in 2018 her mother was told her daughter was on a waiting list for the urgently needed care. She was then referred to a psychosocial rehabilitation center, but four months later still hadn’t received any treatments.
According to court documents, C.W.’s mental health worsened in that period, and she became “verbally and physically aggressive,” harmed herself, and had suicidal thoughts.
After the suit was filed highlighting tragically avoidable downward spirals like C.W.’s, in June, New York Attorney General Letitia James held a public hearing to speak with mental health advocates, parents and social service agency directors.
“When a child is in crisis, parents or caretakers have only two options: go to the ER [or] call 911,” James said at the hearing. “Too often, as we’ve seen in our office, they’ve had run-ins with the police that only make the situation that much worse.”
CEO Richter, a former Legal Aid attorney, New York City Family Court judge and commissioner of New York City’s Administration for Children’s Services, also gave testimony. He said among the children that he serves who experience psychiatric crises, at times they are denied evaluations because emergency rooms are overwhelmed and there’s no place to discharge them. He argued that groups like his need an even greater public investment to properly serve these youth.
Richter said the community team in Brooklyn is a starting point to expand statewide. Four clients are being served so far, with plans to expand to 48.