Hochul pitches $1 billion mental health plan, but barriers to access remain

Hochul pitches $1 billion mental health plan

Advocates say funding may not be enough to equalize resources for marginalized communities.
Published: February 12, 2023
a hand grasping for health resources on the outline of New York State

When New York Gov. Kathy Hochul outlined her administration’s $1 billion plan to “fix New York State’s continuum of mental health care,” the news was praised by healthcare industry experts. President and CEO at Spectrum Health and Human Services, Cindy Voelker, welcomed the plan in an interview with The Buffalo News:

“I was really impressed and just thrilled… to see it actually happen — that she really understands the situation and really has ideas that make sense and that could really help — was the most positive thing I’ve seen in the last few years.”

Hochul’s project seeks to increase the total bed capacity for inpatient psychiatric treatment by 1,000, create 3,500 housing units for the state’s mental health services, increase mental health insurance coverage, and expand outpatient services through the $1 billion commitment.

The plan, announced by Hochul in her 2023 State of the State address, would provide funding to a field that often lacks it the most, especially following the pandemic’s strain on the state’s mental health services. Hochul’s office pointed to statistics showing that roughly one in three New York residents have either reached out for mental health support or know someone who has requested support since the start of the pandemic.

New York is in need of improved mental health resources, as the state’s services continue to be shrouded by structural and financial barriers limiting access to support.

New York State Office of Mental Health’s Public Information Officer Mark Genovese said one of the state’s most prominent barriers to mental health care is a “lack of culturally appropriate care.” The services provided by the state’s mental healthcare system are met with continued “unfamiliarity” from community members in knowing how to properly access and utilize them, with “long waiting lists to access mental health support.”

The New York State Office of Mental Health’s 2022 “Patient Characteristics Survey” points to employment status as a hurdle to proper mental health care coverage. The data reveals that 72% of the state’s patients are unemployed in some capacity, with a vast majority of those in residential or inpatient care. While those services are valuable, they are also much more intrusive. The state’s Office of Mental Health labels these services as “24-hour care,” in which patients are often under supervision and support for an extended period.

As such, for those unemployed, seeking mental health care could mean more time without the ability to find a job or receive income, and is a possible reason why the data shows there is a significantly greater number of patients not in the labor force. Even when they get the mental health care needed, the type of service provided may further enable their place within the system or leave them without the proper care to support themselves outside of these crowded inpatient settings.

In consultation with the state Office of Diversity and Inclusion, Genovese also admitted that language access remains a prominent obstacle to mental health treatment within the state. According to a 2022 Mental Health Equity Report conducted by the state Office of Mental Health, “approximately 2.5 million New Yorkers speak a language other than English as their primary language and have limited ability to speak, read, write, or understand English.”

The language gap remains a point of emphasis for the state, with the same report mentioning that such obstacles can “lead to lack of patient satisfaction and overall health disparities.” For already marginalized communities, this could add to the stigma and hesitation associated with seeking mental health care, another hurdle to finding representative and comfortable care within the system. In the meantime, while there is a push to hire more representative bilingual and multilingual providers, the limitations in language accessibility prevent people from seeking care altogether, leaving them stuck without the ability to communicate their needs for adequate care.

Beyond employment status and language obstacles, financial access is a significant hindrance blocking large sections of the state population from seeking care.

Findings from the same patient characteristics data reveal that as little as 5% of those seeking mental health services within New York are uninsured. Of the recorded patients, the white population is, on average, the least likely to be uninsured, with 4.02% of white people seeking treatment being uninsured. In comparison, minority race populations routinely had higher percentages of uninsured patients. For example, in Central New York, 20% of the Black patient population is uninsured compared to a state average of 7.07%.

Without insurance coverage, mental health treatment can prove unattainable for many. Psychiatrist visits alone, for instance, can cost hundreds of dollars for those who are uninsured, according to Aetna coverage details. As such, with only 5% of the representative patient pool being uninsured, it illustrates how inaccessible mental health care can be for those who cannot afford insurance coverage, on top of outside costs for related mental health medication or continued treatment.

The region-specific discrepancies in insurance coverage further signify the barriers to culturally appropriate care mentioned by Genovese. While Hochul’s plan promises a much-needed financial boost to service providers, insurance coverage remains a significant impediment. These problems are especially prominent in underserved communities that often cannot afford the extra time and cost commitments to mental healthcare.

Despite this, there is reason to be optimistic about New York’s future in mental health. Hochul’s new proposed plan to fix mental health is on top of a $3.3 million commitment she made in 2022 aimed at expanding childhood mental health services. Moreover, Genovese referenced many initiatives within the system to continue improving care, such as “increased language access translations” and “efforts to diversify the mental health workforce.”

The $1 billion plan announced by Hochul is an added boost to these initiatives, but work is needed to break down the systemic barriers to mental health care. It remains to be seen how the plan’s funding and focus on inpatient and outpatient services will trickle down to underserved populations in marginalized, low-income communities or if these initiatives will be enough to support language barriers between health services and the diverse communities within New York.