2022 California Council of Community Behavioral Health Agencies (CBHA) Conference

A New Era in New York’s Behavioral Health System

On his first public appearance after the 2010 election, Governor-Elect Andrew Cuomo visited Manhattan Psychiatric Center on Wards Island, New York City. During this visit, the Governor-Elect made clear the priorities which he hoped would define his administration; the provision of high-quality services, such as mental health, for vulnerable New Yorkers and the balancing of New York’s budget. In July, as the New York State Office of Mental Health (OMH) released a plan calling for the creation of fifteen Regional Centers of Excellence and a statewide expansion of community-based services, these priorities were given life for people with a mental illness and their families.

OMH has a long history of ground-breaking service provision, dating back to the opening of the Utica Asylum in 1843. Since then, New York has pioneered mental health treatment, research and policy implementation in a way which has positively impacted the current modes of behavioral healthcare in the United States and throughout the world. However, our structure is fundamentally flawed by the same history which has led us to this point, namely by the outdated and costly way in which we provide long-term inpatient treatment in our twenty-four legacy psychiatric centers, three times as many as other comparable states.

Embarking on this journey required an unflinching look at the forces of change within the world of behavioral health. No longer is recovery a far-off goal for individuals with serious mental illness, but an expectation of many individuals who would have formerly received long term care in an institution. Individuals in treatment have a better chance of recovery when receiving care within their communities and an investment in early intervention methods, as we will see through this plan, will help individuals stay connected with their communities and stay in school or keep their job.

The forces of change go beyond advances in modern medicine and treatment trends. The Affordable Care Act, the transition to “managed care” for behavioral health and the United States Supreme Court’s “Olmstead Decision” will converge and bring change with or without us. It is important that we direct this change in a way that maximizes our current structure, increases availability of community-based services and allows us to remain competitive in a fast-changing field. This plan is an investment in the future of behavioral health services in New York.

Building our future system within our Regional Centers of Excellence plan, we placed recovery and resiliency as the foundation. Promoting choice as both a recovery tool and a much needed addition to our system, we eliminated catchment areas, allowing individuals and families to pursue specialized treatment throughout the State. Enabling local communities to have a voice in the process, OMH created a team-based structure with stakeholders having a formal role, charged with the examination of current services, community needs and reuse of facilities to custom fit a service structure for each region.

Perhaps our most valuable asset is the OMH workforce. It was apparent that in order for this plan to be successful, we would need to empower many of our dedicated employees in new roles. The Regional Centers of Excellence plan creates regional outpatient service hubs. Our employees are among the best qualified and most experienced anywhere in the world and it is important that we use their knowledge to our advantage. Potential new roles for these employees could be much different from their previous jobs; they could be a member of mobile crisis team, they could be part of a maintenance crew working to support residential providers throughout the region or they could be providing outpatient services within a clinic setting, to name a few options.

New Yorkers are courageous and determined, as is the Regional Centers of Excellence plan.

We will bring our history along with us as both education and inspiration, enabling our agency and our State to provide the highest-quality services for the next 170 years. Bringing this transformation about was not easy, nor will be seeing it through to completion, but I am confident that through continued efforts in pursuit of recovery for all, we will begin a new chapter in the history of behavioral health.

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