Gaps still exist in mental health care for children


The state’s recent historic investments in mental health care are laudable. However, there remains a need for deeper, more targeted investments to serve children with the most significant behavioral health needs.

New York has led the nation in child welfare reform by dramatically reducing the use of out-of-home care in the last 30 years. The state’s support of preventive services has had a real impact on the lives of countless young people, helping them thrive with community-based services. Preventing out-of-home care and keeping kids in their homes and communities is preferable whenever possible, and is far more fiscally prudent.

But what about the kids who need care well beyond what can be offered in the home environment? The savings from the tremendous reductions in out-of-home care have not been reinvested in quality children’s services. And the result is that more than half of New York’s residential treatment beds for children with significant mental health challenges have been shut down. In 2012, there were 554 beds. In 2022, there were only 274.

The lack of appropriate placement options has led providers of residential treatment centers to accept children whose needs far exceed the care these programs are designed and licensed to deliver. The consequences are severe: Nonprofit residential treatment providers are seeing increasing levels of violence on residential campuses and in surrounding communities, along with a rise in the number of young people engaging in self-harm and attempting suicide. What’s more, these inappropriate placements divert resources away from children appropriately placed at the centers. Providers are experiencing these crisis levels across the country.

New York’s young people need comprehensive solutions.

We should identify and create placements for the small number of critically ill children whose complex mental health needs cannot be adequately addressed in a residential treatment center.  This will keep all children safe with appropriate care in appropriate settings. Meanwhile, state-set foster care rates must be adjusted to account for the significant provider expenses incurred for providing care to higher-acuity youth. Capital funding from the Office of Mental Health must be used to strengthen residential treatment centers’ capacity. 

Longer term, New York needs to approve and invest in “intensive services models,” which would give providers the additional tools and resources to let them appropriately care for higher-acuity youth.

Finally, the state must invest in the child welfare and children’s behavioral health workforce. All programs are experiencing immense challenges with hiring and retaining staff due to chronically low wages set by government contracts. 

New York urgently needs to boost its continuum of care with enough placement options for children with the greatest levels of need. The children and youth served, and 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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