New Yorkers are fed up with erratic, sometimes violent behavior from the growing ranks of homeless mentally ill on the streets and subways. That frustration has led to increased scrutiny of Mayor Bill de Blasio’s Thrive NYC initiative in recent days, with reporters, city comptroller Scott Stringer and some City Council members asking probing questions about the Big Apple’s mental health status quo.
They would be remiss, though, if they didn’t also direct their attention to state government. In New York, most of the important mental health decisions are made by the state, not City Hall — and some of those decisions are terrible ones.
In his latest budget proposal, Gov. Andrew Cuomo called for closing “unnecessary” beds in psychiatric centers, a ka mental institutions run by state government, and reinvesting those funds in community services.
The official name for the state’s strategy is the Transformation Plan, but in truth, the state has been on the same path on mental health policy for decades. In the 1950s, when mental health care in New York was almost exclusively an inpatient matter, patients in state facilities numbered 93,000. The census is now down to below 3,000, but the Cuomo administration thinks that it could stand to drop still lower.
Back in the 1980s, Mayor Ed Koch argued that “deinstitutionalization” had gone too far, and criticized state government for betraying the promise of better care in community settings.
Stephen Eide is a senior fellow at the Manhattan Institute and author of the report, Systems Under Strain: Deinstitutionalization in New York State and City.
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