PEF mental health professionals talk real repercussions of slashing budget, closing facilities
By KATE MOSTACCIO
Gov. Andrew Cuomo’s 2021-22 Executive Budget proposes staffing and funding cuts at the Department of Mental Health and calls for closures and consolidation of treatment centers for both children and adults.
The governor’s budget may save New York State money during a staggering deficit, but these proposals will hurt patients, their families and the communities they serve. PEF leaders who work on the ground in mental health facilities and psychiatric centers know what these proposals really mean for some of New York’s most vulnerable.
“Most of the OMH facilities treat patients who have not responded adequately to treatment in the private sector,” said PEF Executive Board member Carl Ankrah, a nurse practitioner at Rockland Psychiatric Center. “Cutting these services is going to have significant socio-economic consequences.”
Ankrah said the state does need to look at ways to save money, but this is not where it should be done.
“We need to cut cost, but cutting on the backs of patients who have serious mental illness is not the way to go,” he said. “In the absence of these services and facilities, patients are going to be sent back into the community without adequate stabilization. In weeks or months, they will end up getting readmitted back to the hospital and further increase the cost we are trying to save.”
When these patients are discharged into the community before they are ready, they may get caught up in the criminal justice system or end up homeless. They may hurt someone because of untreated paranoia, not because they are violent by nature, Ankrah said.
Cuts to staffing hinder the work of the agency.
“Treatment for people with mental illness is not a one-size-fits-all,” Ankrah said. “Everybody needs individualized care. Without adequate staffing, it is difficult to provide such care. Yes, we need to retool and contain costs, but cutting the state’s mental health workforce at a time when demand for mental health services has gone up is a step in the wrong direction.”
The COVID-19 pandemic has had a strong impact on mental health in our communities.
“People who had no mental illness are now presenting with depression, anxiety and post-traumatic stress disorder (PTSD),” Ankrah said. “Even before COVID we had a shortage of mental health providers, now this has made it worse.”
Many private providers are not accepting insurance right now, Ankrah said, and appointments are often scarce and booking out a month or two.
“All over the country there is a dire need for mental health care,” he said. “To cut funding for mental health is one of the worst things the state can do. Mental health is an integral part of our overall health and should be treated as such.”
PEF Division 180 Council Leader Vincent Cicatello, a psychiatric nurse 3 at Buffalo Psychiatric Center, shed light on the repercussions of cutting inpatient beds and staffing at psych centers across the state.
“The cuts in beds are obvious cuts in services,” Cicatello said. “Each bed reduction is also a decrease in professional staff. Cutting services is a huge mistake.”
Cicatello said the governor’s budget includes bed reductions based on census data that shows a reduction in use – but he argues that data is misleading.
“Facilities went on pause in November,” he said. “Not admitting new patients and discharging patients. We were running below census and not taking anyone in.”
But prior to the pause, and since the fall of 2020, things have shifted.
“We are consistently running at a full house,” Cicatello said. “I think they are going off charts from when they put themselves on pause. I believe that the numbers are not a true indication of the services actually needed by our population.”
Cicatello said youth facilities, like Western New York Children’s Psychiatric Center (WNYCPC), are admitting fewer patients because parents are reluctant to send their children to facilities during a global pandemic. That lack of admissions is skewing numbers the governor is using to argue for closures and consolidations.
Increased homelessness and violence are very real consequences of cutting mental health services.
“We see former patients discharged into residences and then the community who are now homeless and panhandling,” Cicatello said. “They are asking for money, asking for food. I do think crime is also going to go up. Patients who would normally have a bed to recover now won’t have the ability to be hospitalized. It’s a huge disservice to patients. The community should be as angry and upset as we are.
“There are not enough mental health services and while they’re saying that they are cutting services,” he said. “It’s going to impact more than just patients and state workers; it’s a detriment on the communities themselves.”
Patients won’t be monitored for medication management, attendance at day programs, proper hygiene, eating and drinking, or seeing their doctors regularly.
“Often there is nobody out there and they might not even realize they need help,” Cicatello said.
Mergers and consolidations can force families to send their loved ones even further from home, making visitation difficult, and potentially forcing patient populations to mix, such as youth with adults.
“Rockland (Children’s Psychiatric Center) beds would be going to New York City,” Cicatello said. “That could cause issues. It depends on the area. And merging adolescents with adults is touchy.”
PEF Division 167 Council Leader Stephanie McLean-Beathley, a licensed master social worker at Western NY DDSO, echoed Cicatello’s sentiments on reduction of children’s psychiatric beds, but took it a step further in surmising that reducing beds might be the state’s way to once again attempt closure of WNYCPC.
“WNYCPC has 45 certified beds and they are proposing to cut beds,” she said. “We know if those beds are cut they are not going to keep the facility open with only 20 beds. That would be targeted for closure. For five years, WNYCPC fought to keep the center from closing and they were successful. This is an underhanded way to close that facility that serves 19 counties and a large number of people.”
Catching mental illness early and treating it can mean the difference between lifelong struggles and quality of life.
“Children’s beds are important,” McLean-Beathley said. “While children are young, if you are able to diagnose and treat their psychiatric condition, they are much more likely to comply with medication and attend therapy, and the outlook for long-term treatment is more promising.”
Closing of comprehensive children’s psychiatric treatment at area hospitals has left little other options for the youth surrounding WNYCPC.
“There is a void there and then you are proposing taking away the next layer,” McLean-Beathley said. “You can’t tell me community-based programs are going to fill the void. Community programs are privatized agencies. These proposals are really taking away from state services.”
McLean-Beathley said state staff are highly trained professionals and the state invested in their education. She believes turning to outside providers and closing facilities is wasteful.
“They get all this training to make them good therapists, good aides, and then you turn around and you want to close the facilities where they work,” she said. “The staff at psychiatric centers are licensed social workers with a lot of experience. They bring to the table willingness to work and learn new therapies.”
The value of psychiatric care during the pandemic can’t be brushed aside.
“People who had been hiding under the surface and may have had trouble with anxiety or depression, now they are totally isolated or confined,” McLean-Beathley said. “Those symptoms are going to come out much more strongly – and there is no one checking. There are no teachers and staff to look. People are working at home and not interacting with their colleagues.
“When these things start to pop up, you have to have a way to treat them,” she said. “Outpatient isn’t going to work for everybody. Some of these people are going to need inpatient stays to stabilize them and help get them on the right track.”
To support PEF’s campaign to fight back on this and other bad budget proposals, click here.