Young People Face a Mental Health Crisis. Here’s What New York City Should Do About It.
Data from the national Centers for Disease Control makes clear: Young people across the country, particularly female and LGBQ+ students, are experiencing an alarming increase in poor mental health and suicidal thoughts and behavior. This data has been borne out in New York City, where 15.6 percent of adolescents report seriously considering suicide and 36 percent of high schoolers report persistent feelings of sadness and hopelessness.
In February 2021, youth advocates launched a Voicing Our Futures survey that collected responses from more than 1,300 young people across New York City. More than a third said they wanted or needed mental health services from a professional, but fewer than half of those respondents reported receiving these services.
This data underscores an urgent need. As city leaders enter the budget season in earnest, they must prioritize investments that support the mental, emotional, and behavioral health needs of young people.
City leaders can begin by building on existing initiatives. For the past two years, the City has allocated $5 million for an innovative model called the Mental Health Continuum. It provides an array of integrated services for students with significant mental health challenges in 50 schools with the highest rates of NYPD interventions, suspensions, and chronic absenteeism. The model represents the first-ever cross-agency partnership between the Departments of Education and Health and Mental Hygiene as well as public Health+Hospitals (H+H) system mental health clinics. It features mobile crisis intervention, a supportive hotline to advise school staff, school-based mental health managers, and training for school staff on student mental and behavioral health needs.
This model offers valuable supports for students and schools. Nevertheless, the City has allocated funding just one year at a time, and funding was not included in Mayor Eric Adams’s current proposed budget. City leaders must not only extend funding for this program, but also permanently baseline funding to give it the security necessary for long-term hiring, planning, and expansion.
They can also support the mental health needs of students by increasing the number of school-based mental health clinics and expanding the capacity of existing clinics. Such clinics provide on-site services to children during the school day, including diagnosis, psychiatry, and individual and family counseling.
They are primarily funded by billing Medicaid and, when available, private insurance for services provided to students. However, this is deeply insufficient. Medicaid does not cover services to children without a diagnosis, and clinics are not reimbursed for services provided to children without health coverage. Commercial insurance often does not cover the services at all, or pays a rate that only covers half the cost. And insurance does not cover essential school wellness activities such as mental health education and training.
This is where the City can step in. Wraparound funding for existing clinics – specifically $75,000 per clinic – will enable clinics to offer a more comprehensive and inclusive array of services, including for uninsured children and children without a diagnosis, as well as trainings and support for school staff and the school population more broadly. It will, in short, help ensure the financial stability and effectiveness of these important community clinics.
City leaders must also expand healing-centered practices within schools that focus on trauma-sensitive classroom practices, integrated mental health and wellness supports, parent and student engagement, anti-racist and culturally responsive curricula, strengths-based learning, and opportunities for enrichment and creative expression.
One recent component of this approach has been the Parent Healing Ambassador Program, an effort to support long-term parental involvement in school-based mental health and wellness. During the past school year over 800 parents throughout the city participated. They received professional guidance designed to deepen their skills and knowledge, then led various wellness initiatives for families at their schools, receiving a stipend for their contributions. By including $1 million in this year’s budget, City leaders can continue and expand this important program.
City leaders can also support student wellness by expanding and fully implementing restorative justice practices, which aim to address the root causes of behavior, holding students accountable while building and healing relationships, teaching positive behaviors, and keeping them in school, learning. New York City must use federal stimulus funding allocated for restorative practice before it expires. It also should expand funding by baselining $120 million for full and effective implementation of restorative justice practices in 500 schools.
Finally, it is critical to acknowledge that the primary challenge facing behavioral health access for children in New York City – and across the state – is an inadequate provider network. This shortage is largely due to a deeply under-resourced system, hampered by historically inadequate reimbursement rates in Medicaid and commercial insurance, as well as in City and State contracts.
New York City cannot address access without improving the wages of the human services workforce. At this writing – before adoption of the State budget – advocates were urging adoption of an 8.5 percent cost of living adjustment (COLA) for these workers at the state level. New York City should seek to match this proposed COLA in order to achieve parity in City and State contracts and help ensure a stable and sustainable behavioral health workforce.
Through these investments, New York can see a real and meaningful change in the mental health and emotional wellbeing of its children and adolescents.
For almost 80 years, Citizens’ Committee for Children of New York (CCC) has fought to ensure that every New York child is healthy, housed, educated, and safe. This Urban Matters is adapted from, and updates, CCC testimony to the New York City Council Committees on Health and Mental Health, Disabilities, and Addiction on March 23, 2023.
Photo by: TheErin