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Number of NYers With Mental Illness Rose As Available Psychiatric Beds Declined

The state's effort to increase the number of psychiatric beds have proceeded slowly.

The mental health needs of New Yorkers have greatly increased with 21.1% of adults struggling with mental Illness and 5.1% with a severe mental illness in 2021-2022, according to federal data. 

According to a report by State Comptroller Thomas P. DiNapoli, the rising need for mental health services coincided with a loss of 990 beds, a 10.5% drop in capacity, in inpatient psychiatric facilities statewide between April 2014 and December 2023, a news release said.

“Increased mental health services are urgently needed to meet the rising demand for care,” DiNapoli said. “With the COVID pandemic behind us, New York must redouble its efforts to restore inpatient psychiatric bed capacity and preserve and expand telehealth services.”

Between 2013 and 2022, there was a 23% increase in the number of individuals served by the state’s public mental health system, with nearly 900,000 residents utilizing the services. In Dec. 2023, there were 3,999 inpatient psychiatric beds in New York City and 4,458 in the rest of the state. The state Office of Mental Health (OMH) report from that month indicates the counties with the greatest number of psychiatric inpatient beds were largely downstate. The ratio of beds to population was approximately 1 to 2,084 in New York City and 1 in 2,544 in the rest of the state. There were 20 counties, with a total population of 898,895, that had no psychiatric inpatient beds at all.

The last decade reflects a continuation of a long-term decline in the overall number of inpatient psychiatric beds in New York – particularly in state-operated psychiatric centers – due to policy decisions made decades ago. From April 2014 to Dec. 2023, psychiatric inpatient capacity decreased by 506 beds (11.2%) in New York City and by 484 beds (9.8%) outside of the city. 

During the first wave of the COVID-19 pandemic, community hospitals in New York City closed an estimated 20% of their inpatient psychiatric beds to accommodate the need for increased medical capacity, according to OMH. Lockdowns and quarantines, as well as the increasing use of telehealth services, also contributed to decreases in inpatient psychiatric utilization.

DiNapoli’s report noted the State Fiscal Year 2023-24 Enacted Budget included $1 billion of new funding to support the state's system of mental health care. In January 2023, OMH and the state Department of Health sent a letter to community hospitals directing them to reopen approximately 850 non-operational, licensed inpatient psychiatric beds taken offline during the pandemic. Hospitals were required to reopen the beds by Feb. 10, 2023, or submit a plan to reopen them by April 1, 2023. As of April 17, 2023, only 222 out of 843 off-line beds had returned to operational status. In Dec. 2023, the Executive announced the reopening of a total of nearly 500 psychiatric beds taken offline during the pandemic, but details regarding these beds have not been released publicly. 

DiNapoli’s urged policymakers to continue working with community hospitals to address barriers, commit to expanding the availability, utilization, and effectiveness of telehealth services, and continue efforts to strengthen the overall mental health service structure, including services to youth, stabilizing the mental health workforce and addressing housing insecurity which increases the risk of homelessness and mental health crises.