When Jeffrey McQueen considers how to provide mental health services to those who need them, we emphasize community-based care rather than inpatient psychiatric care.
McQueen, executive director of the Nassau County Mental Health Association, said there is a growing need for mental health services and efforts are being made to open more inpatient psychiatric beds, but some people are hesitant to go to the hospital.
“If you ask someone, ‘Would you like to go to the hospital?’ their first answer is no, even if they recognize that they need a higher level of care,” McQueen said.
Some people are hesitant to do so for fear of being stuck indoors for long periods of time. Some people fear the “stigma” of being hospitalized for mental illness or avoid such treatment due to cultural reasons.
What you need to know
- Experts point out the need for community mentality Medical services continue to grow on Long Island.
- Investing in New York State’s Mental Health Services also continue to increase.
- Increase hospital beds for people in crisisand increasing community services are key for Long Island, experts say.
As a result, McQueen said, “It’s important to normalize conversations around mental illness and trauma because it’s important for people to understand that there’s nothing wrong with them, but something happened to them.” Because it’s important.”
To that end, “we have a hospital diversion program, where people can take a break,” he added. [care] instead of a hospital. ”
Crisis Respite Care programs provide short-term support and intervention when symptoms cannot be managed at home.
But McQueen noted that sometimes a client’s symptoms become too severe to be managed in a community program.
“If an individual is first supported in a community-based organization and then directed to the hospital system or to a higher level of care, that individual is more likely to accept it, and the end result is more “It gets better,” he said.
Investing in mental health
Experts have welcomed the state’s recent investments in mental health services. The 2023-24 budget includes a $1 billion, multi-year plan, and the recently approved 2024-25 budget includes about $118 million in new funding, according to the state Department of Mental Health. health. But experts say community-based programs can be expanded to fill gaps in services and shortages of psychiatrists, social workers and other therapists across a geographically vast area such as Suffolk County. It also points to a serious need.
Among the organizations receiving additional state funding are CN Guidance & Counseling Services in Hicksville and the Outreach Development Corporation, which has centers from Greenpoint, Brooklyn, to Bellport, Suffolk. Both nonprofits have received start-up funding to create crisis stabilization centers that diagnose clients within 24 hours and connect them with treatment services.
CN Guidance CEO Jeffrey Friedman said the agency received about $1.5 million in funding to establish a crisis stabilization center at its Hicksville facility. Since it is not a residential facility, patients can stay for up to 23 hours and 59 minutes.
“Right now, when people are in crisis, they often end up in the emergency room, and ERs can be full of stigma. It can be traumatic for individuals, and it’s often not the right place for care. It’s not a great place to be,” Friedman said. “What we’re building here is emergency mental health care,” he said, saying he hopes to start in early 2025.
“We are building a center that will be open 24 hours a day, seven days a week,” Friedman said. “We’re open on Christmas and New Year’s. … When they come here, they can get something to eat. They can take a shower, do laundry, watch TV. Throughout your stay, you will be evaluated by specialists such as psychiatrists, social workers, and nurses.”
After the evaluation, treatment will begin.
“What we’re building here is acute care for mental health,” said Jeffrey Friedman, CEO of CN Guidance & Counseling Services in Hicksville.Credit: Debbie Egan Chin
“We intend to find a health care provider who can continue that treatment immediately,” he said.
Krista Whitman, vice president and chief operating officer of Outreach Development Corp., said the organization will receive $1.25 million for crisis stabilization centers and another $825,000 for suicide prevention and crisis services. Ta. Representatives are currently looking for a building to lease for the center in south-east Suffolk.
“Our goal is to have a location by the end of the year,” she said.
And, similar to the CN guidance, individuals can only stay for 23 hours and 59 minutes.
As need increases, beds decrease.
A report last month from State Comptroller Thomas DiNapoli found that New Yorkers’ mental health needs have “significantly increased.” The report says that between 2013 and 2022, the number of residents identified by the state’s public health system jumped 23%. At the same time, DiNapoli’s report said the increase coincided with a decrease of 990 (almost 200) inpatient psychiatric beds in the state. on Long Island — from April 2014 until he December 2023.
State officials say they are increasing inpatient beds and adding a variety of community-based care options, from community and school mental health clinics to mobile units and housing programs, to meet the surge in demand. Stated.
Michael Scarpelli, executive director of Northwell Health’s behavioral health service line, is bringing an outpatient clinic and partial hospitalization program to Riverhead through South Oaks Hospital, a 202-bed psychiatric hospital in Amityville. The aim is to open a new facility and provide mental health services. By the end of 2024, children aged 5 to young adults will be eligible. The partial hospitalization program will run from 8 a.m. to 4 p.m.
Overall, Northwell has a total of 533 psychiatric inpatient beds within its health system, which includes facilities in Nassau, Suffolk, eastern Queens, Manhattan, Staten Island and northern Westchester County, he said.
“We ended up in Riverhead because there weren’t a lot of resources for kids,” Scarpelli said.
Asked about gaps in services, Scarpelli said some patients in Suffolk have to travel long distances for mental health care.
“People sometimes struggle with transportation. The further east you go, the more mileage you have to cover,” he said.
To address some of these issues, Stony Brook Medicine is expanding its state-licensed substance disorder outpatient clinic in Riverhead to improve access for individuals with mental health diagnoses. said Susan Wilner, assistant director of behavioral health services. She added that Stony Brook University Hospital has 40 psychiatric inpatient beds for her and Stony Brook Eastern Long Island Hospital in Greenport has 23 beds for her. Both hospitals also have outpatient behavioral health services.
Colleen Marlo, chief executive of the Ronkonkoma-based Mental Health and Wellness Association, said her organization supports a proposal to restore inpatient psychiatric beds that have been idled during the COVID-19 pandemic. He said that Still, she said, her organization “believes that we can best serve people in our communities if we have enough services.”
Merlo praised New York State’s “huge investment in mental health services.” …But the truth of the matter is that the mental health system has been underfunded for decades. So this level of investment will take several years to get to a situation where we can meet the demands and needs of the community. ”
Dr. Leslie Marino, a psychiatrist and president of the Suffolk Medical Society, said inpatient beds are “coming online, but it’s a slow process,” citing difficulty in hiring psychiatrists as the main reason. Ta.
“Long Island has a high cost of living, but public sector psychiatrists tend to be poorly paid. I’ve heard from many inpatient facilities that… [the holdup] “We’re recruiting doctors,” she said.
McQueen of the Nassau County Mental Health Association agrees, “Access to psychiatry is decreasing. We don’t have enough psychiatrists. We don’t have enough clinics.”
“Individuals are retiring or leaving the medical field, and this is something we all need to address,” Northwell’s Scarpelli said.
He said Northwell University is developing two new psychiatry training programs to enhance staffing. “One is in Lenox Hill.” [hospital in Manhattan] The other person is scheduled to go to South Oaks Hospital. At Lenox, he hopes to start doing so in July 2025. We hope to start in South Oaks in 2026. ”
signs of progress
New York State Department of Mental Health Commissioner Dr. Anne Sullivan cited a $1 billion investment in the state’s mental health services as a way to take significant steps toward expanding access, including 700 inpatient beds. (500 beds within the region and 200 beds at state institutions). 50 people at the state’s Pilgrim Psychiatric Center in Brentwood) and a “significant expansion of community-based services,” including a certified health center. He said the number of health centers would “treble” from 13 to 39 over the next two years.
“We currently have one on Long Island,” she said, referring to the CN guidance.
There is also an expansion of the ACT Team, a mobile unit that interacts with people in communities, including Long Island. ACT stands for Assertive Community Treatment, which the state Department of Mental Health describes as a “multidisciplinary, evidence-based team.” [that] We provide comprehensive and flexible treatment, support and rehabilitation services to people in the local community. ”
Friedman said CN Guidance has 56 programs aimed at “assisting people with mental health and substance use issues,” serving 30,000 people on Long Island each year.
The program includes mobile recovery units (RVs and small vans) dispatched throughout Long Island. The unit includes peer counselors, nurses and therapists who meet people in places like parks and train stations. They provide information and training on how to recognize opioid overdoses, administer the overdose reversal drug naloxone, and conduct mental health assessments.
“The mission is to connect people who are struggling with behavioral health issues and get them into treatment,” Friedman said.
The RV rooms are equipped with computer monitors that allow on-site staff to remotely connect patients with psychiatrists, who can then evaluate individuals.
Nick Stahlman, Outreach and Recovery Peer Specialist at CN Guide, explained how a typical encounter with RV staff works.
“We park the RV. We set up a table out front. We pull out the awning. There’s a nice little area in front of us that’s inviting.” We have signs inviting people in. We also have ‘Hope Rides Here’ logos on the sides and back of the van, which are often conversation starters,” he said.
Staff explain the services available and how those who need them can connect with treatment and help them move forward with their lives. As fellow recoveries, we have experienced it. We have real-world, lived experience with both mental health and substance use. ”
Stahlman added that you might often hear someone say, You don’t know what that’s like. So we recovery buddies know what it’s like. we’ve been there. We are showing them that recovery is not only possible, but expected. ”
