Reuven Blau, The City

this article was originally published on March 23 at 5 am EDT by THE CITY

The Hochul administration’s push to force hospitals to bring back 850 psychiatric beds that were taken offline at the start of the pandemic is now tied up in budget talks as medical institutions seek additional public funds, according to Kathryn Garcia, the state’s director of operations.

In January, the Office of Mental Health sent letters to 50 hospitals across the state, including 25 in New York City, including Bellevue Hospital, Maimonides Medical Center, and Montefiore Medical Center.

The missives ordered hospitals with licensed inpatient psychiatric beds to come up with a plan by February 10 to bring back the psychiatric beds.

The need, says the state, is urgent. Between 2014 to 2022, the state lost 1,849 psychiatric beds, according to the state’s Office of Mental Health, dropping from 9,320 to 7,471 units.

The contending hospitals they need more money to hire psychiatrists and other medical personnel trained to handle people diagnosed with serious mental health issues.

In the letter, the Hochul administration threatened to forward legislation to let the state issue fines of up to $2,000 if the hospitals didn’t put the beds — some of which were enlisted for Covid patients, and others that simply remained empty — back in use by April 1.

During an interview in her Midtown office last week, Garcia told THE CITY that the general response to the January 10 letters was: “’It’s really expensive. We need more money.’”

The bed sheets tug of war — with potential direct consequences for people experiencing a mental health crisis — is now one of the many issues being negotiated during state budget talks in Albany, Garcia noted.

“I do think they are also struggling as they think of bringing this back online,” she said. “Where are they finding the psychiatric staff? Refilling those positions after the ‘Great Resignation’ was also hard.”

Garcia’s office said the hospital responded to Hochul’s letter with plans to bring back nearly 60 percent of the missing psychiatric beds. So far, the hospital has reopened 200 of the 850 beds and expect another 300 to come online by the end of the year, according to Hochul spokesperson Avi Small.

State Director of Operations Kathryn Garcia discusses hospital matters at her Midtown office, March 15, 2023. Photo by Ben Fractenberg/THE CITY

Leaders of the umbrella group representing hospitals throughout the state have been in Albany this week lobbying for more funds from the state budget — and they say members want to open more psych beds, but can’t, yet.

“The hospital community is strongly committed to addressing New York’s mental health crisis and we share the governor’s goal of expanding the number of available inpatient psych beds,” Greater New York Hospital Association President Kenneth Raske said in January in response to the governor’s State of the State push.

When asked to comment on this article, GNYHA declined to answer questions on why exactly hospitals are struggling to bring back the psychiatric beds and are instead referred to that previous statement.

A Surge in Need

The behind-the-scenes back and forth over the much-needed added medical care comes as Mayor Eric Adams in November ordered city cops to forcibly hospitalize people who cannot care for their own “basic needs” as a result of apparent mental illness.

That mayoral initiative has been vehemently opposed by civil liberty groups and mental health client advocates who contend a better way to combat the mental health crisis is to provide resources for outpatient counseling and personal services to communities in need.

State officials have been trying to push the hospitals to reopen the 850 beds taken offline during the pandemic for over a year, as the Gotham Gazette reported in November, but this is the first time they have threatened fines.

NYPD officers, standing watch in Grand Central Terminal, have been given new responsibilities for people with mental health issues. Photo by Ben Fractenberg/THE CITY

Previously, Albany used the carrot approach: In the last budget, Hochul and state lawmakers earmarked $27.5 million in state funding in order to raise the Medicaid reimbursement rate by 20 percent for services provided in those specialized units.

New York-Presbyterian Brooklyn Methodist Hospital in Park Slope is down 28 psychiatric beds since the pandemic, according to Irving Campbell, who works in the unit and is the chief delegate for the New York State Nurses Association (NYSNA) at the hospital.

All told, the hospital went from 52 such beds to 24, said Campbell.

“There’s no reason why they aren’t open,” he told THE CITY. “There’s definitely a need. We’ve got clients in the emergency room waiting multiple days for a bed.”

Representatives for NYP Methodist’s administration did not return requests for comment.

No Money, More Problems

On Wednesday, hundreds of union nurses rallied in Albany to advocate for “a state budget that expands access to healthcare, fully addresses chronic underfunding of safety-net and public hospitals, and stabilizes the nursing workforce by enforcing safe staffing laws and supporting education, recruitment , and retention efforts,” according to a statement from NYSNA.

Hospitals throughout the state have struggled to recruit medical personnel to staff the psychiatric units, noted Cheryl Roberts, a city court judge in Hudson, NY, who presidents over the mental health court in the area.

Columbia Memorial Hospital in the area has a 22-bed unit, but only has staff available for 16 beds, according to Roberts, who is also the executive director of the Greenburger Center for Social and Criminal Justice.

“They don’t have enough staff, even though there’s a need,” she said. “It’s a real problem.”

People who are in crisis are often first placed in hospitals by the police, but the ultimate goal is to have enough supportive housing so that the psychiatric bed is the last resort, noted Roberts and other mental health experts.

At Methodist in Brooklyn, the average psychiatric treatment stay is approximately two weeks — and some patients are released directly to homeless shelters, according to Campbell, the nurse.

Asking for More Jail Beds

Meanwhile, 14 City Council members on Wednesday sent a letter to the mayor calling on the Adams administration to open 400 planned therapeutic beds for people locked up in Rikers and in other detention centers at public hospitals.

Currently, more than 50 percent of people in city jails have some type of mental health diagnosis, with 16 percent deemed seriously mentally ill, according to the latest Mayor’s Management Report.

“These individuals represent a disproportionate amount of the deaths on Rikers Island, struggling to receive adequate services in a jail environment, and strain staffing resources,” read the letter spearheaded by Council Member Lincoln Restler, a Brooklyn Democrat.

The city Department of Corrections initially planned to have 100 beds in Bellevue for that population by December 2022.

“This is an invaluable opportunity to better meet the needs of hundreds of the individuals held in Rikers Island on a given day who would benefit from a hospital environment and access to a higher level of clinical and medical care, while at the same time reducing the burden on the city’s jail system,” the letter said.

“Yet in recent weeks, it has appeared that the plan is being delayed, and that the number of beds targeted for development is decreasing.”

THE CITY is an independent, nonprofit news outlet dedicated to hard-hitting reporting that serves the people of New York.

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