Addressing the Children’s Behavioral Health Crisis in NYC
Testimony & Public Comments
March 24, 2025
On Monday, March 24, Associate Executive Director of Policy and Advocacy Alice Bufkin delivered testimony to the New York City Council for a preliminary budget hearing with the Committee on Health, Disabilities and Addiction and the Committee on Health on Health and Mental Health, Disabilities, and Addiction. On behalf of CCC, the testimony urges our elected leaders to secure investments in the FY26 City Budget to support the mental, emotional, and behavioral health needs of young people, providing data on the alarming unmet need for behavioral health care services for NYC children.
Read the full testimony below.
Testimony of Alice Bufkin, Associate Executive Director of Policy and Advocacy
Citizens’ Committee for Children of New York
Submitted to New York City Council Committee on Health, Disabilities and Addiction and the Committee on Health
CFY26 Preliminary Budget Hearing – Health and Mental Health, Disabilities, and Addiction
March 24, 2024
Since 1944, Citizens’ Committee for Children of New York has served as an independent, multi-issue child advocacy organization. CCC does not accept or receive public resources, provide direct services, or represent a sector or workforce; our priority is improving outcomes for children and families through civic engagement, research, and advocacy. We document the facts, engage and mobilize New Yorkers, and advocate for solutions to ensure that every New York child is healthy, housed, educated, and safe.
We would like to thank Chair Lee, Chair Schulman, and all the members of the City Council Committees on Health and on Mental Health, Disabilities, and Addiction for holding today’s important hearing on the Mayor’s FY26 Preliminary Budget and its impact on the health and mental health of New Yorkers.
Addressing the Children’s Behavioral Health Crisis
Throughout New York, families are sitting on waitlists for weeks, months, and even years for behavioral health services their children urgently need today. As a result, parents are leaving their jobs so they can navigate the mental health system for their children; children are cycling in and out of ERs and hospitals; and young peoples’ needs are becoming more acute, complex, and difficult to address as they grow into adults.
At the center of this crisis is a deeply-underfunded children’s outpatient system, which is preventing children and youth from accessing the preventive services they need. In fact, a recent study by the Healthy Minds, Healthy Kids Campaign found that at most, 1 in 5 New York City children covered by Medicaid are accessing the outpatient behavioral health (mental health and/or substance use disorder) services they need.[i]
Decades of underinvestment in the children’s behavioral health system, including low salaries and insufficient reimbursement rates, have contributed to the long waitlists confronting families.
At the State level, CCC is working closely through the Healthy Minds, Healthy Kids Campaign to advance a series of rate reforms to the children’s behavioral health outpatient system.[ii] These reforms would transform the children’s outpatient system, helping address the waitlist crisis confronting families in New York City and across the state. We hope City leaders will help support and uplift these recommendations with State leaders, as they will result in improved rates of reimbursement necessary to attract and retain the community-based outpatient behavioral health workforce needed to increase timely access to care for children and adolescents in New York City.[iii]
State-level challenges – and the threat of federal funding cuts – only underscore the important role of city mental health investments in providing targeted support to New York City youth and families. As city leaders negotiate the FY26 City budget, we urge you to prioritize the following city investments to support the mental, emotional, and behavioral health needs of young people.
Restore Funding for City Council Mental Health Initiatives
The City Council Mental Health Initiatives have for years used non-traditional, community-based settings to help identify children and families in need and offer developmentally appropriate services and support. These trusted community services have been able to adapt to the specific needs of communities and support programs that are challenging to fund through state and federal sources.
The FY26 NYC budget must continue to support these initiatives by restoring previous years’ cuts and providing a 3% increase to match the citywide human services COLA initiative, thus allowing providers to address the increasing costs to provide these services to their communities. Possible federal funding reductions are also expected to negatively impact mental and behavioral health services for vulnerable populations. This is why it is critical that the New York City Council continue to invest in the Mental Health Services Initiatives in FY 26.
As the City Council negotiates the Fiscal Year 2026 budget, we urge you to restore and maintain funding for essential City Council Mental Health Initiatives, including:
- Mental Health Services for Vulnerable Populations — $4,050,990. This initiative supports community-based behavioral health programs, including medication for individuals in transitional housing and mental health services for families with child welfare involvement. This initiative was cut by $270,000 in FY24 and was funded at $3,933,000 in FY23.
- Children Under Five — $1,840,610. This initiative funds mental health treatment for children under 5, including screening and clinical evaluation, individual and child- parent psychotherapy, consultations with child-serving agencies, and trauma-informed interventions. Early childhood is a critical time to identify, prevent and treat stress & trauma, and to build resilience for kids and families. This initiative was cut by $230,769 in FY24 and was funded at $1,787,000 in FY23.
- Autism Awareness — $3,416,351. This initiative supports wraparound services for autistic children in after-school, weekend, summer programs and during school closings. The programs also provide training to teach coping skills to families and caregivers impacted by autism. Approximately 2,000 children and families are served annually with this funding, including individuals without access to OPWDD services. This initiative was cut by $55,000 in FY24 and was funded at $3,316,846 in FY23.
- Court-Involved Youth Mental Health — $3,527,750. This initiative funds assessments and connects youth and families with criminal justice involvement and mental health needs to mental health services. 3,000 youth are served annually with these funds.
- Developmental, Psychological and Behavioral Health — $2,323,158. This initiative helps individuals with behavioral health needs and developmental disabilities, supporting harm reduction, clubhouses and more. The funding may support medically supervised outpatient programs, transition management programs, Article 16 clinics, recreation programs, or other behavioral health services.
- LGBTQIA Youth All-Borough Mental Health — $1,236,00. This initiative supports comprehensive mental health services for vulnerable LGBTQ youth.
- Mental Health Workforce Retention and Development — $309,000. This was a new initiative in FY24 and supports the retention and recruitment of public-mental health professionals working at public-facing agencies/organizations.
- Youth Peer Support Pilot – $257,500. This was a new initiative in FY 25 and supported the launch of a new program for 14- 24-year-olds living with mental illness.
- New Initiative: Youth Mental Health — $3,000,000. This new initiative would provide flexible mental health services for youth programs run by CBOs – such as Beacons, Cornerstones, COMPASS/SONYC, and others–with a focus on out-of-school time. Programs would be able to hire mental health professionals, lead structured group activities, or test other innovative, hyper-local solutions to youth mental health needs.
Invest in School-Based Behavioral Health Supports
Schools play an essential role in meeting the behavioral health needs of children, yet New York City’s approach to addressing the social-emotional needs of students in schools has often been fragmented and insufficient. Far too many students experiencing an emotional crisis are still sent to emergency rooms, subjected to police intervention, or punished with disciplinary practices such as suspension.
Schools need the resources and training necessary to support the mental health of all students, rather than relying on punitive and traumatizing responses to student behavior. We urge you to take the following actions in the budget to support the mental and emotional wellbeing of students.
- Extend and baseline school-based mental health and social-emotional supports at risk of ending. The following programs are essential for supporting student mental wellbeing, but large portions of their budgets were funded for one year only in last year’s budget and must be restored.
- Restorative justice practices ($12 million). Restorative practices address the root causes of behavior, hold students accountable while keeping them in school learning, build and heal relationships, and teach positive behaviors. They also correlate with improved academic outcomes, school climate, and staff-student relationships.
- Community schools ($14 million). Community schools provide students and families with wrap-around supports and services, including mental healthcare and the types of material and social supports that prevent the emergence of heightened behavioral health needs. This initiative has proven effective at lowering chronic absenteeism and increasing on-time high school graduation. We demand a full restoration for community schools, as they serve as pivotal resources in their communities and provide holistic supports for students.
- Baseline $5 million to fully implement and sustain the Mental Health Continuum, an innovative model that integrates a range of direct services, including expedited mental healthcare, a NYC Well hotline to advise school staff, mobile response teams to respond to students in crisis, training for school staff in Collaborative Problem Solving, and culturally-responsive family engagement to students with significant mental health challenges. This cross-agency partnership (NYCPS, Health + Hospitals, Department of Health & Mental Hygiene) supports students at 50 high needs. As part of this initiative, the Mayor and H+H announced in April that 16 school-based mental health clinics would be open, serving over 6,000 students across the Bronx and Central Brooklyn. However, funding for this program was for one year only and the program will end if funding is not restored and baselined in this year’s budget ($787k for NYCPS, $3.75 million for H+H, and $472k for DOHMH).
Enhance Students’ Access to Community-Based Services Provided through School-Based Mental Health Clinics
Article 31 School-Based Mental Health clinics provide on-site services to children during the school day, including diagnosis, psychiatry, and individual and family counseling. SBMHC staff work closely with school staff to identify children in need and coordinate services. They work to engage the whole family and can serve family members at their community location. SBMHCs provide crisis mental health services, ensuring children receive a compassionate response when they are in need and reducing the use of suspensions, detentions and punitive measures.
These clinics are primarily funded by billing Medicaid and, when available, private insurance for services provided to students. However, this funding is deeply insufficient. For example, Medicaid does not cover services to children without a diagnosis, and clinics are not reimbursed for services provided to children without health coverage. Other essential supports that clinics can offer schools – such as mental health education and training for staff, de-escalating a child-in-crisis scenario to prevent law enforcement involvement, and consulting on specific behavioral supports for classrooms – are not reimbursable through the Article 31 SBMHC model.
A $3.75 million investment would enable up to 50 SMHC to provide the types of comprehensive wraparound services necessary to support the mental and social-emotional needs of students. Flexible funding to meet the specific needs of schools could include hiring an after school social worker for the clinic; hiring a behavioral specialist to consult with clinic staff several times each week; hiring a family/peer support worker; hiring a clinician that specializes in working in schools and advising on behavior supports for students; and numerous other targeted interventions designed to complement the school-based mental health clinic model.
We urge city leaders to invest $3.75 million to expand school-based mental health clinic services in up to 50 clinics. Ultimately, we recommend a long-term goal in the future of expanding funding to all SMHC’s in the city.
Thank you for your time and attention to these critical issues.
