Dear Governor Hochul:

On behalf of the Healthy Minds, Healthy Kids Campaign, we want to congratulate you on your election as Governor and thank your office for meeting with us on September 30th to discuss the urgent challenges facing children with behavioral health needs in our state, as well as our preliminary recommendations for how we can address these challenges in the FY24 Budget.

We would also like to thank you for your leadership in advancing a FY23 Budget that included significant and urgently needed investments in the children’s behavioral health system. The 5.4% COLA for human service providers represents the first time in over a decade that mental health and substance use programs have received a significant cost of living adjustment. Given the depth of the workforce crisis for children’s behavioral health services, this is an important step towards enhancing capacity. We also applaud the expansion of behavioral health services within the Child Health Plus Program and the extension of APG rates until 2027, as well as rate enhancements to Children and Families Treatment and Support Services, Residential Treatment Facilities, and Home-Based Crisis Intervention Services, among others. Moreover, the recovery and reinvestment of funds from MCOs resulting from their failure to provide behavioral health services helps right a deep injustice and provide critical funding for the system.

As essential as these investments have been, however, our coalition must underscore the reality facing tens of thousands of families every day in our state: finding timely mental health supports for children and adolescents is overwhelming, isolating, exhausting, and often impossible.

The percentage of children who have anxiety or depression in New York grew from 8.9% in 2016 to 10.9% in 2020, a 22.5% increase. Death by suicide is the second leading cause of death for youth age 15-19 in our state. This crisis was further exacerbated by the many economic and social harms heightened by the COVID-19 pandemic. Nationally, emergency department visits for suicide attempts during the pandemic were 51% greater than pre-pandemic for adolescent girls and 3.7% greater for boys.

Frighteningly, families throughout the state are facing waitlists in the hundreds or more, forced to wait months for services they desperately need today. For instance, one provider in Western New York has a seven-month wait for outpatient clinic services, while another capital region provider of community-based services has twice as many children waiting for services as they have capacity to serve. We are hearing similar stories throughout the state of impossibly long waitlists and families unable to access care.

New York has experienced decades of chronic disinvestment in the children’s behavioral health system, and has significant work ahead to ensure we have a sustainable system that can support children’s behavioral health needs.

In light of these challenges, the HMHK Campaign is eager to continue the partnership with your administration to address the behavioral health needs of children and families in the state. Key areas we feel must be addressed include creating a sustainable children’s behavioral health system by funding a full continuum of care, addressing the crisis of waitlists and access, and enhancing behavioral health supports in schools. Though our recommendations will continue to develop as we approach the FY24 Budget Cycle, we are sharing below our preliminary recommendations for confronting the children’s behavioral health crisis in next year’s budget.