Opinion: Too many New Yorkers still can’t get the mental health care they need

Here’s the truth – it’s still taking way too long for adults, youth, children and families to access the behavioral health care they need in New York state. While the federal administration has made devastating cuts to Medicaid and mental health programs, behavioral and mental health needs in the state continue to grow. Families are relying on their health insurance to receive meaningful care for mental health and substance use-related needs. Yet for countless New Yorkers, especially younger adults and those experiencing economic hardship, that need is not being met. Our bills, S8426 and S5241, have the power to break down barriers to accessing life-changing care.

The state Office of Mental Health notes that 3.4 million New Yorkers – more than 17% of the state’s population – live in rural areas, which often face barriers to mental health care. The New York City Department of Health and Mental Hygiene found last year that nearly 945,000 adults – or 1 in 7 adults in the city – had an unmet need for mental health treatment in the past year. Nearly 40% of respondents said cost kept them from seeking care, while 37% said they did not know where to go for help. Almost half of respondents reported trying to manage their symptoms alone.

This lack of access to care often comes down to one thing: insurance. Insurance networks regularly deny the care prescribed by doctors and fail to deliver on the guarantees they make to their customers. A 2023 investigation by the state Attorney General’s Office found that 86% of mental health providers listed in insurance directories were unreachable, not accepting new patients or were out of network.

Even when patients manage to find a mental health provider, insurers often deny medically recommended treatment by relying on outdated standards to determine if a service or treatment is “medically necessary” for an individual’s condition – standards that do not reflect accepted clinical guidelines. These denials delay care until symptoms become more severe, leading patients to seek treatment in emergency rooms or crisis programs and pay even higher bills for care.

Federal cuts to Medicaid and mental health programs have raised the stakes even further. When insurers refuse to cover necessary treatments, patients eventually rely on public systems, shifting significant health care costs to state and local governments. This is not sustainable for families or taxpayers, and it is not acceptable to us as lawmakers entrusted with protecting the health and well-being of New Yorkers.

We believe our state can and must do better. That is why we will be advancing two essential bills during the upcoming legislative session. The Protect Mental Health Act (A8839 and S8426) would codify in New York the federal law that requires mental health coverage be treated the same as health coverage. Simply put, this will prevent insurers from discriminating against an individual seeking mental health or substance use care. The second piece of legislation, the Fair Standards in Health Care Act (A6648 and S5241), ensures that medical necessity decisions are based on evidence-based clinical criteria rather than insurer-created rules that restrict access to care. Together, these bills address the structural barriers that prevent New Yorkers from receiving the mental health treatment they are entitled to and has been deemed necessary by their doctors.

New York’s children, families and communities are counting on us to uphold the promise of real, reliable mental health coverage. Happier and healthier families will create a stronger, more prosperous future for every New Yorker.

Securing investments in mental health isn’t just good policy; it’s absolutely necessary for the well-being of our residents.