June 9, 2023
Governor Hochul’s recent announcement of a groundbreaking $1 billion investment to revamp mental health care in New York is a timely and essential initiative. For far too long, the mental health system in the state has suffered neglect and insufficient funding, leaving countless New Yorkers without access to the care they desperately need. Governor Hochul’s plan, which includes bolstering community housing and resources, establishing certified community behavioral health centers, and increasing the availability of beds, will play a pivotal role in addressing this critical issue.
In review of the plan, it became apparent that there is a pressing need to direct resources toward behavioral health services provided by primary care providers and organizations across the state. Research has consistently shown that primary care providers write more prescriptions for behavioral health than specialty mental health practitioners (Muench et al., 2022). Moreover, alarming statistics reveal that a significant number of patients who die by suicide had seen their primary care provider in the month leading up to their death (Luoma, Martin, & Pearson, 2002; Ahmedani et al., 2014). In fact, a payer in New York reported that patients who die by suicide, but were not receiving care, resurfaced in primary care settings for an average of two visits in the month of their death. Clearly, primary care providers are frequently relied upon by New Yorkers for their behavioral health needs, and they have the potential to serve as key gatekeepers for prevention.
It is worth noting that physical health provider organizations, known as Article 28 entities, are restricted in their ability to bill for all populations when providing behavioral health services. New York State has long championed the Collaborative Care model, an evidence-based approach to identifying and treating conditions such as depression, anxiety, and ADHD (AIMS Center, n.d.) in primary care settings. Despite the state’s leadership in advocating for this model, the reimbursement rates remain significantly lower than those in other states, limiting its widespread adoption and optimization.
In light of these observations, we strongly recommend allocating a portion of the resources towards expanding the capacity of primary care providers to deliver mental health care to the New Yorkers who turn to them for support. By investing in infrastructure and reimbursement parity for primary care practices, we can ensure that these trusted healthcare professionals are equipped to meet the behavioral health needs of their patients effectively. This targeted approach will complement the broader overhaul of the mental health system and contribute to a comprehensive, person-centered continuum of care for all New Yorkers.
The essay argues that while Governor Hochul’s recent announcement of a $1 billion investment to revamp mental health care in New York is a timely and essential initiative, there is a need to allocate a portion of those resources towards expanding the capacity of primary care providers. These additional resources will ensure that primary care providers - who are already frequently relied upon by New Yorkers for their behavioral health needs - are equipped to meet these needs effectively. This targeted approach will complement the broader overhaul of the mental health system and contribute to a comprehensive, person-centered continuum of care for all New Yorkers.
Dr. Virna Little
virna@concerthealth.io