Getting urgent care to patients in mental health crisis
Proposed mental health stabilization center is expected to relieve burden on hospitals, police
By RUBY RAYNER-HASELKORN
MONTICELLO, NY — The rates of depression and anxiety that afflicted New Yorkers with the onset of the COVID pandemic remain very high three years later, according to the NY Health Foundation. Since 2021, one in three New Yorkers have been suffering with one or both conditions, which disproportionately affect young people, people of color and people of low income.
Stabilization centers, like the one recently proposed for Sullivan County, are seen as an alternative to the overburdened hospitals and police departments that currently staff the front lines in treating mental health and substance abuse disorders. But these institutions are not designed to handle crises of this nature.
A stabilization center, on the other hand, provides skilled and compassionate “urgent treatment” to people in the middle of an acute disorder. “Services are for recipients experiencing challenges in daily life that do not pose the likelihood of serious harm to self or others,” says 2022 guidelines from the New York State Office of Mental Health and the New York State Office of Addiction Services and Supports. “Such challenges may also create risk for an escalation of behavioral health symptoms that cannot reasonably be managed in the recipient’s home and/or community environment without on-site supports.”
U.S. Rep. Marc Molinaro (NY-19) spearheaded the nonprofit stabilization center that opened in Dutchess County in 2017. He held an informational roundtable at the Monticello Firehouse on Nov. 21 to discuss opening a center in Sullivan County. It was attended by county stakeholders, including officials and legislators, law enforcement personnel, and NYS Assemblymember Aileen Gunther (NY-100).
The proposed 24-hour drop-in center will help people in mental health crisis plan their next steps while sparing hospitalizations and serving as an alternative to the criminal legal system.
Sullivan County lacks any mental health infrastructure. In a 2022 study of priorities, Garnet Health, the area’s dominant medical provider, identified mental health treatment and substance abuse prevention as their top two priorties.
“We have this incarceration setting, and we have hospitals,” Molinaro said. “Neither of those are effective tools and are at the extreme of the conversation.... We need to invest in community-based models and help divert individuals from the jail setting or the justice setting.”
Representatives from People USA, a non-profit that operates the Dutchess center, emphasized that they take everyone and anyone, with or without health insurance. No one is turned away, they said.
The goal is to meet individuals “at their level” and get them to the next step, while allowing the crisis to de-escalate naturally.
Himali Gandhi Pandya, chief strategy and development officer for People USA, got to the heart of the matter. She talked about the biggest challenges other counties face in opening a stabilization center. “Funding is always, always a challenge,” she said. “It sounds like a variety of people in Sullivan County are committed to helping us get funding, but typically it’s the real tough point when it comes to these programs.”
Molinaro said services provided by stabilization centers will soon be billable to Medicaid, which may make the center self-sustaining. Pandya said none of the stabilization centers are self-sustaining at this point “because the licenses just came out, and there haven’t been any licenses given out officially yet.”
Molinaro said he would be happy to leverage funding, and Gunther said she would help source funds, but neither provided specifics.
Molinaro said hospitals in the county could be a source of money. “The other partner at the table effectively is the healthcare system,” he told the roundtable. “Hospitals will benefit financially from seeing the diversion. That savings needs to be put on the table and invested in this model.”
Jerry Dunlavey is chief executive officer at Garnet Health Medical Center-Catskills and vice president of operations of Garnet Health. He expressed strong support for the stabilization center. “One of the challenges throughout the county is that there are just not enough behavioral health providers,” he told the River Reporter. The ones already here are often booked solid, he said.
“We’ve seen an increase to the point where our unit is full,” he said. A stabilization center would be “tremendously helpful.”
Dunlavey said Garnet Health will “do all we can to support our community partners.” But, he added, “If we had the money, sure. Garnet Health Catskill operates on a razor-thin margin. In fact, the organization has seen financial losses. I’m not sure the hospital is the proper source of funding for a stabilization center.”
There may not be any money coming from the other institution a stabilization is expected to help. “We just don’t have any money,” said Sullivan County Deputy Sheriff Eric Chaboty. He said he would first need to know what would have to be cut from the sheriff’s budget to make a contribution possible.
Still, Chaboty is also enthusiastic about getting a stabilization center for Sullivan County.
“If you don’t have a crisis center, there’s really very little alternative for a police officer to get somebody to help,” he told the River Reporter. “You have to go to the hospital and typically in 20 minutes they’re out. It doesn’t solve the problem. It doesn’t get them the treatment and services they need.”
When talking about next steps, Molinaro told the stakeholders, “If I were in your shoes. the county should increase this as a focus. You have to figure out who the right stakeholders are and then agree on January 2nd, or whenever it is, we’re going to have our first meeting.”
Molinaro called for action. “Stakeholders agree, and commit,” he said.
District 2 legislator Nadia Rajsz agreed. She exclaimed, “We need to move forward on this!”
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