Unless something remarkable happens, the fight over where to provide psychiatric services to children in Western New York is over. Gov. Andrew M. Cuomo has vetoed a bill intended to keep the center at its location in West Seneca, and even though the measure passed both chambers of the Legislature unanimously, the likelihood of an override is close to zero.
That means that within about two years, children needing inpatient psychiatric care will be treated at a new children’s unit at the Buffalo Psychiatric Center. It will have a separate entrance, separate clinical staffs and, the state assures, complete isolation from adult patients. Assuming any override attempt fails, it will now be up to New York State to make good on all its promises, including improved services to the troubled children who are in the middle of this dispute. This can’t be “Deinstitutionalization, Revisited.”
Deinstitutionalization was an idea that began in the 1960s and took hold around New York State in the 1970s and ’80s. It was based on the plausible idea that, with the advent of new drugs, fewer psychiatric patients needed to be confined to hospitals. They could be released from mental hospitals and into communities where outpatient services would meet their needs. It would be more humane and less expensive – or so the theory went.
New York reneged. It moved the patients out of hospitals – the part of the equation that saved money – but didn’t follow through on the community care, which would have incurred expense. The result was a lack of appropriate attention and jails burgeoning with increasing numbers of inmates with mental illnesses.
In truth, it shouldn’t be financially difficult for the state to keep its promise to increase outpatient children’s services. By reducing “back office” costs and eventually shedding itself of the need to maintain the bucolic West Seneca site, the state says it will direct an additional $3.2 million in services to children needing mental health care. As a “good faith” gesture, the state has already begun providing $1.7 million worth of those services, said Dr. Ann Sullivan, the New York commissioner of mental health.
In addition, the state has promised that no children currently being treated at the West Seneca facility will be moved to the new one when it opens in 2019. Work there is about 25 percent complete.
It is easy to understand the apprehensions of those who don’t want the state to move the center into Buffalo. Change is always hard, and this is a big one. Still, there is reason to believe that treatment at the new center will be as effective and that the loss of the rural setting will not be the huge problem that opponents predict.
Opposition to the change was bipartisan in Western New York. Rep. Mickey Kearns, D-Buffalo, and Sen. Patrick Gallivan, R-Elma, sponsored legislation to block the move. It passed unanimously, though more likely in deference to the wishes of local lawmakers rather than as a matter of conviction for members representing other areas of the state.
So, while those distant Senate and Assembly members supported their colleagues on a local issue, they are unlikely to want to provoke a veto fight with Cuomo. That is especially true in the Assembly, where many Democrats resented Kearns’ determined independence and know he is leaving to become Erie County clerk.
Barring the unexpected, this move is going to happen. It is fast becoming time for the opposition to become the monitors, helping to ensure that the state is as good as its word.
Sullivan seems to understand that the fears of her critics are real. She and her staff need to be transparent as this project moves along, ensuring that the public sees that promises are being kept and that children who are in desperate straits will receive the care they need to overcome their challenges.