What 1 system plans to do with $41M for behavioral care

NYC Health + Hospitals is working to turn the city's behavioral health crisis into an opportunity to level up its care. 

That is the mission outlined in a six-part blueprint the system published in June. The municipally owned system plans to increase its inpatient and outpatient capacity, recruit and retain more workers, tackle social determinants of health and reduce workplace violence. 

The overhaul will be funded in part by $41 million from the state's Behavioral Health Centers of Excellence. Other funding will come from opioid settlements and other city, state, federal and philanthropic sources. 

Omar Fattal, MD, system chief for behavioral health and co-chief medical officer at NYC Health + Hospitals, told Becker's the system is working to increase its capacity to provide behavioral health services. 

"We collaborated very, very closely with the state to work on [capacity] because that's the priority the state has identified, and we agree with it, and the city has identified as well," he said.  

The system provides around 60% of the behavioral health services delivered each year in New York City, caring for more than 76,000 patients annually. 

The system plans to renovate its inpatient behavioral health units and intends to keep all 1,000 of its inpatient psychiatric spaces fully staffed through 2024 and 2025. The system also set a goal to increase the number of outpatients served by 10% in 2024. 


Supporting existing staff and recruiting new employees are key parts of the plan to increase behavioral care capacity. 

The system is launching a Psychiatric Physician Assistant Career Pathways Program to train providers to specialize in behavioral health. 

"It's really a comprehensive program from A to Z," Dr. Fattal said. "What's exciting about that is the physician assistant really has not been fully tapped in our system and in society in general." 

Graduates who stay with NYC Health + Hospitals for three years could be eligible for loan repayment programs, Dr. Fattal said. The system has rolled out wider loan repayment programs for behavioral health staff as well. 

"It continues to be very popular and very successful in the sense that people are asking for it, applying for it, and we're able to give them grants in turn for them staying with us for a three-year commitment," Dr. Fattal said. 

Decreasing workplace violence is another pillar of the system's blueprint. NYC Health + Hospitals is approaching the issue in several ways, Dr. Fattal said, including staffing more intelligently. 

The system will add to the number of licensed creative arts therapists on its units to keep patients engaged, and add wellness coordinators designed to support staff, Dr. Fattal said. 

The system will also introduce simulated training to allow staff to practice violence deescalation skills before they may be needed in practice. 

"This is a very important topic for us. It has its own strategic priority; there's a team supporting it and resources being put behind it," Dr. Fattal said. "We see that as something needed in and of itself, and a retention issue. Obviously, staff don't want to work in an environment that is unsafe." 

Care across a continuum 

In addition to upskilling inpatient services and staff, NYC Health + Hospitals is adding outpatient care at sites across the city. 

Earlier this year, the system announced plans to open 16 school-based mental health clinics in public schools. 

The system also bringing mental health services to 65 domestic violence shelters across the city and is reaching community members though mobile outreach vans. 

"The nice thing about this continuum is it ties back into our services. So if people are connected and interested in care, they can come to our facilities," Dr. Fattal said. "If they're not ready yet, then at least they're getting something and not just falling through the cracks." 

Increased need for mental health services brought on by the COVID-19 pandemic, the opioid crisis and other factors have brought increased funding and attention to behavioral health, Dr. Fattal said. The next step is to build on this momentum. 

"For years and years, we saw our system neglected, starved for resources when there was need," he said. "The need was always there. But it feels like the need, with multiple crises, the stigma coming down, I think opened the door for more resources. 

"They're not going to last forever. They're going to be around maybe another year or two. So it's extremely exciting to be able to grab those resources and turn them into programs, modernize our facilities and help launch things that will eventually become sustainable."

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