Good morning and thank you to Chairs Schulman and Chair Lee for holding this hearing today. I am here representing Brooklyn Borough President Antonio Reynoso to discuss the importance of investing in health and mental health resources and services to create a more equitable and healthier city.
The Preliminary FY26 Budget includes $2.13 billion in funding for the Department of Health and Mental Hygiene, of which around $1.14 billion is from City funds. This investment is a marked decrease of over $457 million in total funds and $35 million in City funding from the FY25 adopted budget. Some of the largest cuts are in federally funded HHS grant programs; among the most devastating were to immunization programs. This comes at a time when vaccine-preventable diseases are on the rise nationwide, and NYC as a major hub of travel and communal activity is particularly susceptible to spreading these contagions. Large cutbacks are also seen in funding for STI programs, though the rates of reported STI’s in NYC continue to be alarmingly high. In acknowledgement of what will likely be additional federal divestment in public health, the City must proactively find ways to support ongoing programs in these areas.
The Preliminary Budget falls short in other critical ways. It includes no funding for the Mental Health Continuum program, a partnership between H+H, DOE and DOHMH to provide mental health and wellness services in schools and communities. It also provides no funding for Access Health NYC, the citywide initiative that supports community-based organizations in their efforts to assist New Yorkers in obtaining health care and health insurance. The City also continues to face unacceptable racial and ethnic disparities in maternal health outcomes, yet the Preliminary Budget does little to acknowledge this reality by supporting either hospital-based or community health initiatives focused on maternal well-being.
According to a 2024 report from the State Comptroller, 21.1% of adults in New York have a mental illness and 5.1% have a serious mental illness. Between 2012 and 2022, the number of people served by the State’s public mental health system increased by 23%. Despite the increased need, many New Yorkers, particularly those who are lower income or in need of more intensive services, are unable to access mental health resources. Like other health issues, the City must invest in evidence-based, lifesaving solutions to truly address mental health concerns.
Assertive Community Treatment (ACT) provides community-based and 24/7 services for individuals with severe mental health needs. The goal of ACT is to provide individuals with mental health concerns with high-quality care outside of the context of a hospital setting and empower them to lead the lives they want to. Services associated with ACT include psychiatric treatment, medication monitoring, counseling, support, employment assistance, and housing support. Though ACT is a nationally recognized, evidence-based model, the program needs additional funding. Unfortunately, as of 2022, there were over 1,000 New Yorkers on a waitlist for the lifesaving services provided through ACT. Forensic Assertive Community Treatment (FACT) is similar to ACT but is tailored to the needs of individuals impacted by the criminal legal system. We know that incarcerated individuals have higher rates of mental health concerns than the general population, indicating a need for additional mental health investments, such as FACT. Baselined funding for additional FACT and ACT is necessary to combat the long waitlists for these services.
Low and middle-income New Yorkers also need additional resources for mental health concerns that are not hospital based. Respite centers help to fill this gap. Respite Centers are supportive environments that allow individuals experiencing mental health concerns to access a variety of services. Services provided in respite centers include peer support, self-advocacy education, psychoeducation, self-help training, social support groups, recreational activities, and connections to medical and psychiatric services. Despite the value of respite centers and the high level of need for their services, there are currently less than 80 beds for adults in New York City. This is an egregious deficit; however, it is not insurmountable. As a city, we must allocate funding for four new respite centers in order to comply with Local Law 118 and allocated funding for out year projected costs.
Direct forms of mental health treatment are invaluable for addressing mental health concerns. However, we know that social determinants of health impact a person’s mental health and ability to consistently access treatment. In November 2015, then-Mayor de Blasio announced the City’s commitment to development 15,000 units of supportive housing in the next 15 years, an initiative known as 15/15. According to a report from 2024, the City has only created 3,853 units of supportive housing nearly a decade into the 15/15 initiative. This is significantly behind where we should be as a City. For this reason, baselined funding is necessary in FY26 to ensure that supportive housing is prioritized in the coming years.
The City must also do more to address substance use concerns. Overall, there is a deficit in treatment options for individuals with dual-diagnoses, or co-occurring disorders. Many providers and treatment centers feel ill equipped to treat patients that have mental health concerns in conjunction with substance use issues. Harm reduction practices save lives by empowering individuals to make more informed decisions and by mitigating risk factors associated with substance use. Harm reduction practices are incredibly important to build out, especially considering that a fatal drug overdose occurs every three hours in New York City. In 2023, 3046 New Yorkers died due to drug overdose. To help combat this epidemic, the City must support baselined funding for expanded mobile syringe programs in addition to opioid settlement dollar allocations.
To be specific, Borough President Reynoso has endorsed the Progressive Caucus’ Crisis to Care campaign, which calls for:
- $22 million in baselined funds for Intensive Mobile Treatment teams;
- $7 million for additional FACT teams;
- $6.3 million for the Mayor’s Office to end Domestic and Gender-based Violence;
- $4.8 million for Justice-Involved Supportive Housing (JISH);
- $6 million for four new respite centers;
- $9 million in baselined funding for expanded mobile syringe services programs;
- $4.5 million in baselined funds for 60 Peer Specialists for mental health and crisis response; and
- $1 million to pilot and EMS Wellness and Peer Support Program.
Thank you again to Chair Schulman, Chair Lee, and members of the Health and Mental Health, Disabilities, and Addiction Committees for holding this hearing today. Health, including mental health, is central to our ability to thrive. The City must invest and support measures that improve health and address existing health inequities.