Government exists to serve the people it represents. Today, on the issue of mental health, it is failing us. More than 1 in 5 American adults and 1 in 7 children experience mental illness each year, and suicide is the second leading cause of death for children between 10 and 24. Few crises facing our children, our neighbors, and our nation are graver.
We should not measure our success as elected leaders in this city by the boldness of our promises or the headlines they earn. We should measure it by whether a New Yorker in distress can get help in the middle of a mental health crisis – and, better yet, find care before the crisis ever arrives. Our healthcare system was built to react, withholding treatment until the damage grows too severe to ignore. Families exhaust themselves hunting for providers who take their insurance, and sometimes that search comes up empty. Students wait out the semester on a list. Unhoused New Yorkers cycle between shelters, hospitals, and jails. Police officers are sent to handle behavioral health emergencies that should belong to trained medical professionals.
New York City, along with other local and state governments, has led the way in building healthcare systems around prevention, harm reduction, treatment, recovery, and community-based care. But a framework is only as strong as its execution. Building the infrastructure and services our communities need takes sustained funding and support from the federal government. This crisis tests our resolve to serve people when they need us most.
We need a bold, clear plan.
First, repair the damage the Trump administration has done to our healthcare system, then deliver real mental health parity. We already have laws requiring equal coverage for mental and physical health, but those laws mean nothing while barriers keep New Yorkers and Americans from the care they need. More than 900,000 adult New Yorkers report unmet mental health needs. Over 57% of them struggled to find care because navigating the bureaucracy or finding an in-network provider proved too hard, while 39% said they couldn’t afford treatment. Many more battle insurance plans that maintain “ghost networks,” pile on administrative hurdles, and reimburse providers at rates too low to sustain.
Congress must strengthen federal oversight of how insurers comply with the Mental Health Parity and Addiction Equity Act. Plans should have to report the data that shows whether patients can actually get care: how many treatment providers they offer, how often they deny coverage for mental illness or addiction services, how long patients wait for treatment after a referral, and what obstacles stand in the way. Give regulators the funding to enforce compliance, expose the plans that fail, and punish those that break the law. The Trump administration paused enforcement of a parity rule finally issued in 2024. Enforce it, and more therapists, psychiatrists, and substance use disorder providers will accept insurance across New York City and the country.
Second, rebuild our mental health workforce. Roughly 144 million Americans live in a federally designated mental health professional shortage area, and psychiatric beds in New York City fell 11% between 2014 and 2023. A right to care means nothing when no one is there to provide it. No policy works without enough doctors, social workers, school counselors, peer specialists, addiction counselors, and community providers. We have tackled these shortages at the local and state level; now Congress must act.
Congress holds the tools it needs to fix this pipeline. Expand loan forgiveness, scholarships, residency slots, and grant funding for psychiatrists, psychologists, psychiatric nurse practitioners, social workers, addiction counselors, and certified peer specialists. Fight the new work requirements in Trump’s Big Beautiful Bill and the recently released rules released just this week, which make it even harder for Americans with chronic mental health conditions to keep their Medicaid. Raise Medicare and Medicaid reimbursement rates for behavioral health – these federal benchmarks set the market, and chronically low rates drive good providers out of public and insurance-based care. Federal dollars should prioritize culturally competent, multilingual, neighborhood-based providers who reflect the communities they serve.
Third, build a true crisis-care continuum. A real strategy takes more than a hotline. Someone reaching out for help may need a trained counselor, a rapid mobile response team, a same-day appointment, a short-term stabilization bed, or sustained treatment. Federal funding should reward states and cities that build the full continuum. In New York City, B-HEARD and related crisis-response programs deserve to grow where they work and to be rebuilt where outcomes fall short.
Fourth, confront the youth mental health crisis. New York City’s families, schools, universities, and young adults are living through it now. Anxiety, isolation, and trauma among young people show up in classrooms, homes, emergency rooms, and on campuses. We have to teach our children to navigate a world run by predatory social media algorithms and shield them from the harms of AI – technology that has far outpaced our ability to cope.
Increase funding for school-based mental health clinics, pay livable wages to school-based providers, fund trauma-informed care, social workers, and referral partnerships with local hospitals and providers. Work with the City, the Department of Education, CUNY, SUNY, and nonprofits to turn schools and campuses into trusted entry points for care. Early intervention beats punishment, absenteeism crackdowns, and needless emergency-room referrals.
Fifth, treat serious mental illness, housing, and public safety as one challenge. Humane care, effective government, and public safety reinforce each other. People living with serious mental illness need stable housing, assertive community treatment teams, medication support, peer-led programs, and coordinated discharge planning after hospitalization. New York State already runs a vast mental health system serving hundreds of thousands of people a year. The problem is not too much government – it is too little coordination, accountability, and follow-through – all levels need to work together for their mutual constituencies.
Finally, put health in every policy. Solving this crisis takes a holistic approach: confronting the systemic socioeconomic and racial divides in our society, taking on the affordability crisis directly, and guaranteeing every American quality, affordable healthcare. Provide supportive housing and step-down treatment so vulnerable New Yorkers leave inpatient care for a home, not the street. Invest in health-led crisis response so police are no longer the default answer to nonviolent mental health emergencies. Daniel’s Law — a statewide proposal directing local governments to establish civilian crisis‑response teams for mental‑health incidents — illustrates a broader principle: public safety and compassion are not competing values but mutually reinforcing obligations. The most dangerous system is the one that waits for illness to escalate into an emergency.