The Office of Mental Health is the largest state agency, with a budget of over $3 billion, yet it has no commissioner.
Gov. Andrew Cuomo has not announced a replacement for Michael Hogan, who recently left the job after five years of "transforming" OMH from an organization that treated the most seriously ill to one now focused on "improving the mental health of all New Yorkers."
Cuomo should appoint a commissioner who will undo that transformation and return OMH to its roots: helping the most seriously ill.
Hogan's transformation effort was successful. There are more bullying brochures, anti-stigma efforts and "how to reduce stress" programs than ever. But the cost was to abandon the most seriously mentally ill to jails, prisons and shelters, where they cost taxpayers more.
Today, 15,000 seriously mentally ill New Yorkers are being incarcerated, largely because less than 4,000 are receiving hospital services. Police are being forced to step in where the mental health system no longer treads. This puts police, public and patients at risk.
The new commissioner should want to work closely with police, sheriffs, courts, and corrections on reducing the number of mentally ill criminalized. The policies that allow OMH to close hospitals and fail to provide aftercare often have the impact of turning patients into prisoners. While this looks like a success for OMH — their budget is reduced — it increases cost for the governor, who now has to fund services behind bars. As a result of OMH failures, rather than just providing treatment for serious mental illness, the state is now forced to fund police, sheriffs, courts, corrections, parole and probation programs, plus provide food shelter and clothing to those OMHs neglect caused to be incarcerated.
To return OMH to its proper focus, Cuomo should choose a commissioner who has extensive experience helping people with serious mental illness. New York used to have a requirement that the commissioner be a medical doctor because medical doctors are more likely to understand the consequences of lack of treatment.
This was waived to allow Ph.D.s to serve and suddenly OMH was helping people get better grades, saving marriages, and ending poverty. Serious mental illness went out and social services came in.
The new commissioner should want to treat the seriously mentally ill rather than relegate them to a sideshow.
The new commissioner should believe in, champion and expand the use of Kendra's Law. OMH research shows Kendra's Law — by allowing courts to require certain historically dangerous, hospitalized, or incarcerated mentally ill to stay in treatment as a condition of staying in the community — reduced homelessness, hospitalization, arrest and incarceration over 70 perfect each. It also saves money because it commits the mental health system to do what it has failed to do voluntarily: serve the most seriously ill.
Many in the mental health industry will howl if Cuomo does this. Returning OMH to its original function of helping the most seriously ill will require them to abandon social services to others and start helping more symptomatic patients. But the governor's obligation should be to the most seriously mentally ill New Yorkers and to taxpayers — not to the mental health industry, which is happy to feed on taxpayer dollars.
D.J. Jaffe is executive director of Mental Illness Policy Org., a nonprofit think tank on serious mental illness.