The push is on for advocates wanting half of the $1.1 billion for mental health in Gov. Kathy Hochul's proposed budget to be dedicated to improve services for young people as they face record rates of suicide, mental disorders and substance use. 

Suicide is the second leading cause of death for New York teens ages 15 to 19, according to the state Health Department.

Decades of disinvestment in children's behavioral health has made it impossible for families to navigate the system, forcing young people to be on wait lists for months before they can receive care.

"Half of young people with a depressive issue are not able to get the services that they need," said Alice Bufkin, Citizens' Committee for Children executive director of policy and advocacy. "And a lot of that really primarily is being driven by the lack of an adequate workforce."

As thousands of children lack access to services, providers want funding to create a program preparing high schoolers for nonclinical mental health careers. 

Stakeholders and lawmakers are also in discussion to create of a retirement plan for workers in the human services sector, Mental Health Association of New York State CEO Glenn Liebman said. They're working to draft legislation to study the costs of such a program for the state's more than 800,000-person workforce.

"We have a retirement system in place for the state workforce, for police, for firefighters, for teachers, all sorts and we want that pension to stay and be as strong as ever, but what about the human service workforce?" Liebman said. "Shouldn't they have some ability to be able to have some sort of pension when they do retire or when they do leave?"

Providers continue to push back against Gov. Hochul's proposed 2.5% Cost of Living Adjustment pay increase for workers — an increase for the second year in a row, but down from a 5.4% hike in last year's budget.

They're advocating for an increase of 8.5%, which they say will address the workforce crisis and make up for decades of insufficient funding for services.

"We have to pay our staff what they're worth that ultimately will help sort of stop that blockage that we see in this system of care," Liebman said.

Gov. Hochul proposed $10 million of her $227 billion executive budget to increase school-based mental health clinics to give students access to meet with clinicians and assist overburdened school counselors; $10 million for suicide-prevention programs and $12 million for home-based crisis intervention teams to meet with children and youth where they are.

"Our children need preventative services now to stop them from needing intensive services later," Gov. Hochul said at a mental health event in the Bronx earlier this month. 

She said the state must take action, citing a recent U.S. Centers for Disease Control & Prevention report that shows a 40% increase in teenage girls experiencing sadness, depression and violence nationwide over the last several years.

"Think about a teenager starting off as a sophomore in high school ... finishing middle school remotely — a lot of them have anxiety, they need those services," Hochul said. "...My goal is to reduce the unmet mental health needs of our children by half in the next five years. That's ambitious, that's bold, but we have no choice."

Advocates are pleased with Hochul's proposals in her executive budget to help youth, including $24 million over two years to help providers screen and identify mental health risks in children and $18 million over two years in reimbursements for family preventive mental health services like therapy.

But at a rally about mental health funding for children Wednesday, families from across the state recount longtime issues accessing and affording the care they needed, or driving hours to find availability. They require answers and support in wake of an ailing system that won't take years to materialize.

Mental health professionals say bolstered support for the human services workforce must be proportionate to the  supporting behavioral health services and resources for children and families for workers must be proportionate to the response so intervention can happen as early as possible. 

"What we're trying to do is get ahead of the cycle where we have young people who don't get the care they need when they're young, then they become adults with even more complex and acute needs who also can't get the care they need," Bufkin said. "So our focus is really trying to support those families and children as early as possible, as far upstream as we can ... specifically the behavioral health supports that they need."

Providers are fighting for an increase in reimbursement rates for families using commercial insurance for care equal to Medicaid government rates. Hochul proposed legislation in her executive budget requiring commercial insurance providers to pay for school-based services at a rate that's equal to the higher-paying Medicaid rate.