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As part of the Governor's proposed 2001-2002 Executive Budget for the New York State Office of Mental Health, four free-standing children's psychiatric centers (Western NY, Rockland, Queens and Sagamore) were slated to be "co-located" onto the grounds of nearby adult psychiatric centers. This was in addition to the proposed closure of two adult centers, Middletown and Hutchings in Syracuse, as well as the consolidation of an adult forensic facility in New York City.

The response to the plan was fast, and the rhetoric furious, with substantial statewide focus on the plan to close the adult facilities. For six weeks, while the legislature mulled options regarding the governor's proposal as the responsive budget resolutions were formulated in each house, arguments on both sides focused on keeping the adult facilities open.

Yet, the proposal to move the children's facilities generated the most emotional response, and an important debate may never be had. According to the Office of Mental Health, six state operated children's facilities here in New York already occupy space on the same plot of land as the adult facilities, and that nearly 30 private psychiatric hospitals in this state have both adult and children's wards safely placed together.

The proposal to move the children's facility had merit, particularly from a financial point of view. Of course, the merit of a new idea is often joined at the hip with serious and legitimate concerns. MHANYS board of directors took a position stressing the need to address these concerns.

In the fast paced world of "spin", the deluge of concerns overwhelmed the proposal before the public policy was ever truly addressed. Family members and their advocacy leaders charged forth, questioning why it was that the state wanted to reverse a policy that 30 years ago had made these separate facilities shining lights in the children's service community. They asked questions about safety, with a handful using prejudicial language to differentiate their children from the adults also being served in state facilities. And they made it a community issue, drawing local legislators into a fray in which there was only one popular position.

While the issue of downsizing the state psychiatric hospital network will continue to be discussed this session (and it should be), any hope to change the children's system may be lost.

That is unfortunate. The real question here is not whether 500 of New York's children can be safely co-located on the grounds of adult facilities. That question ignores the fact that twice that many of our children are institutionalized, outside New York's borders as well as in, everyday.

It does not address the deeper concerns for children's needs like those expressed last week at the MHA in Suffolk's meeting on the proposed co-location of Sagamore. From a high of 200 children at Sagamore 20 years ago, the facility now has beds for 69. Children's residential services are in short supply, with 1.2 million people being served by the 69 in-patient hospital beds there and another 90 in the community. Residential Treatment Facility (RTF) beds are extremely limited, with as many or more children going to Pennsylvania, Connecticut or areas in upstate New York as are actually being served in the county.

In the children's system, there is a shortage of chemical dependency programs, Intensive Case Management slots (2 month backlog), insufficient Home and Community-based waiver slots, and an insurmountable amount of paperwork required to open a private community mental health hospital.
The real question is: "Why are 1000 of our children institutionalized every day to begin with?" No matter what happens in this year's state budget, we must begin to work to find the answer to that most pressing question.