New York’s mental health and supportive housing system is currently facing a significant challenge: an aging population among its residents. Forty years ago, when the original funding and housing models were developed by state leadership, the longevity of residents was not a primary concern. Today, more than 48,000 New Yorkers living with mental health challenges depend on mental health housing providers to find appropriate and necessary care.
The population among those 48,000 individuals in mental health housing is aging, and this demographic shift presents numerous challenges. Nursing homes are increasingly refusing to admit individuals with severe mental illness, leaving mental health housing providers to shoulder the responsibility of elder care. However, a recent poll revealed that 75% of these providers across the state admit that with the current state-funded housing models, they are not equipped to handle their residents’ aging medical concerns. This lack of preparedness has significant implications for the well-being of residents and the sustainability of mental health housing providers.
It is important to understand that mental health conditions and comorbidities can cause individuals to age faster biologically than their peers. Mental health challenges, such as schizophrenia, bipolar disorder, and severe depression, often come with comorbidities like cardiovascular disease, diabetes, and chronic pain. These conditions can significantly reduce life expectancy and accelerate the aging process, making people in their 50s or 60s experience health issues typical of much older adults. Consequently, when we talk about elder care in the context of mental health housing, we are often referring to individuals well before the typical retirement age or “elderly” classification. This creates its own set of challenges in that many benefits for “older” adults are not redeemable until the individual has reached retirement age, leaving another gap in care that is currently unaddressed.
As residents age, their medical needs become more complex. Mental health housing providers are now faced with the task of managing chronic conditions such as diabetes, heart disease, and mobility issues, which require specialized care and resources. To address these needs, staff in mental health housing require additional support, including but not limited to:
- Nurses and On-Site Health Aides: Having medical professionals on-site is crucial for managing the health of aging residents. Nurses and health aides can provide necessary medical care, monitor chronic conditions, and respond to emergencies.
- ADA-Compliant Spaces: Many mental health housing facilities are not designed to accommodate residents with mobility issues. Making spaces ADA-compliant would ensure that aging residents can move around safely and comfortably.
- Additional Staff Training: Staff need specialized training to understand and manage the unique health concerns of aging residents with mental health issues. This training would equip them with the skills to provide better care and support.
- Better Pay for Staff: To attract and retain skilled workers, it is essential to offer competitive pay. Better compensation would also reduce staff burnout, a common issue in this demanding field.
Appropriate and necessary funding is crucial for addressing the needs of aging residents in mental health housing. Increased financial support is needed to hire additional medical and support staff, renovate facilities to meet ADA standards, provide ongoing training for staff, and, most importantly, ensure fair wages and reduce staff turnover. Unfortunately, funding has been a contentious issue. While Governor Hochul has historically demonstrated support for mental health, and specifically mental health housing, it isn’t enough to combat the decades of underfunding this field has endured. The age of our housing models and the lack of resources to meet residents’ modern needs requires ongoing and sustained investments. This includes a need for an adequate and consistent annual cost of living adjustment (COLA), which helps providers cover mandated operation costs and pay their staff a living wage.
Addressing this time-sensitive issue facing aging New Yorkers in mental health housing and those who support them requires collaboration between various stakeholders, including state leadership, mental health housing providers, and advocacy organizations. Yet, twice (2021-2022: A.10139/S.9041, 2023-2024: A.5119/S.5178) Governor Hochul has vetoed a bill, which passed in both the Senate and Assembly, that would have organized a task force to make suggestions on how to handle the crisis among mental health housing communities. This lack of progress exacerbates the crisis, as time is lost and residents continue to age without adequate support.
To remove barriers to the care of older adults living with mental health challenges, several solutions should be considered:
- Establishing a dedicated task force, as in the proposed legislation, could provide expert recommendations on addressing the needs of aging residents. This group could identify best practices, propose funding mechanisms, and suggest policy changes to improve care.
- Developing integrated care models that combine mental health services with elder care could provide comprehensive support for aging residents. These models would ensure that residents receive holistic care tailored to their unique needs.
- Implementing enhanced training programs for staff would equip them with the skills needed to care for aging residents. These programs should focus on both medical and mental health aspects to provide well-rounded support.
- Securing increased state funding is essential for implementing these changes. Advocates and providers must continue to push for financial support to ensure that facilities can meet the needs of their resident, and the growing costs of operations.
- Raising public awareness about the challenges faced by aging residents in mental health housing could garner broader support for necessary changes. Highlighting the stories of affected individuals could humanize the issue and drive advocacy efforts.
The aging population in New York’s mental health housing presents a significant challenge that requires immediate attention. By addressing the needs of aging residents through increased funding, enhanced training, and comprehensive care models, we can ensure that these individuals receive the support they deserve. Collaboration among state leadership, advocacy organizations, and providers is crucial for creating a sustainable solution. As we move forward, it is imperative to remember that the well-being of our most vulnerable residents is at stake, and we must act with urgency and compassion to address their needs.
Sebrina Barrett is the Executive Director of the Association for Community Living, which advocates on behalf of more than 48,000 New Yorkers living with mental health challenges to find appropriate and necessary care among the mental health housing providers across the state. She can be reached at sebrina@aclnys.org. More information about their advocacy and mission can be found on their website. To reach ACL staff, call (518) 688-1682.
