We’re about one month out from the Democratic primary and Andrew Cuomo enjoys a commanding lead in the polls. Should he win the nomination and prevail in the general, many challenges await. Some of the toughest will involve fixing problems Cuomo himself created as governor.

One such challenge is mental health. During the 2010s, the Cuomo administration slashed hundreds of beds from the state psychiatric hospital system. Those cuts exacerbated New York’s crisis of untreated serious mental illness and imposed heavy burdens on city systems such as jails and homeless services.

Reducing the use of inpatient psychiatric treatment was the core thrust of Cuomo’s “Transformation Plan” for the state Office of Mental Health. When that plan was launched in 2014, the supply of beds in state psychiatric centers stood at about 4,000, down from more than 90,000 during the mid-1950s.

Cuomo nonetheless argued that New York’s psychiatric hospital system was bloated. By the time of his August 2021 resignation, Cuomo, via the Transformation Plan, had cut about 770 beds in OMH psychiatric centers statewide, a 19% reduction, and 275 such beds in New York City, a 17% reduction.

Cuomo argued the bed reductions would yield better, community-based care for the mentally ill and at a lower cost. He was wrong.

Costs were not saved so much as pushed down onto city taxpayers. In the first four years after the Transformation Plan’s launch, the city Department of Homeless Services saw its budget for mental health shelters increase by more than 50%. The number of “emotionally disturbed person” calls for police service rose by a similar proportion. By the time of Cuomo’s resignation, the percentage of seriously mentally ill inmates in city jails had risen from 10.2% to 16.5%.

New Yorkers overlooked Cuomo’s bed cuts because at that time Mayor Bill de Blasio owned mental health with his poorly-conceived “Thrive NYC” plan. Also, Cuomo did not shut down entire hospitals (though that was, initially, part of the plan). Spreading the cuts across the system made them harder to notice.

This year, in his run for mayor, Cuomo has presented a mental health plan. It’s a mix.

He continues to defend his bed cuts based on the utilitarian logic that, because community-based care is cheaper than inpatient, shifting resources to the former will benefit more people. This “more mental health for all” approach, also central to Thrive NYC, is not the way forward. Confronting New York’s crisis of untreated serious mental illness will require concentrating, not diffusing, resources and energy.

New York doesn’t have enough beds, period. The current system cannot even accommodate and appropriately treat individuals who pursue psychiatric hospitalization on a voluntary basis, much less those who will only be able to access care involuntarily. We must be able to do both.

Cuomo seems to grasp the benefit of inpatient psychiatric care more than he did ten years ago. His campaign calls for adding psych beds in city hospitals for “forensic” cases involved in the criminal justice system and “consistent” enforcement of involuntary community law.

If and when Mayor Cuomo gets down to business on untreated serious mental illness, he can count on a couple advantages. In Gov. Hochul, he’ll have a counterpart far more committed to the issue than he was. Hochul has restored more than 300 psych beds Cuomo cut from the state’s supply.

Hochul, along with Mayor Adams, has made excellent use of a political environment highly supportive of mental health reform. Polls make clear that New Yorkers want action on involuntary psychiatric hospitalization.

Cuomo’s major disadvantage is his record. On mental illness, the city needs the state. But how are Albany lawmakers supposed to react when, on “Tin Cup Day,” Mayor Cuomo comes across as asking for their help in fixing a mental health crisis worsened by his own gubernatorial policies?

Albany absolutely needs to hear that only with state government in the lead can New York’s mental health system gain a measure of functionality. But will Andrew Cuomo be the most effective messenger?

The Adams administration, flawed as it may have been on other fronts, has made a very promising start, guided by expert staff at City Hall and outstanding leadership at the city’s public hospital system, to focus attention and resources on the needs of people with serious mental illness.

Cuomo should pledge continuity with Adams on the issue. It’s the least he could do for the city and the seriously mentally ill in light of his past mistakes as governor.

Eide is a senior fellow at the Manhattan Institute and a 2024–25 public scholar at City College’s Moynihan Center. Sandorf is the president of the Charles H. Revson Foundation. The views represented are solely those of the authors.

https://www.nydailynews.com/2025/05/25/cuomos-real-record-on-mental-health/