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Your (Unofficial) Guide to State-Sponsored Therapy in New York

There’s a way to get affordable mental health care that you might not know about. That’s New York’s mental health system.

If you qualify, you can get mental health care at a local community mental health program in New York for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services at a state-funded program, New York’s system can still give you information, referrals to affordable providers, and other essential help for free.

If you’re in a hurry, you can read our quick start guide below for the most important information about the New York mental health system.

Quick Start Guide

Quick facts about New York’s mental health system:

  •     New York’s public mental health system helps over 800,000 people every year.
  •     In 2023, New York passed a billion-dollar mental health budget that increased funding for every part of the state mental health system in order to improve statewide access to public crisis, outpatient, and inpatient mental health services.
  •     All publicly-funded mental health programs in New York accept Medicaid and most offer low sliding-scale fees to people without insurance coverage.

What services are available?

  •     Many public mental health programs in New York provide specialty and intensive mental health services that can be hard to find anywhere else, like case management, day treatment, and community-based services.
  •     Outpatient mental health services including psychiatric evaluation, medication management, and group and individual therapy are also available at most public mental health programs.

Who’s eligible?

  •     Some services, such as state and local crisis and information lines, are available to any New York resident without exception.
  •     Eligibility for outpatient mental health services like therapy vary from program to program, but many OMH-licensed clinics serve a wide range of clients.
  •     Some services are only available to people who have severe conditions like major depression or schizophrenia. However, more people have one of these conditions than realize it! In fact, 1 in 10 Americans experience major depression each year.

Where can you get started?

  •    You can reach local mental health crisis and information services from anywhere in New York by dialing 988.
  •     You can find phone numbers for local state-funded programs (and local crisis lines) by scrolling to your county in the directory below.

To learn more about public mental health services in New York, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if New York’s mental health system might be right for you.

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Who Is Eligible?

New York’s mental health system can meet many people’s needs, but you should especially consider it if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have Medicaid, or have a limited income.

Everyone in New York can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call a state or local crisis line to get the help you need, quickly.

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Use the State System When You're in Crisis

Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.

State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.

The people who answer crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.

Even if you’re not in crisis, you can call a state or local mental health hotline for information about affordable mental health services in your area.

When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about affordable providers.

There are many options for affordable care. There are no statewide restrictions on who can use the New York mental health system. Instead, eligibility criteria vary from county to county and provider to provider.

Most publicly-funded mental health providers in New York don’t have strict (if any) limits on who can receive standard outpatient mental health services like therapy and psychiatric care.

What changes depending on your financial situation and diagnosis is whether you qualify for specialty and intensive services like case management or whether you qualify for financial aid.

You need to meet income eligibility criteria to qualify for state funding through Medicaid, which all providers who participate in the New York public mental health system accept.

However, you don’t need Medicaid to go to most publicly-funded providers. Most providers in the public system also accept private insurance. If you don’t have insurance or would prefer to pay out of pocket, most also offer sliding-scale fees.

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Check If You're Eligible for Medicaid

Medicaid is a great way to access the public mental health system in New York. Not only do all OMH-licensed clinics in New York accept Medicaid, but you can also use your Medicaid managed care plan to access services at other providers.

You’re eligible for Medicaid in New York if your income is 138 percent of the federal poverty level or less. You may also qualify based on a combination of your income, your medical history, and your mental health condition.

If you’re not sure whether you’re eligible, it’s worth looking into. You can apply for Medicaid in person, by phone, or online. To learn more, you can visit the New York State Medicaid page.

In some ways, going to a publicly-funded provider in New York is the same as going to any other provider: you either pay for services with your insurance or pay out of pocket. So, the best way to get affordable care is to look for providers who accept your insurance or who offer sliding-scale discounts.

Many publicly-funded mental health programs and integrated clinics in New York offer outpatient mental health services like group and individual therapy, psychiatric evaluation, and medication management for an affordable fee or co-pay.

However, if you need specialty or intensive services, you’ll need to look for specialty providers who offer them. Many that do are part of the public system.

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Check Out the State System If You Need Specialized Services

Publicly-funded mental health programs in New York are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.

The programs licensed by New York’s Office of Mental Health vary in the forms of payment they accept. Most accept Medicaid and Medicare, and some accept private insurance plans.

Most public clinics have a sliding-scale fee structure if you don’t have insurance or don’t have a plan that the program accepts. However, you may have to meet other requirements to get services at one. Some OMH providers and programs only provide services for people with serious mental illness, while others include services for people with more moderate symptoms or conditions.

Some programs may not generally have strict eligibility criteria, but may temporarily impose stricter criteria or limit admission when funding is low or demand is high. Some may encourage potential clients to look elsewhere if they have long waiting lists.

The best way to find out if you’re eligible for services at a public mental health program in New York is to call that program and describe your needs and the services you’re looking for. If you’re not sure who to call, most counties have a general mental health crisis and referral hotline you can call to talk about your symptoms and get matched with the right provider.

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Check with Your County for Accurate Local Eligibility Information

One of the most important things to know about the New York public mental health system is that programs vary in what they offer and who they serve. The Office of Mental Health licenses a variety of mental health programs to address different needs.

Whether you can get the care you need at a state-funded program depends on where you live and what your local programs’ policies are. So, it’s important to check with your local program or county mental health agency to find out what’s available where you live.

You can find the numbers for state-funded mental health programs in New York in the directory below. We encourage you to call even if you think you might not be eligible.

Even if you’re not eligible, or if the program doesn’t offer the service you want, they can probably still help you. The people who work in these programs are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.

Where Do You Call to Get Started?

The easiest way to learn more about state mental healthcare in New York is to call a state or local mental health hotline. The 988 mental health hotline will connect you to local crisis and information services no matter where you are in New York. You can also call your county or city’s crisis line directly.

You can find statewide mental health hotlines in the information box directly below and can find your county’s crisis line in the directory in the next section.

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Important Numbers in New York

The statewide New York mental health crisis hotline is 988.

The Crisis Text Line for the state of New York is 741741.

You can get crisis support by phone, text, or chat by going to the NYC Well website. You can also use their search tools to look for mental health services in the NYC metro area.

If you’re not in crisis, but just need to talk to someone, you can reach the NY Connects Warmline by calling (844) 976-5463 or (607) 687-1314.

You can speak with a peer any time of day by calling the Mental Health Association of the Southern Tier’s Peer-to-Peer Warmline at (607) 240-7291.

You can reach the National Alliance on Mental Illness (NAMI) Helpline by calling 1-800-950-NAMI (6264).

You can reach the non-emergency NAMI New York State Helpline by calling (518) 245-9160. You can reach their main number and information line by calling (518) 462-2000.

You can get mental health information and referrals by calling the Mental Health Association in New York State’s Mental Health Information Center at (800) 766-6177 or (518) 434-0439.

You can reach the New York State Office of Mental Health by calling (800) 597-8481.

Public mental health services in New York are managed on the state level by the Office of Mental Health. For general information about New York’s system, you can contact OMH by calling (800) 597-8481.

However, you’ll probably get the best results by calling the program you’re interested in directly or by calling a state or local crisis line. You can find local contact information in the directory below.

New York Clinics and Crisis Lines

Each county in New York has its own mental health crisis and information line (except the counties that make up New York City, as there is a citywide mental health crisis and information line for NYC).

Publicly-funded adult outpatient mental health services in New York are primarily provided by clinics licensed by the Office of Mental Health (OMH). Severity requirements vary; some OMH providers and programs focus on serving people with serious mental illness, while others include services for people with more moderate symptoms or conditions.

The best way to find out if a publicly-funded mental health program in New York is right for you is to call that program and describe your needs and the services you’re looking for. If you’re not sure who to call, you can call your county’s mental health hotline.

You can find the website and contact numbers for your county crisis line and OMH-licensed adult mental health outpatient clinics in the directory below.

County Crisis Lines and Mental Health Clinics

Western New York Mental Health Clinics and Crisis Lines

 

 

Central New York Mental Health Clinics and Crisis Lines

 

 

Hudson River Region Mental Health Clinics and Crisis Lines

 

 

Long Island Mental Health Clinics and Crisis Lines

 

 

New York City Mental Health Clinics and Crisis Lines

 

You can use OMH’s “Find a Mental Health Program” search page to generate an updated list of OMH-licensed clinics or to search for other types of mental health providers that we haven’t covered here.

If you’re living in New York City, you can search for programs in your borough by filtering for the county your borough is in. However, you may be better served by using NYC Well, New York City’s free and confidential crisis, information, and mental health referral service.

To connect with NYC Well, you can call 988, text 988, or open a chat window on the website to talk to a mental health professional who will listen, offer support, and give you referral information for providers who can meet your needs.

Also Consider: Federally Qualified Health Centers

Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in New York.

These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care so you can get primary medical and mental health services at the same location. Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance.

You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.

Troubleshooting Guide

The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.

Problems and Solutions

 1.   You can’t get through to someone on the phone.

Except in extremely rare circumstances, someone should answer a state or local crisis line any time you call. But if you’re not in crisis, the person you talked to gave you another number to call, and you’re having a hard time getting through, you can try going to a walk-in clinic instead.

Many public mental health programs in New York run walk-in clinics where you can be seen during regular business hours on Monday through Friday. Some let you walk in and wait without an appointment. You can often be seen the same day. If the wait is long or they don’t have availability, you can schedule an appointment and come back.

We recommend checking your local program’s website for clinic locations and hours.

2.    There’s a long waiting list.

State-funded services are often in high demand. New York is working to shorten waiting times and make sure you can get seen for essential services right away. However, if you’re not in crisis, you may still have to wait before you can be seen by a therapist or other mental health provider.

Sometimes, it’s worth it to wait if you’ve found a good therapist or service. You can read our article on what to do before your first therapy session for tips on how to maintain your mental health while you wait.

If your symptoms are getting worse and you’re worried you can’t wait, you should call a crisis line. The caring people who answer can help you figure out if you need help right away and tell you where and how to get the level of care you need.

If you’re not in crisis but don’t want to wait, you can call a mental health hotline, an intake worker, the main number, or your contact person at the agency to ask if there are other options. There may be another affordable local program they could tell you about that could meet your needs but has a shorter waiting list.

3.    You’re not eligible for state-funded services.

If you’re not eligible for services at a publicly-funded mental health program in New York, you’re not eligible for the service you want, or your local program doesn’t offer that service, the people who work there should still be able to help you.

Intake workers usually keep lists of affordable local mental health resources for people who aren’t eligible or would prefer to go somewhere else. Ask for information, a printed resource list, or even a direct referral to another provider.

4.   The state system doesn’t offer the service you want.

State mental health programs sometimes have to change or limit the services they offer based on their current funding. If you’re admitted to an OMH program but it doesn’t offer the service you need, you have two options.

One is to try an alternative service that they do offer. The other is to ask if they can recommend an affordable alternative provider who does offer that service.

If they do offer the service you want, but it’s limited, stand up for yourself if they try to get you to do something else. Don’t accept getting pushed into something you don’t want just because it’s easier for them or because they can get you in faster.

If you’re willing and able to wait, tell them you would prefer to wait for the service you want, whether that’s therapy, medication, or something else.

5.    You don’t like your therapist.

You should never accept bad therapy—or bad mental healthcare of any kind—for any reason. This is just as true in the public system as it is anywhere else. If you have a bad therapist, ask for a new one. Tell your main contact person at the agency, an intake worker, or a manager that you want to try a different therapist.

If you’re not sure whether you have a bad therapist, you can read our articles on how to spot an unethical therapist and how to do a background check on a therapist. If you don’t like your therapist but wonder if it the problem might be fixable, you can read our articles, “What If I Don’t Like My Therapist?” and “How to Fix Problems with Your Therapist.”

If you don’t like the first therapist you’re assigned, ask someone at the agency if they have a webpage or list of therapists you can review. You can read their bios and see if you think one might be a better match. Not all agencies do this, but it doesn’t hurt to ask. You can read our article on how to choose a therapist for information on what to look for.

If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or a local hotline) and tell them what’s going on.

You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.

If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.

Deep Dive: How Does the System Work?

To understand New York’s mental health system, it helps to understand how it started and how it’s changed since then.

Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.

In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.

In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.

DEEP DIVE

For More Information

To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”

To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”

Many state mental health programs trace their origins back to the 1960s when these important changes started to happen.

New York was ahead of the curve. It established its state mental health department, originally called the Department of Mental Hygiene, in 1926. It started opening community mental health programs in 1954, when it passed its own state Community Mental Health Act, one of the first such laws in the country. This law established state funds to build and develop community mental health programs.

New York’s approach to community mental health care has varied in the decades since, but it has consistently spent and focused more on its mental health system than many other states. New York continues to have one of the highest concentrations of mental health professionals of any state and has a robust statewide network of public and non-profit agencies that provide therapy as well as other outpatient, inpatient, mobile, and in-home mental health services.

DEEP DIVE

What Is the Structure of the New York Mental Heath System?

New York’s public mental health system is one of the largest and most complex in the country.

Many of New York’s public mental health programs are administered by the counties they serve. Each county has a mental health department and crisis line. Rural New York counties with low population densities are the most likely to directly provide mental health services through a central county agency.

However, some counties contract with independent programs to provide state-funded services in their county. In some counties, especially the urban counties that make up New York City and other large metropolitan areas, services are provided by a scattered collection of state, local, and independent organizations.

No matter how each county does it, the Office of Mental Health oversees and evaluates each county’s program to make sure they are providing the full range of essential mental health services and that mental health services are accessible to everyone in the area regardless of their ability to pay.

In the 2010s, New York started making efforts to improve and update its mental health system. The OMH Transformation Plan and Medicaid Redesign Program were two ways New York sought to improve the structure and function of its mental health system and establish better coordination between medical and mental health providers across the state.

New York was also one of the states chosen to participate in the Certified Community Behavioral Health Clinic (CCBHC) pilot program overseen by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS).

Though these programs were successful, New York wanted to do even more to continue improving its system. In 2023, the New York government passed a new billion-dollar mental health transformation plan to expand access to mental health care and reduce wait times for both outpatient and inpatient mental health services across the state.

The plan expands state inpatient mental health capacity in order to reverse the loss of mental health beds during the pandemic; adds additional assertive community treatment teams, crisis centers, and walk-in mental health clinics; and provides more support for the newly streamlined state 988 crisis line.

It also further invests in CCBHCs and expands capacity at OMH-licensed outpatient clinics, which “often serve as a front door to mental health services in communities across the state,” according to a 2023 OMH report.

DEEP DIVE

The Office of Mental Health

The Office of Mental Health oversees the public mental health system and works to ensure that every New York resident has access to essential public mental health services. OMH directly operates the state’s psychiatric hospitals and associated mental health clinics.

OMH also evaluates, manages, and licenses over 4,500 programs that participate in the state mental health system. These include county mental health centers, hospital-based outpatient clinics, and independent non-profit agencies.

While OMH oversees most of the system, there are mental health programs in New York that are “operated outside of OMH authority, including federally-operated programs, private practices, and primary care settings that provide mental health services, such as Federally Qualified Health Centers and most primary care clinics,” according to a 2022 OMH report.

Each county in New York decides how its local mental health program works. Some county agencies provide services directly, while others contract with other community agencies to provide state-funded mental health services.

No matter how your county does it, you should start by calling a local program or mental health hotline to ask where and how to get started. They know how the system works and will help you get where you need to go.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 41 percent of people in New York who have mental health conditions get treatment for them. Many of them qualify for public mental health services but don’t know about them.

You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for New York state mental health services, call a local program or a state or local crisis line. You may find out that you can get mental health services through a publicly-funded program or that there’s another affordable option nearby.

The most important thing is to get started—the help you need may be only a call or click away.

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