Mentally ill, nowhere to go

There’s a lot to like about First Lady Chirlane McCray’s ThriveNYC programs to help New Yorkers in distress get mental health treatment — but it’s dastardly dissonant that in the meantime, this city’s capacity to get intensive psychiatric care to the most severely mentally ill is vanishing before our eyes.

At the northern tip of Manhattan, New YorkPresbyterian is preparing to shed 30 inpatient psychiatric beds at its Allen Hospital, where patients with conditions like schizophrenia and severe depression — many grappling with addiction to boot — get sustained treatment.

Not because the beds and caregivers aren’t in high demand, but because the hospital decided that expansion of operating rooms and maternity services would be a better use of the space.

The outrage of community residents who are petitioning to keep the facility open speaks to a city’s greater anxiety about our patently obvious failure, visible on too many streets and subway trains, to get care to the most extremely ill.

New York-Presbyterian should be free to make its best judgments about how to deploy its limited real estate for the vast range of medical needs its top-notch docs treat — but also needs to recognize, as should the state health authorities that must approve the closure, just how dire a shortage this city already has of mental health treatment options.

The great shrinkage started with state-run psychiatric facilities, whose population statewide plummeted more than 90% between 1982 to today, when fewer than 2,400 adults are served, many of them committed after perpetrating crimes.

Hospital emergency rooms get the brunt of the overflow, with a greater and greater share of those hospitalizations falling on the financially flailing New York City Health + Hospitals system.

Nor is New York-Presbyterian the only private hospital dispensing with psychiatric beds. In the past two years, Mount Sinai also dropped 30, cutting its capacity by 60%. Staten Island University Hospital closed a unit and has just 35 spots left. H+H Woodhull Medical and Mental Health Center dropped 23 last year, and is down to just 112.

Advances in drug technology, outpatient treatment (including court-ordered care under Kendra’s Law) and supportive housing all combine to make hospitalizations less necessary now than once upon a time.

But when patients show up at the ER in acute distress, many will need somewhere to spend many more nights under medical care.

Never, ever forget them.