New York City Releases Its Inaugural State Of Mental Health Report (Updated)

By NYC.gov

The Department of Health and Mental Hygiene today released a landmark report on the State of Mental Health of New Yorkers.

This is the first report of its kind ever released by the City of New York. The report presents data from across age groups, spanning children and youth to adults, including formal diagnoses, measures of well-being, and environmental factors that may affect these outcomes, such as access to resources and use of mental health services. 

“Clear understanding of New Yorkers’ mental health and the factors that shape their wellbeing improves our ability to best meet the needs of the 8.5 million people we serve,” said Health Commissioner Dr. Ashwin Vasan. “What we see in the data is that mental health is neither static nor homogenous. We see a deep crisis in some communities, while observing relative wellness in others. We also see an evolving post-COVID-19 picture of New Yorkers recovering from some of the worst impacts of the pandemic and longer-term effects still developing. This report represents a landmark moment, the start of a process where the city’s mental health is routinely reported on as a civic responsibility.”

“Expanding our awareness of New Yorkers’ mental health …”

“Expanding our awareness of New Yorkers’ mental health and the many environmental factors that shape their daily lives will help us better meet the diverse needs of our neighbors,” said Executive Deputy Commissioner of Mental Hygiene Dr. H. Jean Wright. “I look forward to continuing the work to support the health of the city.”

Adults

Among the six million adults in New York City, nearly one in four experience a mental health disorder in a given year, similar to the national average. More than two thirds of adults with a diagnosis received treatment in the past year but 34 percent report unmet mental health needs — not receiving as much treatment as they would have wanted, not receiving it as soon as they wish they had, or not easily accessing it at any point when they wanted it, which can be due to cost or stigma. Treatment access varies widely by community, with Asian New Yorkers accessing care the least.

The percentage of adult New Yorkers who have been diagnosed by a health care professional, by condition, include: schizophrenia, schizoaffective disorder or psychosis (1 percent); bipolar disorder, mania or manic depression (3 percent); PTSD (5 percent); MDD or severe depression (11 percent) and anxiety (18 percent). A person can have multiple mental health diagnoses. More than two thirds of adults with intellectual and developmental disabilities — such as ADHD or autism — also have one or more mental health diagnoses, including schizophrenia, bipolar disorder, PTSD, MDD or anxiety.

The report explores mental health before and after the height of the pandemic, which worsened feelings like loneliness and grief, as well as economic instability, and existing inequalities, which are drivers of mental health. For example, during the COVID-19 pandemic, a 2022 survey found that 14 percent of adult New Yorkers had serious psychological distress. Serious psychological distress is a term to describe the feelings of people who have recently been having problems functioning due to negative emotional or mental experiences. Earlier surveys, before the pandemic, found that about 5 percent of adults had serious psychological distress. A 2023 survey showed that 8 percent of adult New Yorkers had recently experienced serious psychological distress. Although some of these surveys used different methods, the data indicate that the mental health of adults in NYC seems to be improving post-pandemic.  It is worth noting that in 2023, serious psychological distress was more likely to be experienced by Black (8 percent), Latino (10 percent), and Middle Eastern or North African (12 percent) adults and adults who identify as multiple races (13 percent) than white adults (7 percent).

“… young adults (18-24) reporting more serious psychological distress …”

Differences were also apparent across adulthood with young adults (18-24) reporting more serious psychological distress, social isolation and unmet mental health need while the oldest New Yorkers (65+) struggled the least with these issues.    

Stressors impacting mental health include not only education access and quality, emotional support, but also physical environment. Adults who personally witnessed or experienced violence in their neighborhood, or who encountered rodents on their street, lacked heat in the most recent winter or recently saw mold in their home were more likely to experience serious psychological distress than adults who had not. Less than half of New Yorkers said they had someone they could count on for frequent emotional support.

Young People

In both 2019 and 2021, 15 percent of children aged 3 to 13 in NYC had a mental health diagnosis. In 2021, the most common diagnosis was anxiety, at 8 percent followed by a diagnosis of depression at 3 percent. Latino, Black and white children were more likely to have mental health diagnoses compared with Asian or Pacific Islander children.

Among teenagers, the 2023 survey found that most worry about the future, something bad happening to them or to their families, which may be a sign of anxiety. Additionally, the survey found, 48 percent of teens experienced depressive symptoms ranging from mild (27 percent) to severe (11 percent).

However, teenagers also display strong signs of resilience, with 69 percent describing their level of resilience as high or medium. The survey found that common coping mechanisms include listening to music, using social media — which many use as a place to connect and showcase creativity — and making jokes about their situation. However, the data also show that young people who report daily social media use were highly likely to worry (90 percent). Moreover, 28 percent of teens who use social media on a daily basis report moderate to severe depressive symptoms.

Adult Substance Use

Alcohol is the most consistently used substance by New Yorkers, with 45 percent of adults reporting drinking at least one alcoholic drink and 21 percent engaging in binge drinking in the past 30 days in 2022. Cannabis was second most commonly used substance, with approximately 23 percent reporting any cannabis use in 2023.

In the same period, 2.9 percent of New Yorkers reported misuse of a prescription opioid or benzodiazepine, while 3.2 percent of New Yorkers reported using drugs other than alcohol or cannabis. Approximately 207,000 New Yorkers reported receiving any substance use treatment during 2023, but nearly 90,000 New Yorkers reported an unmet need for substance use treatment.

Policy Recommendations

The nature of healthcare delivery and a fragmented mental health system has created gaps in services including cost barriers, stigma, workforce shortages and inequities like service delivery gaps for specific populations. These issues informed the Department of Health’s policy recommendations.

These include prevention through nurturing a healthier environment for young people to strengthen resilience and coping skills, establishing standard screening for risk factors in youth, addressing potential harms of social media as a toxic exposure, and making sure online spaces are safe for children and youth; addressing stigma in organizational policies, prioritizing policies focused on improving factors that shape an individual’s health such as access to education, affordable housing and healthy food; expanding the peer workforce; and increasing access and availability of medications for opioid use disorder.

Many of these are already seeing early stages of implementation as the city works to expand on the commitments to address the holistic needs of New Yorkers and promote a healthier environment. Efforts include mindfulness exercises in public schools, the launch of the city’s first tele-mental health service for teens, the expansion of clubhouses services and access to treatment for substance use disorder.

Editor’s note: From COVID-19 to drug abuse in the 1980’s and now, homelessness, and mental health issues we can go on and on, and yet we do not have free healthcare for all Americans.

Photo credit: NYC.gov.