BUT TURNING NOW TO SUBSTANCE USE, MENTAL HEALTH AND HOW THEY'RE CONNECTED IN NEW YORK.

IF YOU WATCH THIS SHOW, YOU ALREADY KNOW HOW URGENT THE STATE'S MENTAL HEALTH CRISIS REALLY IS.

EVEN TWO YEARS AGO, MORE THAN 2.8 MILLION ADULTS IN NEW YORK HAD A MENTAL HEALTH CONDITION.

THAT'S ACCORDING TO THE NATIONAL ALLIANCE ON MENTAL ILLNESS, AND TWO YEARS SINCE, WE'VE SEEN SIGNS THAT THIS CRISIS ISN'T GETTING ANY BETTER.

MORE THAN 3 IN 10 NEW YORKERS REPORTED POOR MENTAL HEALTH IN MARCH OF THIS YEAR.

THAT'S ACCORDING TO THE NEW YORK HEALTH FOUNDATION.

THAT'S ABOUT THE SAME RATE THAT WE SAW IN 2021 AS WELL.

AT THE SAME TIME, WE KNOW THAT OVERDOSE DEATHS TICKED UP IN NEW YORK LAST YEAR AND BOTH OF THOSE ISSUES, MENTAL HEALTH AND ADDITION ARE OFTEN INTERCONNECTED.

SO TWO ADVOCACY GROUPS, ONE FOCUSED ON MENTAL HEALTH AND ONE FOCUSED ON ADDICTION, DECIDED TO TEAM UP AND WORK ON BOTH ISSUES TOGETHER.

THE RESULT IS AN ENTIRELY NEW GROUP CALLED THE IN UNITY ALLIANCE.

FOR MORE ON THAT AND THE FUTURE OF MENTAL HEALTH AND ADDICTION IN NEW YORK, SPOKE WITH JOHN COPPOLA, A CODIRECTOR OF IN UNITY ALLIANCE.

[ THEME MUSIC ] JOHN, THANK YOU SO MUCH FOR BEING HERE.

I APPRECIATE IT.

>> HAPPY TO BE HERE.

>> THANK YOU.

>> SO MY FIRST QUESTION IS, WHY TEAM UP?

>> WELL, WE HAD TWO ORGANIZATIONS THAT BOTH HAD A MAJOR FOCUS ON ADVOCACY AND TRYING TO ENSURE THAT COMMUNITIES ACROSS NEW YORK STATE HAD ADDICTION SERVICES OR MENTAL HEALTH SERVICES AND IN THE ADVOCACY WORK, BIGGER IS BETTER.

MORE VOICES IS BETTER THAN FEWER VOICES, AND PARALLEL TRACKS.

SO WE REALLY FELT IT WOULD BE A REALLY GOOD IDEA TO BRING OUR ADVOCACY EFFORTS TOGETHER AND TO POOL RESOURCES AND TO BE A STRONGER ORGANIZATION AND BETTER REPRESENTATIVES OF THE PEOPLE THAT WE ARE ADVOCATING FOR.

>> YOU KNOW WHEN WE TALK ABOUT MENTAL HEALTH AND SUBSTANCE USE, THESE ARE TWO AREAS THAT OFTEN INTERSECT.

AND I DON'T THINK THAT A LOT OF PEOPLE UNDERSTAND THAT.

CAN YOU TALK ABOUT THAT?

YOU SPECIALIZE IN SUBSTANCE USE BEFORE THIS GROUP.

>> YES.

>> YOU HAVE A VERY FIRM UNDERSTANDING OF THIS.

>> YES.

I MEAN, FOR ALL OF US EXPERIENCE DIFFICULTIES IN OUR LIVES AND YOU KNOW, MANY OF US BELONG IN FAMILIES WHERE SOMEBODY IN OUR FAMILY TREE HAD AN ISSUE WITH ALCOHOL OR DRUGS.

SO THERE'S A BIOLOGICAL DIMENSION, A SOCIAL AND EMOTIONAL DIMENSION AND ALMOST ALL OF US AT SOME POINT DURING OUR LIFETIME NEED SOME HELP AND SUPPORT FROM SOMEBODY, AND INCREASINGLY, I THINK PEOPLE ARE MORE COMFORTABLE WITH THE THOUGHT OF THERAPY AND HELP, BUT IT IS A VERY COMMON FOR PEOPLE TO HAVE AN ISSUE WITH MENTAL HEALTH OR ADDICTION, AND PROBABLY NONE OF OUR VIEWERS TODAY PROBABLY COULD SAY I DON'T KNOW ANYBODY WHO HASN'T HAD THAT.

>> YEAH.

>> AGAIN, UNFORTUNATELY, WE HAVEN'T HAD THE INFRASTRUCTURE OR THE SERVICES OR THE SUPPORT NECESSARY FOR PEOPLE TO EASILY ACCESS THOSE.

IF YOU HAVE A YOUNG CHILD FOR INSTANCE, IT'S EXTRAORDINARILY DIFFICULT TO FIND GOOD THERAPIST OR GOOD PROGRAM BECAUSE THERE'S SUCH A LACK OF RESOURCES, WHICH IS REALLY UNACCEPTABLE.

>> I THINK I WOULD EVEN SAY NOT EVEN JUST FOR CHILDREN.

I THINK FOR REGULAR U.S.

ADULTS, NEW YORK ADULTS, IT'S TOUGH TO FIND A THERAPIST FOR A LOT OF DIFFERENT REASONS.

I MEAN, IT'S TOUGH TO FIND THEM BECAUSE THEY'RE OUT OF YOUR INSURANCE NETWORK.

IT'S TOUGH TO FIND THEM BECAUSE YOU LIVE IN A RURAL AREA WHERE A LOT OF PEOPLE HAVEN'T SETTLED AND THERE ISN'T ACCESS THERE.

I WANT TO UNPACK THAT BIG BOX FOR A SECOND.

WHAT DO YOU SEE AS THE MOST PRESSING NEEDS IN THESE ISSUE AREAS?

>> I THINK WE'RE STARTING TO TALK ABOUT IT.

>> YEAH.

>> YOU KNOW, RESOURCES AND THAT REALLY STARTS FIRST WITH WORKFORCE.

ARE THERE PROFESSIONALS IN OUR COMMUNITIES THAT WE CAN TURN TO?

ARE THOSE PROFESSIONALS ADEQUATELY SUPPORTED?

ARE THE SERVICES ADEQUATELY SUPPORTED?

ARE THEY ACCESSIBLE?

>> RIGHT.

>> AND THE SIMPLE FACT OF THE MATTER IS WE'VE DONE A POOR JOB OF DOING THAT.

SO CONSEQUENTIALLY, WE HAVE PEOPLE, YOU KNOW, WHO ARE UNTREATED, UNDIAGNOSED AND JUST HAVE NOT BEEN ABLE TO ACCESS THE SERVICES THEY NEED.

I THINK FUNDAMENTALLY IT'S HOW SERIOUS ARE WE IN ADDING THE NEEDS THAT PEOPLE HAVE?

YOU KNOW, FOR MANY YEARS, CANCER HAD A LOT OF STIGMA ATTACHED TO IT, AND THAT'S WHAT WE REALLY ENCOUNTERED ALLOT WITH ADDICTION AND MENTAL HEALTH.

AS WE SEEK TO REDUCE THE STIGMA ASSOCIATION QUITED AND I THINK A LOT OF PEOPLE ARE BECOMING MUCH MORE PUBLIC ABOUT THEIR RECOVERY.

>> ABSOLUTELY.

>> AND THAT GOOD THINGS CAN HAPPEN FOR PEOPLE WHO HAVE AN ADDICTION ISSUE OR A MENTAL HEALTH ISSUE, THAT RECOVERY IS POSSIBLE AND THAT PEOPLE CAN GET BETTER.

BUT WE'VE GOT TO HAVE THE RESOURCES.

WORKFORCE IS A HUGE ISSUE, ADEQUATE RESOURCES IS SECOND.

>> ON THE WORKFORCE ISSUE, I SPOKE TO THE MENTAL HEALTH COMMISSIONER IF SEPTEMBER ABOUT THIS, AND SHE SAID TO ME THAT REALLY, THE SOLUTION THERE SHOULD BE TO INCENTIVIZE MORE PEOPLE TO ENTER THESE INDUSTRIES.

THAT COULD COME IN THE FORM OF SCHOLARSHIPS FOR PEOPLE OR LOAN FORGIVENESS.

PERSONALLY, I DON'T SEE LOAN FORGIVENESS AS A GREAT OPTION JUST BECAUSE IF SOMEBODY DOESN'T HAVE THE MONEY UP FRONT TO GO TO SCHOOL, LOAN FORGIVENESS ISN'T GOING TO HELP THEM.

WHAT DO YOU THINK ABOUT THAT?

HOW DO WE GET MORE PEOPLE IN HERE TO JUST DO THIS WORK?

>> I THINK THERE'S A HUGE OPPORTUNITY ACTUALLY.

ONE OF THE THINGS THAT'S HAPPENING IN A LOT OF SERVICES IS THAT PEOPLE WHO, THEMSELVES, HAVE HAD AN ISSUE WITH ADDICTION OR WITH A MENTAL HEALTH CHALLENGE, WHO WOULD MAKE FANTASTIC PEER HELPERS, PEER PROFESSIONALS, PEOPLE WHO COULD BECOME SOCIAL WORKERS, PSYCHIATRISTS, PSYCHOLOGISTS, ET CETERA, NURSES, SO I THINK PART OF IT IS REALLY, YOU KNOW, BUILDING THAT SENSE OF, YOU KNOW, GIVING BACK AND ALSO THAT THERE ARE OPPORTUNITIES, AND YOU KNOW, IF YOU THINK ABOUT PEOPLE WHO ARE COMING OUT OF THE CRIMINAL LEGAL SYSTEM, PEOPLE WHO HAVE PAID THEIR DEBT TO SOCIETY AND ARE NOW LOOKING FOR AN OPPORTUNITY TO GET BACK, THERE ARE NUMEROUS SUCCESS STORIES OF PEOPLE WHO LEARN FROM THEIR MISTAKES AND WERE ABLE TO HELP OTHER PEOPLE.

SO AGAIN, I THINK IF WE LOOK AT THE COMPOSITION OF THE COMMUNITIES THAT WE LIVE IN AND DO THE PEOPLE THAT WE'RE EMPLOYING LOOK LIKE THE PEOPLE THAT WE'RE HELPING, AND SO LOOKING AT EQUITY, LOOKING AT STRUCTURAL RACISM, LOOKING AT OTHER THINGS THAT KIND OF KEEP PEOPLE FROM ENGAGING, I THINK IF WE DO A REALLY GOOD JOB OF BEING A WELCOMING PROFESSION, THAT'S OUR JOB IS TO HELP TO CREATE A PUBLIC AWARENESS OF THE GOOD THAT CAN BE DONE IN PREVENTION AND TREATMENT AND RECOVERY AND HARM REDUCTION SERVICES AND TO TRY TO REALLY HELP TO PROMOTE THAT WORK BECAUSE IT REALLY MAKES-- IT HELPS TO MAKE FOR A BETTER COMMUNITY.

>> INCARCERATED PEOPLE, THAT'S AN INTERESTING POINT.

INCARCERATED PEOPLE, OFTEN WHEN THEY COME OUT, TALK ABOUT TRAUMAS THAT THEY EXPERIENCED EITHER AT THE TIME OF THE CRIME, TIMES IN THEIR LIVES OR PRISON, THEMSELVES.

I BET THAT WOULD REALLY LEND A HELPFUL DEVICE FOR THEM TO USE IF THEY ENTERED THE MENTAL HEALTH FIELD.

I WANT TO SWITCH GEARS AND TALK ABOUT SUBSTANCE USE FOR A MOMENT.

YOU KNOW THAT OVERDOSE DEATHS IN NEW YORK TICKED UP IN 2022, AN UNFORTUNATE THING THAT HAPPENED.

THE STATE IS KIND OF ENTERING THIS SPACE THAT LOOKS LIKE HARM REDUCTION IN SOME SPACES, BUT AT THE SAME TIME, THE STATE ISN'T REALLY ENDORSING OVERDOSE PREVENTION CENTERS THAT HAVE OPENED IN NEW YORK CITY.

SO WHAT DO YOU SEE AS THE FUTURE OF HARM REDUCTION IN NEW YORK?

SHOULD IT BE THAT ENDORSEMENT OF THOSE OVERDOSE PREVENTION CENTERS, OR ARE THERE OTHER STRATEGIES THAT WE CAN PURSUE TO GET THOSE NUMBERS DOWN?

>> I THINK IT'S VERY SIMPLE.

ANYTHING THAT WE CAN DO THAT'S GOING TO SAVE SOMEBODY'S LIFE, WE SHOULD DO.

THERE ARE PEOPLE WHO USE DRUGS AND PEOPLE WHO HAVE ADDICTION AND IF THEY'RE NOT READY YET TO SORT OF LET GO OF THAT, OR IF THEY HAVE NO INTENTION OF DOING SO THEN TO WHAT EXTENT CAN WE HELP THOSE PEOPLE TO BE AS HEALTHY AS POSSIBLE.

SO WHEN THEY DECIDE, IF THEY DECIDE, THEY WANT TO STOP, THEY HAVE THE OPPORTUNITY TO DO SO AND THEY HAVE THE STRENGTH TO DO SO.

THEN FOR OTHERS, I THINK, JUST TRYING TO REDUCE RISK AND REALLY, YOU KNOW, THINKING OF HARM REDUCTION AS PART OF THE CONTINUUM OF SERVICES.

PREVENTION IS A HUGE ISSUE AND IT'S PREVENTION AT ALL AGES AND AS THE RISK GOES UP, TRYING TO REDUCE THAT RISK AS MUCH AS POSSIBLE AND TO HELP PEOPLE BE AS HEALTHY AS THEY POSSIBLY CAN BE.

SO I DO THINK THAT IT'S GONNA BE-- I THINK HARM REDUCTION TREATMENT, PREVENTION, RECOVERY ARE ALL COMPONENT PARTS OF A COMPREHENSIVE STRATEGY THAT ARE REALLY IMPORTANT.

>> THE STATE HAS AUTHORIZED THE OPENING OF WHAT ARE CALLED CRISIS STABILIZATION CENTER IN COUNTIES ACROSS THE STATE, WITH THE STIPULATION THEY CAN OPEN IF THEY HAVE THE FUNDING TO OPEN.

DO YOU SEE THAT AS THE BIGGEST BARRIER HERE IN TERMS OF ADDRESSING BOTH MENTAL HEALTH AND SUBSTANCE USE IN TERMS OF THE RESOURCES?

DOES THE STATE JUST NEED TO PUT MONEY INTO THIS TO GET BETTER?

>> I THINK IT'S PART OF THE ANSWER AND I THINK THE OTHER THING IS TO RE-EXAMINE.

YOU KNOW WE HAVE A LOT OF MONEY THAT WE'RE INVESTING.

>> YEAH >> ARE WE INVESTING IT IN THE RIGHT PLAYS WE VERY A HUGE, HUGE SYSTEM, BUT DO WE-- CAN WE JUSTIFY SPENDING AS MUCH MONEY ON THESE HUGE BUILDINGS AND GROUNDS, ET CETERA, SERVING A RELATIVELY SMALL NUMBER OF PEOPLE AND THERE ARE UNDERFUNDED SERVICES.

IF YOU THINK ABOUT RECOVERY SERVICES THERE ARE MANY COUNTIES IN THIS STATE THAT DON'T HAVE A RECOVERY CENTER.

>> YEAH.

>> THERE ARE MANY COUNTIES, MANY SCHOOLS, MANY SENIOR CENTERS THAT DON'T HAVE PREVENTION SERVICES.

SO THERE'S A-- IT'S A COMBINATION OF USING OUR RESOURCES THAT WE ALREADY HAVE IN THE SYSTEM EFFECTIVELY AND EFFICIENTLY AND THEN SAYING, YOU KNOW, WHERE ARE THE AREAS AND ARE WE SERIOUS ABOUT THIS?

THAT'S THE OTHER THING.

I MEAN, ARE WE REALLY SERIOUS ABOUT REVERSING?

WHEN WE WANTED TO DEAL WITH COVID, WE WERE SERIOUS.

>> WE REALLY DEALT WITH COVID.

>> WE WERE SERIOUS.

AND WE HAD THE STATISTICS ON THE NUMBER OF PEOPLE WHO DIED YESTERDAY, LITERALLY 24 HOURS.

WE'RE STILL ADDING THE NUMBERS UP FOR 2022 AND EARLY 2023.

>> YEAH.

>> I MEAN, WE'RE NOT EVEN CLOSE TO RESPONDING WITH THAT SAME LEVEL OF URGENCY.

>> WE TALKED ABOUT GOVERNMENT.

ARE INSURANCE COMPANIES ALSO PART OF THE PROBLEM HERE, OR ARE THEY PART OF THE SOLUTION?

WHEN I SEE-- I'LL TELL YOU MY PERSONAL STORY JUST BRIEFLY IS-- AND I'VE MENTIONED THIS ON THE SHOW BEFORE.

WHEN I WAS LOOKING FOR MY MOST RECENT THERAPIST, IT WAS SO DIFFICULT BECAUSE NOBODY WAS IN NETWORK FOR MY INSURANCE COMPANY AND NOBODY WHO WAS IN NETWORK WAS CLOSE TO ME AND I WASN'T REALLY COMFORTABLE WITH VIRTUAL THERAPY.

I WANTED TO DO SOMETHING IN-PERSON.

DO INSURANCE COMPANIES NEED TO CHANGE HERE, OR IS IT THE GOVERNMENT THAT NEEDS TO DO SOMETHING?

>> WE'LL START WITH YOUR QUESTION ARE THEY PART OF THE PROBLEM OR PART OF THE SOLUTION, AND THE ANSWER IS YES.

>> YEAH.

>> THEY ARE PART OF THE SOLUTION AND YES, THEY ARE PART OF THE PROBLEM.

YOU, I THINK, HIT THE BULL'S EYE.

TO THE EXTENT THAT THERE'S A REASONABLE RATE FOR SERVICES, RIGHT, WHAT DOES IT COST TO HAVE A THERAPIST, A PSYCHIATRIST, A SOCIAL WORKER, A PEER PROVIDE THE SERVICES THAT YOU NEED?

WHAT DOES IT COST?

AT A MINIMUM, THE INSURANCE RATES SHOULD COVER THE COST OF PROVIDING THE SERVICE.

IF EVERY TIME SOMEBODY WALKS THROUGH THE DOOR, THE PROGRAM YOU'RE GOING TO, THE THERAPIST YOU'RE GOING TO IS GOING TO LOSE MONEY, AT SOME POINT, THEY SAY, I CAN'T TAKE THOSE PEOPLE ANYMORE.

I CAN'T AFFORD TO TREAT SOMEBODY WHO HAS INSURANCE THAT PAYS ME LESS THAN WHAT IT COSTS ME.

AND THAT DECISION IS MADE.

IT'S NOT UNUSUAL TO FIND THERAPISTS THAT DON'T ACCEPT PEOPLE WHO HAVE COMMERCIAL INSURANCE.

THAT'S NOT OKAY.

ALL RIGHT.

SO AGAIN, I THINK WE'VE GOT TO REALLY WORK TO MAKE SURE THAT-- AND AGAIN, IN UNITY ALLIANCE IS VERY, VERY STRONG ON DEVELOPING A POSITIVE RELATIONSHIP WITH HEALTH PLANS, TO HELP MOVE IN A GOOD DIRECTION, BUT ALSO CONFRONTING THE-- YOU KNOW, THE ISSUES, SO THAT'S SOMETHING THAT'S RIGHT ON OUR RADAR RIGHT NOW, AND IT'S REASONABLE FOR ANY EMPLOYER TO EXPECT WHEN THEY PAY THEIR PREMIUMS FOR MENTAL HEALTH SERVICES, FOR ADDICTION SERVICES, THAT THEIR EMPLOYEES WILL BE ABLE TO FIND A THERAPIST AND GET THE HELP THAT THEY NEED.

THAT'S REASONABLE.

>> RIGHT.

I MEAN, THIS IS SUCH A BIG ISSUE AREA.

WE COULD TALK ABOUT THIS FOR HOURS.

THERE ARE SO MANY DIFFERENT PARTS TO IT, FROM INSURANCE, TO CARE, TO WHAT THE STATE DOES, THAT THERE'S A LITTLE BIT TOO MUCH TO UNPACK AND WE'RE OUT OF TIME.

[LAUGHTER] JOHN COPPOLA, CODIRECTOR OF IN UNITY ALLIANCE AND YOU PREVIOUSLY SERVED AS EXECUTIVE DIRECTOR OF ALCOHOLISM AND SUBSTANCE USE PROVIDERS IN NEW YORK STATE.

THANK YOU VERY MUCH.

>> HAPPY TO BE WITH YOU.

>> OF COURSE.

>> IF YOU OR SOMEONE YOU KNOW IS STRUGGLING WITH SUBSTANCE USE OR THEIR MENTAL HEALTH, WE'LL POST SOME RESOURCES AT OUR WEBSITE.

AS ALWAYS, THAT'S NYNOW.ORG.