Mental Hygiene, Department of

For the first fifty years of the State's history, local governments and private agencies were responsible for the care of New York State's mentally ill. In 1836 (Chapter 82), the legislature authorized the construction of the State's first mental health institution, the State Lunatic Asylum at Utica, which opened in 1843. By 1890, the State had opened nine additional asylums for the mentally ill. Local governments were responsible for expenses of inmates at these asylums and continued to confine the mentally ill in jails and poorhouses. In 1867 (Chapter 951), the legislature established the Board of State Commissioners of Public Charities to inspect and report to the legislature all publicly funded charitable and custodial institutions. Legislation in 1873 (Chapter 571) replaced this board with a new State Board of Charities, mandated licensing of public and private institutions for the mentally ill, and created the office of state commissioner in lunacy. This commissioner's office was abolished in 1889 (Chapter 283) and replaced by an independent State Commission in Lunacy consisting of three gubernatorial appointees. The 1894 State constitution subsequently transferred the responsibility of inspecting mental institutions from the State Board of Charities to this commission.

In 1890 (Chapter 126), the State took on the entire responsibility for the care of New York State's mentally ill. The State thereby began providing for the care of all indigent mentally ill at State expense in State institutions and prohibited their confinement in jails and poorhouses. In 1912 (Chapter 121), the commission was renamed the State Hospital Commission and was given responsibility for the administration of the State's mental hospitals. In 1918 (Chapter 197), State supervision of care for the mentally handicapped was further centralized with the creation of the State Commission on the Feeble-Minded. Renamed the State Commission for Mental Defectives in 1919 (Chapter 633), it supervised the care of "mentally defective" persons at five State special-care institutions.

A Department of Mental Hygiene was established in 1926 (Chapter 584) as part of the constitutional reorganization of State government. The new department took over all functions of the State Hospital Commission and the State Commission for Mental Defectives, which were abolished. A Division of Mental Disease was assigned the oversight of State hospitals for the mentally ill.

Although the organization of the department remained essentially the same until 1966, changes in the 1950s began a shift to a decentralized aproach to care for the mentally ill. In 1954 (Chapter 10), the legislature established community mental health boards and provided for partial State funding of local mental health services. The federal Community Mental Health Act of 1963 provided additional funding for community mental health centers, and further State legislation strengthened the role of local governments and community-based services in New York State throughout the 1970s. As a result of decentralization, patient population in large State mental institutions declined over 60 percent from 1955 to 1975.

During this same period, State programs began reflecting the growing societal awareness of the problems caused by alcoholism and drug abuse. In 1966 (Chapter 192), the Narcotic Addiction Control Commission was created within the department to supervise the operation of alcohol and narcotics-addiction treatment centers and coordinated community rehabilitation and prevention programs. In 1973 (Chapter 676), this commission was renamed the Drug Abuse Control Commission and two years later (Laws of 1975, Chapter 667) the commission was replaced by the Office of Drug Abuse Services.

In 1977 (Chapter 978), the Department of Mental Hygiene was divided into three autonomous agencies: the Office of Mental Health, the Office of Mental Retardation and Developmental Disabilities, and the Office of Alcoholism and Substance Abuse (comprised of two autonomous divisions: the Division of Alcoholism and Alcohol Abuse, and the Division of Substance Abuse Services). The previous administrative structure of the department was heavily weighted in favor of mental health programs, and it was difficult for programs in mental retardation and alcoholism/substance abuse to receive proper attention. In addition, the previous department structure continued to emphasize institutional care of the mentally ill and was unable to effectively support the growth of needed community care. This significant new legislation created the new units to function independently with complete responsibility for planning and administering their respective programs. The three autonomous offices are each headed by a commissioner.

In 1992 (Chapter 223), the Division of Alcoholism and Alcohol Abuse and the Division of Substance Abuse Services were consolidated into one Office of Alcoholism and Substance Abuse Services (OASAS). In 2010, the Office of Mental Retardation and Developmental Disabilities was renamed through legislation to Office for People With Developmental Disabilities (OPWDD). In 2019, OASAS was renamed the Office of Addiction Services and Supports in an effort to reduce the stigma of addiction and better highlight the services and support offered to individuals and families across the state.

Although there is no central authority within the department, several mechanisms coordinate the work of the autonomous offices and divisions. An Inter-Office Coordinating Council coordinates the care of the multiply disabled and department research efforts and assists the administrating local assistance programs. The Council for Mental Hygiene Planning formulates statewide goals and objectives for the care and treatment of the mentally disabled. In addition, advisory councils established by each office or division review any matter related to their specific programs.