Service cut

Amid a mental health crisis, creative arts therapists are removed from a NY bill

By ANNEMARIE SCHUETZ
Posted 2/7/23

NEW YORK STATE — Buried in the end-of-2022 bills signed by New York Gov. Kathy Hochul was a final unpleasant surprise for the state’s licensed creative arts therapists (LCATs).

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Service cut

Amid a mental health crisis, creative arts therapists are removed from a NY bill

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NEW YORK STATE — Buried in the end-of-2022 bills signed by New York Gov. Kathy Hochul was a final unpleasant surprise for the state’s licensed creative arts therapists (LCATs).

Bill A1171A/S6574A would have enabled LCATs, as well as other mental health professionals, to be covered by blanket health insurance policies (issued to groups, schools and colleges) for outpatient treatment.

Instead, the LCATs were written out of the bill at the last moment.

This wasn’t the first time. A change to a 2021 bill prevented them from being covered by Medicaid. A June 2022 bill would have enabled creative arts therapists and other mental health counselors to diagnose mental illness and create treatment plans. LCATs were dropped from that bill too.

What is creative arts therapy?

Licensed creative arts therapists (LCATs) combine psychotherapy with the creative arts.
It’s “a new path to be seen, heard and understood,” wrote LCAT Jennifer Giuglianotti in an email. She practices at Balanced Life Movement in Wurtsboro, NY.

The profession includes art, music, drama, poetry and dance/movement therapists. “Therapists work to help clients restore healthy functioning. It’s evidence-based, effective and transformational.”

Those who seek out creative arts therapists can have major mood disorders, from anxiety and depression to bipolar disorder. Others have autism or dementia and are unable to communicate in traditional ways, she said.

“The creative arts therapies are incredibly effective for so many people of all ages and challenges,” she wrote.

For many of her clients, traditional talk therapy was less useful, and her work includes reading bodily cues. Non-verbal communication is 80 to 90 percent of “how we all ‘speak’; it is absolutely critical that we are not overlooking body language and the arts in treatment,” Giuglianotti said.

Creative arts therapists are required to have master’s degrees and multiple years of supervised training before they can apply for a license, she pointed out.

For Giuglianotti, ignoring the creative arts in therapy shuts out a significant part of who people are and where they are happiest.

“Most of the people I’ve surveyed express that they felt free, light, happy and were most often engaged in play, music, dance or the arts. If we neglect to engage in these critical sources of joy and identity, we miss the mark in health care and see only a tiny piece of the person and who they are,” she said.

The profession blends traditional psychotherapy with the creative arts; practitioners often treat people who struggle with expressing themselves verbally. (See sidebar.) They frequently work with children.

“The reality is this,” wrote Maya Benattar, co-founder of the LCAT Advocacy Coalition, in an email. “LCATs being removed from the insurance bill shrunk the number of mental health practitioners [that would be covered by patients’ insurance]… by 14%. This is a significant number at a time when NY is undergoing a mental health crisis, and waitlists for therapy are extremely long.”

The coalition promotes and supports creative arts therapy in New York.

Many of New York school districts’ mental health teams are understaffed, with too few available services, a 2022 audit by New York State Comptroller Thomas P. DiNapoli found.

“The upheaval caused by the COVID-19 pandemic created a crisis for many students in New York, but not enough is being done to make sure they are getting the information and support they need,” DiNapoli said at the time. “The state education department should work with state and local entities to ensure resources to address the problem are available, and prioritize mental health instruction and outreach among school districts, so students and staff can recognize warning signs of distress and know how to get help.”

“Mental health crises have skyrocketed during the pandemic and persisted, with anxiety and depression rates rising by more than 35 percent,” said LCAT Jennifer Giuglianotti, who practices in Brooklyn and Wurtsboro. “Traumatic experiences, grief and overwhelm are very difficult to articulate in words.”

The creative arts therapists were dropped from A1171A due to concern that their inclusion would increase costs, per Hochul’s approval memo.

According to the state department of labor, there are fewer than 2,000 LCATs in New York.

The numbers affected are small. Even aside from that, the governor’s concern is inaccurate, Benattar said. “LCATs provide psychotherapy, same as any other licensed mental health practitioners. We bill psychotherapy [billing] codes for insurance, and always have.”

In the June bill, the problem was that LCATs did not have diagnostic privileges in their statutes, said Marsha Wineburgh, legislative chair of the New York State Society for Clinical Social Work in an email.

Being able to diagnose and plan treatment was “a huge win” for counselors, according to a St. Bonaventure University post at online.sbu.edu. No social worker or psychiatrist would be needed to sign off on a plan.

The approved counselors had to complete master’s degree-level work and thousands of clinical hours. They have to register with the state and pass a licensing exam.

New York’s licensed creative arts therapists fulfill those requirements, according to the state education department. Even so, they were excluded.

Getting that privilege was a long-fought battle. In 2004, Wineburgh wrote, mental health practitioners sought permission to diagnose. “To the best of my knowledge, the LCAT leadership did not participate.”

However, nearly 20 years on, given the damage from the pandemic, the exclusion “creates yet another barrier to efficient and accessible mental health care,” Benattar wrote.

And, she added, “for this last bill, LCATs were the only one of the four licensed mental health practitioners without a lobbyist to represent them in Albany.”

“When it comes to protecting New Yorkers’ well-being, strengthening our mental health care system is essential and long overdue,” Hochul said in her state of the state address. “We have underinvested in mental health care for so long, and allowed the situation to become so dire, that it has become a public safety crisis as well.”

The state’s billion-dollar investment, she said, “marks a monumental shift to make sure no one falls through the cracks, and to finally and fully meet the mental health needs of all New Yorkers.”

But cutting out the LCATs from the bill “affects… people who might seek support and not be able to use their insurance, [receive] a proper diagnosis, or utilize government-funded health care,” said Giuglianotti. It “deprives those in our most vulnerable and marginalized communities.”

licensed creative arts therapists, therapy, creative arts, health insurance

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