For Many New Yorkers, Mental Health Care Remains Inaccessible Due to a Lack of Robust Paid Medical Leave

A Better Balance
4 min readMay 29, 2024

By Moriah Engelberg

A Better Balance Organizer Moriah Engelberg (second from left) joins advocates in Albany to call for comprehensive paid leave for New Yorkers.

Last year, my partner was hospitalized for a mental health crisis. I will never forget the look of shock and fear on his face when I told him in a hospital bed that he could, in fact, be fired for putting his health in front of his paycheck. As a previous social services case manager, I know a lot about what the city and state has to offer its residents and I had initially confidently told him that he would be able to receive 67% of his wages with job protection and guarantee of health insurance, thinking of New York’s Paid Family Leave program. I was wrong.

Instead, in New York, his only option was to take Temporary Disability Insurance (TDI), the state’s closest thing to a paid medical leave program. TDI has languished since being passed in 1989 and, at present, provides no more than $170 a week, no guarantee of health insurance coverage and no job protection for those who need time off to treat cancer, recover from an injury, take care of a complicated pregnancy, seek mental health treatment or any of the many important reasons a worker might need to attend to their health needs.

It does not have to be this way: New York has the opportunity to reform our paid medical leave program under legislation sponsored by Senator Ramos and Assemblymember Solages (S2821B/A4053B).

Ironically, after my partner’s hospitalization, TDI became my entire life as I started my new job as an organizer with A Better Balance, where we work to ensure all workers can care for themselves and their loved ones, without sacrificing their economic security. We helped lead the coalition that helped enact Paid Family Leave in New York State in 2016 and we work around the country to enact strong paid family and medical leave programs, ensuring these laws meet the needs of workers who most urgently depend on these protections. New York passed Paid Family Leave in 2016, giving New Yorkers decent benefits and job protection when they had a new child or needed to care for a seriously ill loved one, but paid family leave did not provide benefits for one’s own illness and in passing that law, nothing was done to improve the existing TDI program where benefits were capped and jobs not protected. Without a robust paid medical leave counterpart to ensure workers can care for both a seriously ill loved one and for their own personal health needs, New York has fallen behind other states that provide both

For my partner and I, $170 a week barely covered any of our needs. For workers with children or other family members who are financially dependent on their paycheck, this amount won’t even cover groceries.

Under S2821B/A4053B, legislation sponsored by Senator Ramos and Assemblymember Solages, our state’s paid medical leave program would better meet the needs of the workers who most urgently need these protections. The bill would implement progressive wage replacement, which ensures that all workers, including lower wage earners, will be able to afford to take the leave they need when a medical crisis arises. The bill would also make these benefits more accessible for self-employed workers, all while ensuring employers can’t retaliate or interfere with workers’ access to the program. Additionally, it will ensure that workers who need periodic treatment for their medical needs have the ability to take leave intermittently, an especially necessary protection for workers who need to take a few days off at a time to receive chemotherapy, for instance.

If these reforms had been in place at the time of my partner’s experience, he could have received a larger part of his paycheck while on leave, alleviating the financial anxiety and allowing him to pay his medical debt back sooner. We were lucky and we did not lose our apartment, and he did not lose his job nor his health insurance, though he legally could have under the current program.

He is certainly not the only New Yorker who needed to take medical leave last year. New York has a mental health crisis– every year 1 in 5 New Yorkers experience symptoms of a mental disorder. Without adequate paid leave for mental health treatment, which would allow New Yorkers to focus on their health without added financial and occupational stress, we can’t actually address this mental health crisis. New Yorkers will not be able to access essential treatment for their mental health disorders if doing so means financially kneecapping themselves and their families. And our flawed TDI system does not just cover mental health, but also provides leave for the millions of New Yorkers who need to take time off of work to manage long COVID diagnoses, complicated pregnancies, cancer, heart disease, injuries, accidents, and much, much more, all of whom also deserve better than $170 per week with no job or insurance security.

We need a paid leave system that will work for all working New Yorkers. May is Mental Health Awareness Month — but awareness means nothing without real, systemic support — and New York can do better. We have the chance to get this done, and New York lawmakers must seize this opportunity to create a more equitable future for New Yorkers. We can’t wait.

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A Better Balance

We use the power of the law to advance justice for workers caring for themselves and their loved ones. (learn more at abetterbalance.org)