Officials: Somerset County mental health services underfunded

February 23, 2019 GMT

The mental health care crisis is a major crisis in medicine, particularly in Somerset County. Medical insurances only pay for so much, so there are limits on services at local agencies and many of those options experience shortages of trained and licensed staff, according to Mary Piatt-Bruner, Bedford-Somerset Developmental & Behavioral Health Services administrator.

Other issues include a lack of public transportation in rural areas, which prevents people from seeking needed services. In addition the lack of safe and affordable housing perpetuates ongoing health issues.

“The drug epidemic has also hit our small counties, and some studies show there to be a correlation between mental health problems and illegal drug abuse,” Piatt-Bruner said. “County agencies are tasked with doing the best they can with the local resources. This typically means most folks in need get something, leaving some not fully served but supported in some capacity.”

DBHS treats approximately 3,000 adults, families and children in Bedford and Somerset counties. Within the HealthChoices program, the managed care organization for medical assistance dollars, there were 30,243 members enrolled in the program and 5,892 distinct members served in fiscal year 2017-18.

Statewide, Pennsylvania has a population of approximately 12.9 million people, and more than 4 percent of adults in the state live with serious mental health conditions such as schizophrenia, bipolar disorder and major depression, according to the Substance Abuse and Mental Health Services Administration.

Piatt-Bruner indicated that state funding for the county programs has remained flat for many years. It’s forced them to serve more people with less. Former Pennsylvania Gov. Tom Corbett cut county human services spending by 10 percent when he was in office in 2012. One program that suffered in particular was the Somerset Long Term Structured Residence program, which served adults with serious mental illness who were typically individuals just being discharged from a state hospital or community-behavioral health unit.

“The program served up to 12 people and was considered one of the most intensive treatment programs in the area. Somerset County now utilizes the Bedford County LTSR,” Piatt-Bruner said.

Piatt-Bruner said that if the 10 percent in funding were restored, along with a periodic increase of 1 to 2 percent, their base budget would have included about $1 million in additional funds.

Piatt-Bruner indicated that additional funds would help fully fund programs and guarantee doors remain open after restricted funds are used. Money would help the community provider network be fully funded when other funding resources, such as revenues from insurance companies, do not cover all the costs.

“There is a need locally for additional psychiatric services as some providers utilize tele-psychiatric services to help meet the need,” she said. “There is a need for a diversion program for adults with serious mental illness and are involved in the criminal system. Other areas that could be enhanced are increased available evidenced-based services for adults, family and children.”

In October, Gov. Tom Wolf signed into law House Bill 1233, which is designed to make outpatient mental health treatment available to someone with a serious mental illness before they become a danger to themselves or others. Both Republican state Sen. Pat Stefano and Republican state Rep. Carl Walker Metzgar voted in support of the bill. Wolf’s office couldn’t be reached for comment regarding state funding of mental health care. The bill didn’t provide any additional funding to county agencies for mental health services.

Since 2012, the state government has not increased mental health spending. Christine Michaels, CEO of the National Alliance on Mental Illness Keystone Pennsylvania, said the state Legislature has had a very difficult time creating budgets for the past few years.

“It would be very helpful and prudent if the Legislature developed a multiyear, multifaceted plan to invest in mental health services including supportive housing, workforce development, transportation, etc.,” Michaels said. “In the ideal community, mental health services should be considered part of the community’s infrastructure requiring regular maintenance and upgrades to meet the needs of the community.”

In some state budgets passed since that time, the Legislature cut spending on mental health. Metzgar clarified that point when he said the funds were not cut, but were instead simply replaced by federal fund transfers.

One place where things have improved is in the wait time to get help, but there’s a caveat: It depends on whether the service is even an option. Piatt-Bruner said that outpatient counselors strive to get an appointment on the books within seven days of a request. Psychiatric appointments can take two to three weeks.

“In years past, it wasn’t unusual to wait months to see a psychiatrist,” she said. “When looking at ‘waiting times’ if a service isn’t available, or there is no funding, obviously then no wait list is created. So even though a needed service is identified, if it is not available then we look for the next best option on how to best support the individual.”