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Pennsylvania has a behavioral health crisis.
One in five adults experience mental illness, yet fewer than half of those with a mental health condition receive treatment, according to the Substance Abuse and Mental Health Services Administration. Another one in six children annually experience a mental health disorder, a 2019 study published in JAMA Pediatrics found. Simply put, there is more need for behavioral health care than there are services available.
This results in backlogs and bottlenecks that strain our entire health care system. Worse, it means that many Pennsylvanians must wait to access the care they need to live healthy and happy lives.
These challenges are not new. But the COVID-19 pandemic — which increased mental health challenges and worsened a shortage of all health care professionals — made the crisis much worse.
The General Assembly has an opportunity in this budget to make a meaningful difference in the lives of millions of Pennsylvanians by helping to expand behavioral health services.
More services mean shorter waits to get an appointment with a behavioral health provider. It means that patients who no longer need inpatient psychiatric care at hospitals can more quickly go home and continue their care in community or home-based settings. It means that people in crisis can get the post-emergency care they need sooner instead of waiting days, a week, or longer in the emergency department.
Like many health systems across the country, WellSpan Health experiences similar delays in access to behavioral health care. Nearly half of our hospital beds designated for this care are occupied by patients who have hospital stays of almost three weeks. This means patients may spend hours being cared for in the emergency department while awaiting one of those inpatient beds. One backlog compounds the other.
That is why we have introduced innovative programs like our START clinic in York that enhances community-based access to behavioral health care by bringing the resources our patients need all under one roof. Since opening one year ago, the program has diverted more than 1,000 patients from the WellSpan York Hospital emergency department. Rather than waiting months, the program provides patient evaluations within one week of a request. We also provide support to mobile crisis services and staff that ride along with local police departments to assist in behavioral health emergencies. Intervening at this level can also help relieve the stress on the emergency departments.
But let’s be clear, these initiatives alone will not resolve this problem.
Pennsylvania’s behavioral health crisis is complex. There is a shortage of behavioral health professionals throughout the state, which makes it difficult to expand services. Solving these challenges will require efforts over the long-term that address how behavioral health care is paid for, and therefore, what resources providers have to attract and retain staff.
Yet there are important first steps that lawmakers can take in this budget that will make an immediate and tangible difference.
Pennsylvania hospitals and other stakeholders are advocating for a $41 million increase in funding to county mental health programs to both bolster community and home-based behavioral health services and to help facilitate transitions to post-acute care for patients who arrive at hospitals in crisis. Additionally, we are calling for improving how Pennsylvania’s Medicaid program supports behavioral health, and for the passage of House Bill 1644, which would establish care transition teams to help patients access the services they need faster. More support is also needed to invest in and strengthen the behavioral health workforce.
Much more work lies ahead, and now is the time to take the first steps. State lawmakers have a meaningful opportunity this year to help improve behavioral health in Pennsylvania. We urge them to seize it.
Andy Carter is president and CEO, the Hospital and Healthsystem Association of Pennsylvania. Phil Hess is senior vice president, WellSpan Health, and president, WellSpan Philhaven.
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