Mental health professionals in Lancaster County called on their state legislators Thursday to support a significant increase in the 2024-25 budget for mental health and substance abuse disorder treatment and support services.
They also asked for regulatory changes to ease professional licensure challengers and broaden insurance coverage for patients needing their care.
“Mental health has been sidelined for way too long, and the consequences are dire,” said Kim McDevitt, executive director of Mental Health America of Lancaster County, which hosted the breakfast forum at the Eden Resort & Suites.
May is national Mental Health Awareness Month. Statistics show there has been a decline in mental wellbeing since the pandemic, especially among young people. Professionals say the need for help greatly outweighs the resources available.
“The mental health system is underfunded, and it has been for years,” said Judy Erb, executive director of Lancaster County Behavioral Health / Developmental Services, or BHDS.
The 2023-24 state budget included an extra $20 million for mental health, the first increase in a decade — but that was spread across 67 counties. Lancaster County’s share was $637,000 — “It just went to fill a gap,” Erb said.
Her department served 12,000 people in 2021-22, the last year for which full data is available. Its crisis intervention team has been fielding more than 2,000 calls a month, she said, and “those numbers are just going to increase.”
Gov. Josh Shapiro’s is proposing another $20 million boost to mental health “base dollars” in his 2024-25 budget, building on the $20 million increase in its predecessor. McDevitt and Erb asked legislators to continue supporting even more.
A panel of four local state representatives — Democrat Mike Sturla and Republicans Bryan Cutler, Brett Miller and Tom Jones — agreed there’s a crisis. Navigating the existing system is frustrating, full of delays and roadblocks that end up driving costs higher, Sturla said.
Miller, a former school guidance counselor, said he thinks the legislature will be able to provide “decent funding” for mental health services, but cautioned that it’s just one of many competing priorities for state resources: “No one has ever come to me and asked for less funding,” he said.
Cutler, the House Republican leader, advised advocates to make their case with data. How long are the waitlists? What is the utilization data? If they had a given amount of funding, how many more people could they help?
He and Jones both stressed that they want to see demonstrated effectiveness: Programs that work should be scaled up, those that don’t should be phased out.
Sturla said that in light of the challenges Pennsylvania faces, not only on mental health and social services, but education and housing, his colleagues in the legislature should weigh the benefits of raising taxes. A 1-percentage-point increase in the state income tax (from 3.07% to 4.07%) would keep it among the lowest in the country but would bring in $4 billion; alternatively, Sturla’s own bill to allow counties an optional 1% sales tax would bring in $100 million in Lancaster County alone, much of which could go to human services.
“There are ways to go about this,” he said. “It’s a matter of setting our priorities.”
All four legislators agreed there is more work to be done to streamline insurance regulation and licensure. Cutler said he wants to build easier pathways for young professionals; for example, by creating associate licenses or similar certifications that allow them to earn money and gain experience while working toward their final degree.
Pennsylvania Behavioral Health Council
Before the legislative panel, the leader of the newly created Pennsylvania Behavioral Health Council outlined the organization’s mission: To create a more accessible, holistic system of care for mental illness and substance abuse disorder.
Gov. Shapiro issued an executive order creating the council last fall. It is now in the process of creating a statewide action plan, which it expects to issue by the end of the year, executive director Christina Finello said.
The council has 33 members drawn from government, provider and advocacy organizations, and individuals with lived experience; and is supported by a 25-person advisory committee. The latter group includes WellSpan Health psychiatrist Mitch Crawford, who is co-chair of Joining Forces, Lancaster County’s coalition of organizations battling the opioid disorder.
“We need everybody’s voice in the room,” Finello said.
In coming months, the council will be looking at the existing landscape, identifying unmet needs, and how mental health and substance abuse treatment interacts with health care systems, the justice system and other social services. Its action plan will report findings and offer recommendations for funding and legislative action.
It is paying particular attention to the needs of marginalized and underserved communities, Finello said. That includes rural communities, many of which are struggling to retain service providers amid disinvestment and population decline.
One of the council’s first efforts was a survey of behavioral health stakeholders, which yielded just over 900 responses. The findings were not surprising, Finello said, and they show what the council needs to accomplish: Respondents said providers are facing workforce shortages, struggles to secure reimbursement and regulatory barriers; and that their clients need better access to care that is timely, affordable, convenient and appropriate to their needs.
Once the action plan is released, there will be a public review and comment period before it is finalized. Finello urged those in the audience to weigh in.
“We are ultimately trying to create a more resilient behavioral health care system,” she said.
