PA MH-MR Services Fall Short, Research Center Concludes
Harrisburg, October 23 - Thirty-five years after Pennsylvania began to shift delivery of mental health and retardation services out of state facilities, the state's community-based system is not living up to its promise, the Keystone Research Center concluded in a report released in the Capitol Rotunda at 2:30 p.m.
Entitled "Keeping the Promise - Community-based MH-MR Services in Pennsylvania," the Research Center report documents that there has been a wholesale shift of services to the community. Today, over 25,000 people receive residential services in the community compared to only 4,000 in state mental hospitals and MR centers.
Ninety-five percent of 205,000 Pennsylvanians served by the public MH system receive non-residential services.
While "deinstitutionalization" has resulted in personal growth for many with mental retardation, it falls far short of the original vision of high quality community care for all who need it.
Demands for MR services are mushrooming. The state Waiting List for mental retardation services now tops 21,000. This includes over 8,000 needing services in a year or less, twice as many as recorded in 1998. The Waiting List will continue to grow as a result of the aging of family caregivers - nearly four out of 10 on the Waiting List have caregivers aged 60 or over.
In community-based residential services, low wages contribute to high turnover that continuously destroys the client-worker bonds essential to high quality care. Average turnover among direct care workers equals 42 percent according to a Legislative Budget and Finance Committee report. Turnover can run as high as 300 percent.
Thousands of Pennsylvanians fall between the cracks of the state's mental health system into homelessness or the criminal justice system. The seriously mentally ill (SMI) account for an estimated 7,000 homeless people in Pennsylvania. The number of mentally ill inmates in state prisons has "increased dramatically" as the population of state hospitals has declined.
With the shutting of mental hospital adolescent units in 1996, increasing numbers of emotionally disturbed young Pennsylvanians are served only by the juvenile justice system.
State Senator Robert Thompson (R-Chester) says that "we have made great strides in 'deinstitutionalizing' the mentally ill. But in many cases we have only moved them from one institution to another. And we all suffer the results."
According to Bucks County Administrator Don MacGregor, "What we're doing…is taking our mental health children and turning them into mental health criminals."
Stephen Herzenberg, Keystone Research Center Executive Director, concludes, "Improving community-based services is a matter of common sense and common decency. Common sense because expanding MH services will pay for itself. Common decency because not addressing the problems we document will translate into wasted lives, impossible burdens for aging family caregivers, and neglect of those with MR lacking service."
Keystone's report makes a number or recommendations about how Pennsylvania should act to shore up it’s MH-MR support system, among them:
Make it possible for providers to raise wages and benefits high enough to lower turnover and improve quality.
Develop a new five-year plan that can eliminate the Waiting List and promote quality community-based residential services with adequate compensation.
Charge a state task force with developing a consensus on both the problems from adult and juvenile mentally ill falling into the criminal justice system and on bipartisan solutions.
Conduct a study of how Pennsylvania can capitalize on the knowledge and commitment of state workers in bolstering its community-based mental health system.