Pennsylvania’s Mental Health Program Faces Crisis Amid Funding Cuts

Funding cuts and a shift in priorities have severely undermined Pennsylvania’s plan to close state psychiatric hospitals and transition to community-based mental health care. The state’s initiative, known as the Community Hospital Integration Project Program (CHIPP), was established over 30 years ago to facilitate this transition. However, a recent investigation by Spotlight PA reveals that instead of advancing these objectives, the program has regressed, with the state failing to close significant numbers of hospital beds since 2015.

The program was designed to channel funds from the closure of psychiatric hospitals into local community services. As Sherry Snyder, a former official in the Office of Mental Health and Substance Abuse Services, explained, CHIPP was not meant to be the exclusive source of funding but rather a critical component in a broader support system. It served as a foundational element to ensure that the funds saved from hospital closures would benefit mental health services in local communities.

In its early years, CHIPP made notable progress. Between 1991 and 2001, funding for the program surged from $6.5 million to over $100 million, resulting in the closure of four state hospitals and the subsequent release of nearly 1,500 patients into community care. The Olmstead v. L.C. Supreme Court ruling in 1999 further reinforced the right to community care, prompting Pennsylvania and other states to develop formal Olmstead plans to facilitate this transition.

Despite these advancements, the tide began to turn after Gov. Tom Corbett took office in 2011. His administration proposed significant cuts to mental health funding, including a reduction of approximately $9 million from CHIPP. This marked a turning point, as funding for community services dwindled, leading to a decrease in the number of hospital beds being closed.

The situation worsened between 2013 and 2023, when the state saw only a 25% decrease in the civil patient population, compared to a 42% drop in the previous decade. The lack of progress pushed counties to become less reliant on state funds, particularly as lingering cuts left them uncertain about future support.

In recent years, state spending has shifted dramatically, with over $175 million allocated to expand psychiatric resources for individuals charged with crimes. This pivot has drawn criticism, especially as many individuals in need of mental health treatment are often caught in a punitive system, facing legal charges rather than receiving the care they require.

The American Civil Liberties Union (ACLU) has been actively involved in addressing these issues, particularly regarding unconstitutional wait times for competency restoration treatment—a legal requirement for individuals unable to understand their circumstances sufficiently to aid in their defense. The ACLU’s class action lawsuit against the state highlighted the inadequacies of the system, leading to a settlement that resulted in an infusion of $8 million for community services. However, the ACLU noted little real progress in alleviating the backlog of individuals awaiting treatment.

The state’s Department of Human Services has attempted to reassure the public, claiming that compliance with judicial orders regarding competency restoration takes precedence over community care initiatives. Spokesperson Brandon Cwalina emphasized that the department still encourages counties to prioritize community placements, asserting that such placements should only occur as a last resort.

Despite these assurances, a troubling trend has emerged. A significant number of individuals entering the judicial system face low-level charges related to mental health crises. A recent state-backed study corroborated findings by Spotlight PA, revealing that over one in four patients in state hospitals had been charged with a crime, many stemming from behavior linked to mental health issues.

The consequences of these trends are stark. As funding for community services declines, the number of individuals with mental health issues being arrested has risen. Jails have become the default option for many who require care, leading to a cycle where the most vulnerable individuals are trapped in a system that fails to address their fundamental needs.

Advocates argue that the shift in funding priorities emphasizes a punitive approach rather than a treatment-oriented one. Jerri Clark, resource and advocacy manager with the Treatment Advocacy Center, condemned the expansion of forensic beds, asserting that they represent a shift towards criminalization rather than supportive care.

Since 2020, Pennsylvania has invested more than $30 million annually in forensic projects, while funding for traditional community mental health services has plummeted to under $2 million per year.

The mounting challenges facing Pennsylvania’s mental health care system underscore the urgent need for a renewed commitment to community-based treatment. As the state grapples with these issues, advocates stress the importance of prioritizing mental health needs over punitive measures, aiming to restore a system designed to support, rather than criminalize, individuals facing mental health crises.