Federal dollars give hope to mental health advocates aiming to launch treatment programs

Lack of funds kept counties from using "assisted outpatient treatment" services in the past.

By Brett Sholtis

FILE PHOTO: Hilda Sierra-Marrero is living homeless in Lancaster.  She has been diagnosed with multiple mental health disorders and finds it easier to live in her own “bubble.”

Keira McGuire / Transforming Health

FILE PHOTO: Hilda Sierra-Marrero is living homeless in Lancaster. She has been diagnosed with multiple mental health disorders and finds it easier to live in her own “bubble.”

(Harrisburg) — Mental health services in Pennsylvania may get a boost thanks to federal funding through the most recent Consolidated Appropriations Act and the American Rescue Plan.

Among other services, money can go toward assisted outpatient treatment, a program designed to help people living with serious mental illnesses.

About half of people with schizophrenia and 40% of people with bipolar disorder are diagnosed with anosognosia, a condition that impairs their ability to recognize they are ill, according to Betsy Johnson, implementation specialist at Treatment Advocacy Center.

As a result, they often refuse medical help until they end up in an emergency room or tangled up in the criminal justice system, Johnson said. People with serious mental illnesses are also 16 times more likely to be killed by police than the overall public.

AOT programs became legal in Pennsylvania in 2019, but so far, no counties have used them, according to the state Department of Human Services.

The programs, which rely on a core team of public health workers as well as a local participating judge, are designed to function without the need for additional resources, Johnson said.

However, for county mental health agencies hesitant to launch a program without dedicated funding, newly available dollars solve that problem.

“You don’t have to implement a full program right out of the door,” Johnson said. “Go slowly. You know—implement a pilot program. Serve five, ten people. And then measure those results.”

Dauphin County is submitting a letter to the state requesting the new resource, said County Commissioner George Hartwick. The funding requires that counties also provide 10% of the total resource requested—money he said will be well-spent on mental health services.

“I believe this is an opportunity to make a level of improvement in areas that have been deficient,” Hartwick said. “I quite frankly would encourage my colleagues to do some heavy lifting and figure out a way to make an investment that is going to serve our citizens in a much more humane way.”

The state notified Pennsylvania’s county mental health agencies to contact the Department of Human Services if interested, according to spokeswoman Erin James.

“Counties best understand their community mental health needs and were asked to share their ideas regarding possible uses of the funds by submitting a letter of interest no later than Monday, May 10,” James said.

Some details and final approvals are still being worked out, James said. Right now, in addition to assisted outpatient treatment, a number of services are eligible for funding. Those include things like mobile crisis planning, crisis stabilization centers, residential services and support for things like student assistance programs and telehealth.

“Once approval is obtained, a portion of funds will be distributed by the Pennsylvania Department of Human Services, in combination with funds from Pennsylvania’s annual [Community Mental Health Block Grant] award, to county mental health administrations to support the behavioral health system,” James said. “The exact amount to be distributed has not yet been determined.”

Brett Sholtis
Brett Sholtis

Brett Sholtis was a health reporter for WITF/Transforming Health until early 2023. Sholtis is the 2021-2022 Reveal Benjamin von Sternenfels Rosenthal Grantee for Mental Health Investigative Journalism with the Rosalynn Carter Fellowships for Mental Health Journalism. His award-winning work on problem areas in mental health policy and policing helped to get a woman moved from a county jail to a psychiatric facility. Sholtis is a University of Pittsburgh graduate and a Pennsylvania Army National Guard Kosovo campaign veteran.

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