September 7, 2023
Addressing The Mental Health Needs of Rural Communities
On September 7, 2023, the Pennsylvania House Republican Policy Committee convened a vital hearing to discuss the mental health needs of our rural communities. This hearing, organized and hosted by Rep. Flick, served as a beacon of hope and a call to action for the rural communities across the state grappling with the pressing challenges of mental health. Rep. Flick's unwavering commitment to this critical issue and his dedication to coordinating the event made the day possible. With a focus on two distinct panels, this hearing aimed to shed light on the urgent need for mental health care in rural areas and the formidable obstacles that residents of these communities face in accessing the care they require. Through the thoughtful contributions of expert panelists, the hearing illuminated the path towards a brighter and more accessible mental health future for Pennsylvania's rural citizens.
The testifiers that joined the Policy Committee were as follows:
Navigating Mental Health Services
Ryan Gardner - Lycoming County District Attorney
Keith Wagner - Executive Director, Lycoming Clinton Joinder
Empowering Mental Health Solutions
Sherry Shaffer - Chief Operating Officer & Government Programs Officer of Community Care Behavioral Health, UPMC Insurance Services Division
Dr. Eric Briggs - Superintendent, South Williamsport Area School District
Beginning the first panel of the day, Keith Wagner, the Executive Director of Lycoming Clinton Joinder, provided crucial insights into the pressing mental health challenges facing rural communities. The Lycoming Clinton Joinder is comprised of human service agencies that offer assistance for residents with mental health ailments, intellectual disabilities, substance use and abuse, as well as children and youth services. The services provided by the Joinder are far reaching, but Kieth expressed that their ability to remain afloat is wavering.
Keith began by presenting startling statistics, revealing that between 2010 and 2020, the suicide rate in Lycoming County increased by a staggering 65%. Furthermore, he highlighted that 40% of the inmate population in Lycoming County Prison had an active mental illness, underlining the intersection of mental health and the criminal justice system. Mental health concerns are on the rise in rural PA, and the tools needed to properly address people’s hardships are limited.
Keith emphasized the primary obstacles to rural mental health services, citing population size, limited access, and funding as the most significant barriers. To address these challenges, he proposed several actionable solutions. Firstly, he called for an increase in base funding for mental health, highlighting that Lycoming-Clinton's current mental health allocation is less than it was in 2006. He advocated for transitioning to a needs-based budgeting model akin to Child Welfare to better allocate resources. Moreover, Wagner stressed the need for incentives, such as student loan relief, tuition reimbursement, and stipends, to attract young people to careers in mental health. He also recommended modifying education and licensing requirements to enable those with master's degrees to work as mental health specialists, especially in child psychology. Lastly, Wagner suggested conjoining mental health funding between existing systems to promote cooperation and enhance access to care. With these initiatives the Joinder would have greater assurance that the finances and manpower required to meet the needs of their communities can be met.
“I know that the men and women who work in the mental health system are doing all they can to keep the system afloat.”
Keith Wagner
Executive Director, Lycoming Clinton Joinder |
Ryan Gardner, the Lycoming County District Attorney, shed light on the challenges faced by law enforcement and our criminal justice system when addressing individuals experiencing mental health issues. He highlighted the unfortunate situation where officers' only recourse often involves making arrests to protect the individuals in crisis. Officers responding to a call understand that arrests and incarcerations may not be the preferred outcome, but it is often the only outcome that is currently possible. District Attorney Gardner underscored the dilemma of mental health-related criminality, which is often classified as misdemeanors but leads to incarceration due to fitness for arraignment, lack of residence, or a shortage of safe drop-off locations.
Gardner pointed out that defendants with mental health ailments frequently endure longer incarceration periods than non-mental health defendants, stressing the need for improved mental health services within the criminal justice system. He also noted the shortage of long-term care group home facilities essential to providing structure and care for individuals with mental health issues transitioning out of the criminal justice system. If a person experiencing mental health concerns is not able to be placed with supportive friends or family, and no group homes are available, the only viable option is extended incarceration.
“Until and unless the financial resources of this Commonwealth are distributed to our rural community, this epidemic-type situation will only continue to worsen.”
Ryan Gardner
Lycoming County District Attorney |
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| Empowering Mental Health Solutions |
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Sherry Shaffer, Chief Operating Officer & Government Programs Officer of Community Care Behavioral Health, UPMC Insurance Services Division, began the conversation on how Pennsylvania currently works to empower mental health solutions. Mrs. Shaffer first provided an in-depth perspective on the current mental health funding model in Pennsylvania, with the primary funds stemming from either the State Mental Health Base Allocation or Medicaid. She stressed the importance of integrating mental health and substance use disorder services into county-directed human services systems as to make best use of the finances and resources available at the county level.
A means to decrease the costs associated with mental health care is to find alternatives to incarceration for individuals addressing substance use and mental illness by emphasizing the value of community-based support and intervention. Furthermore, early access to mental health support is needed for youth throughout the state, and Shaffer recommended a comprehensive approach involving both schools and families in the care of children. She also underscored the importance of addressing behavioral health alongside mental health through home visitation and coordination with healthcare providers, particularly for common physical and mental health ailments like diabetes, hypertension, addictions, and depression. Early access to care is integral to reducing the finances and labor needed once mental illness becomes too much to bear.
In her conclusion, Shaffer highlighted the link between unmet needs such as unemployment, food insecurity, and affordable housing with mental health problems. Addressing these core issues will also work to quell the mental health concerns they inspire. There is currently a severely lacking workforce of mental health professionals unequipped to meet the needs of PA communities, so to increase access to trained professionals Shaffer called for efforts to entice a new generation to work in public behavioral health and human services. With increased access to care, greater numbers of trained professionals, and basic needs being met the residents of rural PA will be able to meet the mental health challenges they face head-on.
“People experiencing mental health problems often have underlying unmet needs.”
Sherry Shaffer
Chief Operating Officer & Government Programs Officer of Community Care Behavioral Health, UPMC Insurance Services Division |
Dr. Eric Briggs, Superintendent of the South Williamsport Area School District, presented the challenges faced by rural school districts regarding mental health. He outlined five core issues: limited access to services, stigma, awareness, educator training, and economic hardship.
Dr. Briggs highlighted the limited access to mental health services in rural areas due to a lack of data management and local facilities, which forces children to travel long distances for support.
Rural Pennsylvania also experiences the pressing issue of stigma against pursuing assistance, and there is a need to create an environment where students and families feel comfortable seeking help.
Furthermore, Dr. Briggs discussed the importance of data in increasing awareness of rising student suicides and bullying. To increase awareness there must be enhanced educator training, including trauma-informed care, to better support students.
Lastly, he highlighted the impact of economic hardship on students' mental health, emphasizing the need for reliable internet access to facilitate remote mental health support. With financial struggles at home, and a lack of resources to access care, economic hardships can be a roadblock to addressing mental illness and privately held battles. To begin addressing this obstacle the South Williamsport Area School District has begun offering programs for students K-5 to increase awareness of the assistance available to all, and to get a head-start on neutralizing concerns before they are carried into adulthood.
“Optimal learning environments are only possible when students’ mental health needs are met.”
Dr. Eric Briggs
Superintendent, South Williamsport Area School District |
Rep. Flick’s hearing, along with the accompanying day’s events and mental health resource symposium, shed light on the critical need for increased funding, improved access, and innovative solutions to address mental health challenges in rural communities. Testifiers jointly emphasizing the importance of collaborative efforts across various sectors to ensure the well-being of residents in these areas. Mental health does not recognize borders, incomes, or lifestyles, and can impact all of our lives. By increasing access to care, addressing underlying stresses, and meeting people’s needs wherever they are we can all enjoy brighter days tomorrow.