Economic pressure fraying rural mental health care services

By Christina Lengyel | The Center Square contributor

WILLIAMSPORT, PA – Experts say rural Pennsylvania’s mental health care services face an unraveling amid the same economic pressures that challenge the broader social safety net.

As complex as the issues are, the refrain is familiar, and the testifiers were clear during a recent House Republican Policy Committee hearing in Williamsport. From their perspective, increasing funding and staffing are essential.

Incentivizing talent and providers to make their homes in vast rural stretches of the state is also a top priority.

“You’re chasing a ghost,” said Rep. Johnathan Fritz, R-Honesdale, noting the advances made in disparate fields while mental health solutions, in his estimation, stagnate.

The recent bustle of the Little League World Series, held annually in Williamsport, belies the remoteness of Lycoming County, which boasts the largest geographic area in the state. Along with Clinton County, its population density rests at 71 people per square mile, according to statistics stressed by Keith Wagner, executive director of the Lycoming-Clinton Joinder.

The Joinder oversees mental health, intellectual disabilities, and early intervention services along with maintaining oversight of the bi-county behavioral Health Choices program. The director lauded the men and women working to provide services across the state in the face of challenges that have led the press and others to comment on the “collapsing” system.

“I know that the men and women who work in the mental health system are doing all they can to keep the system afloat,” Wagner said. “They are not failing.”

Yet, the tireless work of a dwindling few is not enough to support the full weight of mental health demands in rural communities, he said. The region’s suicide rate increased 65% over the last decade.

“The mental health system is, in fact, in deep trouble,” Wagner said.

Ryan Gardner, district attorney for Lycoming County, echoed Wagner’s concerns. With limited options, those in crisis are finding themselves repeat offenders in a justice system that is ill-equipped to provide the necessary services.

“What bothers me the most is we are incarcerating individuals with very low-level misdemeanors because it’s the safest option,” he said.

That strategy betrays the county’s once exemplary handling of these issues, Gardner said – a change he blames on dwindling staff.

Labor shortages remain an area of urgency across human services. Sherry Shaffer, who leads the insurance services division for UPMC’s Community Care Behavioral Health Organization, championed long-term solutions like tuition reimbursement for graduates committed to working in public behavioral health and human services.

Providing care as early as possible is also essential to creating vital communities, and educators are increasingly expected to fill gaps left between the home and the family doctor when it comes to mental health, advocates say.

“The reality is this; we simply do not have the resources and are not trained to address the significant mental health needs our students face,” said Dr. Eric Briggs, superintendent of South Williamsport Area School District.

Despite the severity of issues described by testifiers, some policymakers maintained a laser focus on questions relevant to the culture wars that often paralyze local and national legislative progress.

Rep. Rob Leadbeter, R-Bloomsburg, questioned Briggs about students’ access to Kooth, an optional mental health platform that’s generated controversy because it asks students to identify as “male, female, agender, or gender fluid.”

Leadbeter reiterated this concern, saying the program forces “individuals to pick between one of four genders.”

Kooth, first used in the United Kingdom by the National Health Service, offers students between the ages of 11 and 24 access to an online forum where mental health concerns can be discussed anonymously.

While critics argue the program reinforces progressive gender ideology, supporters argue there’s no medical consensus suggesting it’s emotionally or psychologically harmful for children to know about the existence of non-binary and transgender individuals.

Briggs said the school “is working through” the controversial aspects of the program, which include a Zoom meeting with parents and two school assemblies.