Pennsylvania government weights the pros and cons of a new bill
Pennsylvanians and professionals in the field agree: the mental health crisis throughout the state has reached a critical point.
Data shows roughly 2,000 residents die by suicide each year and the number of children, adolescents and adults reporting symptoms of mental illness continues to rise in the wake of the COVID-19 pandemic.
The Pennsylvania Psychological Association recently held a press conference ahead of National Mental Illness Awareness Week to discuss ways the legislature could help to alleviate some of the strain on the mental health care system.
Rep. Dave Frankel, said his bill, House Bill 1000, which would increase access to care, addresses a major barrier for many who have been blunted by insurance networks, wait times and skittish primary care providers who are unwilling to prescribe psychotropic drugs without more comprehensive evaluations from psychiatric professionals.
The proposal would allow psychologists with additional study in psychopharmacology to prescribe medication, mirroring practices already in place in the military and several other states. Pennsylvania would be the eighth state to create this opportunity.
Frankel described the situation as a “truly desperate behavioral health crisis” and said allowing psychologists to prescribe is “plain common sense.” Allowing professionals to apply expertise they already have clients with whom they are already building relationships could significantly decrease the amount of time patients in crisis have to wait to receive medication.
The average wait time to see a psychiatrist is currently about 4-6 weeks. For psychologists, the wait time is about a third of that.
For some, the difference could be a matter of life and death.
Rep. Andrew Kuzma, described an instance in which an elderly man suffered an acute mental health crisis after his prescribing doctor retired and he was unable to get an appointment with someone new. He murdered his terminally ill brother who was in his care before dying by suicide himself. Kuzma said he left a note saying that he did not get help in time.
“If he would have had a psychologist able to prescribe the psych meds he needed, two lives would have been saved in my very district in Allegheny County,” he said.
Dr. Krista Boyer describes her interactions with incarcerated patients in Pennsylvania living with mental health conditions at a press conference in Harrisburg, Pa. advocating for eased prescribing rules.
The strain is felt even more deeply by already vulnerable populations. The clinicians noted that their patients within the foster care system, in prison and those struggling with financial and housing insecurity have face more obstacles accessing the care they need with starker consequences when they don’t.
Terri Spiegel Tolomeo, director of quality, compliance, and training at the Children’s Home of York, said one foster family couldn’t keep a child who was struggling with behavioral issues as a result of mental illness. An emergency psychiatric evaluation and the proper medication made the difference; he was able to stay with his siblings.
Psychologist Dr. Krista Boyer described her interactions with incarcerated patients. She noted that about 25 to 30% of prisoners have been diagnosed with mental illness, while proper mental health care can reduce recidivism by 40%.
Access to care is only half the battle. The social and environmental factors like isolation, trauma, loss, and loneliness persist, exacerbated by an uptick in poverty, food and housing insecurity.
“We absolutely must do a better job of meeting the demand for psychiatric care in this Commonwealth, and HB 1000 is a safe way to help us get there,” said Frankel.
