A new investigative report shows how Pennsylvania is failing people with the most severe mental health issues who end up in jail. It’s another symptom of the mental health crisis that began mounting in jails across the state during the pandemic.
The news comes as Pennsylvania lawmakers begin to consider funding increases to support mental health services in local communities and keep people in crisis out of jail. As of yet, the legislature has still not allocated the $100 million in mental health funding it approved for this year’s budget, which includes investments that would directly benefit people involved with the criminal justice system.
Languishing longer while being held for petty crimes
The report by Spotlight PA and the Pittsburgh Institute for Nonprofit Journalism tells the story of Rachel Bridgeman, a young woman suffering from psychosis who cycled in and out of the Allegheny County Jail. Because of her condition, she was deemed incompetent to stand trial on prostitution and shoplifting charges, requiring that she be referred to a state hospital for treatment. But due to a longstanding shortage of beds in the state’s two forensic hospitals, she would have to wait in the Allegheny County Jail until a spot opened up.
Rachel waited for 49 days. “In that time, her medical records indicate that she was tased, placed in a solitary padded room, and repeatedly injected with antipsychotic drugs,” according to the Spotlight PA/PINJ report. After all that waiting and the toll it took on her condition, a judge ultimately dismissed the charges against Rachel.
Rachel’s case is typical of people caught up in the state’s competency system. The Spotlight PA/PINJ report looked at nearly 700 cases across the state, and found that most people who were referred to state hospitals because they were too mentally ill to stand trial were charged with low-level offenses that “could stem from experiencing mental health issues in public.” In addition, the time they spend waiting in jail for treatment has increased significantly since the pandemic. Last month, over 40% of people referred to a state hospital had been waiting in jail for two months or longer. This increase in wait-times has coincided with the rising number of people with serious mental health in Pennsylvania jails.
These findings are consistent with what county jail wardens across the state have reported to the Prison Society. The warden at Beaver County Jail, Bill Schouppe, told the Prison Society last year that someone in the jail waited 8 months to be admitted to a state hospital for treatment. At the same time, the number of people who were ordered to undergo a psychiatric evaluation to determine if they were competent to stand trial had tripled. Schouppe said his county needed more funding to meet the growing need for mental health care. “It hasn't increased even for the general public, let alone to involve the corrections system in dealing with some of these more severe cases."
Opportunities to increase funding can help
Ten years ago, Pennsylvania cut spending for county mental health services by 10 percent. The state has maintained that reduced level of spending even as the need for state-funded services in local communities has grown.
"We’re operating with state funding at 2012 levels at this point, even though we know caseloads continue to increase, the severity of the cases that we're seeing is increasing,” says Lisa Schaefer, executive director of the County Commissioners Association of Pennsylvania. "We're basically seeing a system that's at its breaking point right now,” she said of the safety net of treatment services counties provide.
In Cumberland and Perry counties, for example, the 90 people on a waitlist for residential treatment exceeds the total number of beds in the system, and all of those beds are already occupied. As the mental health safety net frays, more people end up in jail instead of getting the help they need.
The $100 million of one-time spending state lawmakers designated for mental health last year could start to bridge the funding gap, Schaefer says. But legislators still need to approve a spending plan before those funds can be put to use. State Representative Michael Schlossberg served on a commission tasked with devising a spending plan and is working on legislation that would finally disburse the money.
"I've met with Democrats and Republicans on this legislation, and there seems to be really widespread interest in making sure we get this funding out the door as quick as possible,” Schlossberg tells the Prison Society. He expects the funding to be approved in the next couple of months. But Schlossberg says the state needs to provide much more support for mental health. “$100 million really is just a drop in the bucket,” he says. “But it's an important drop.”
Lawmakers will also soon consider mental health funding increases Governor Josh Shapiro included in his budget proposal for next year. Shapiro called for a $20 million increase in base funding for mental health, with additional increases over the following two years to restore the funding that was cut 10 years ago. His budget would also provide $4 million in community-based programs to divert people with mental health issues from the criminal justice system, aiming to keep them from being incarcerated and reduce wait times for a state hospital bed.
"We hope that the General Assembly will heed that call and support the ask for additional mental health dollars, not just in the coming year but as a long term commitment,” Schaefer says.