MH/MR jobs cut in Pennsylvania, client care disrupted

From The Tribune-Democrat:

JOHNSTOWN, Pa. — Client advocate Wendy Stewart has a quick reply when asked what she thinks of the elimination of two therapists from Cambria County’s mental health program.

“Most providers are overextended as it is, and this truly is a crisis,” said Stewart, executive director of the local National Alliance for the Mentally Ill, an advocacy organization.

Cambria County Commissioners recently cut two therapists in the 2010 budget in a cost-cutting move.

This is how the decision will shake out:

• Several dozen clients with Mental Health/Mental Retardation are being disrupted – given new counselors within the agency.

Patients who have contacted The Tribune-Democrat complain they have made progress through the years with the therapists who are being let go and now feel they must start over with their treatment.

• The agency is not accepting new clients with private insurance. These folks are being asked to take their business elsewhere, to – for example – Nulton Diagnostic & Treatment Center.

• The agency will continue to take in those with mental health needs who are covered by Value Behavior Health, a public provider for the needy.

• MH/MR says clients already with the agency will not be kicked out.

Less state cash

MH/MR Administrator Peter Kosanovich defends to the public the county’s decision to scrap the two positions.

“As far as budgetary stuff, they need to call the state. That’s where it all comes down,” he said.

“In order to stay open, we had to make some adjustments. Unfortunately, there’s not a good time to do that.”

Kosanovich – whose agency serves about 2,700 residents overall – said all the affected clients have been called and are receiving letters. They’re encouraged to call in to their caseworkers with questions, and call him if they’re not satisfied.

He denied the system is in crisis: “We’re not the only game in town. It would be a crisis if no one else is available.”

Nonetheless, he said state lawmakers need to understand that – as the economy tanked as societal stress increased – the need for mental health services rose, not fell.

In e-mails to The Tribune-Democrat, affected clients expressed their frustration:

• “It has taken me a year to establish a healthy, trusting relationship with my therapist,” one woman wrote. “I have just started the healing process from a horrific tragedy. It all comes down to the almighty dollar. I do not wish to start over with my healing.”

• Another patient wrote: “The mentally ill are cut off from treatment that helps prevent more Virginia Techs, Columbines and the like.

“I still think it is inhumane that this place chose to wait until days before Christmas to notify us,” she wrote, “instead of at least letting us have notice in our therapist’s office, where we could have some guidance on protecting our mental health from the stress of this action.”

She signed her name, adding, “AKA ChildPerson.”

Stewart noted other shortcomings in the system, including the Cambria County crisis line being down two positions. And she mentioned the recent layoff of four city police officers, three of whom are on a crisis intervention team and equipped to deal with the mentally ill.

High cost of neglect

Stewart said the potential loss of services – even during a transition period – could be costly to society as well as to the patients themselves.

“These are just really scary situations with people with mental illness,” she said. “It puts vulnerable people’s lives at risk. People’s lives should be a priority. When people go untreated, there are repercussions.”

That fallout can include increased criminality, homelessness, joblessness and suicide.

“It makes the problems for the community even worse,” Stewart said.

She noted the sporadic attendance of a psychiatrist at MH/MR. “People can’t afford to wait when it comes to their psychotropic medications, and they certainly can’t afford to wait if they need a med change,” Stewart said.

Kosanovich said the agency can’t help when someone gets sick, and that MH/MR is looking for a fourth psychiatrist.

As far as the clients go, he said, “I realize their anxiety. When I heard about it, I was anxious.” But, he said, everyone will be taken care of.

On the plus side, he said, Cambria remains one of only a few counties in Pennsylvania that continues to provide case management. Most other counties contract treatment out to private providers.