How long it takes to get mental health care in Central Pa. & why access remains difficult

Health

HARRISBURG, Pa. (WHTM) — The need for mental health services continues to surge, but access to care is an issue in the Keystone State and across the country.

The demand for help is high, while resources are low. Experts believe the problem isn’t going anywhere, but there is a way around it.

“We’re turning away probably about 50 to 70 clients per week,” said Kimberly Ernest, the executive vice president at Pennsylvania Counseling Services.

Getting denied after reaching out for help is discouraging.

But Ernest admits she and countless other providers are forced to send patients elsewhere without being able to guarantee they have openings either.

“I’m seeing a pretty significant increase in stress and burnout among my staff,” said Ernest.

The pandemic has caused helpers to get hounded and for some to take time away.

“Our field is not only, but predominantly women, and so women with school aged kiddos that might not have consistent access to child care are kind of stepping out of the field right now,” said Ernest.

Ernest says less mental health professionals were going into the field even before COVID-19 hit. That also added to the recipe for long wait times.

ABC27 reached out to Central Pennsylvania’s health care systems.

While Geisinger didn’t answer our questions, Penn Medicine Lancaster General, Penn State Health, UPMC and WellSpan did.

Current Wait Times

How long is the average wait for a new patient to see a therapist? Is that different for a psychologist or psychiatrist?

Penn Medicine Lancaster General Health

“Because Penn Medicine Lancaster General Health has licensed behavioral health counselors as part of the team at each of our 35 primary-care practices and many of our specialty practices, we are able to provide timely access for new patients. We are able to see new patients with urgent needs within one week and new patients with more routine needs within three weeks.

“The wait is generally longer for new patients who would benefit from seeing a psychiatrist. This is similar to what is seen across the region and the country.”

– Caroline Thomas Barnhart, MSS, LCSW, Director, Behavioral Health Service Line, Penn Medicine Lancaster General Health
Penn State Health

“Wait times vary quite a bit depending on the urgency of the issue and the needs of the patient. In our region (and across the country), wait times for psychiatrists may be a bit longer than for psychologists or therapists because there are fewer psychiatrists than psychologists or therapists. For some specialized services such as neuropsychological assessment, wait times can be many months, but for general psychiatric or psychological services for acute problems, systems tend to have different ways to address the needs. One program we and other health systems in our area have put into place recently is therapy support in primary care offices for acute needs. For less urgent needs, the wait times are often weeks to months in many areas.”

– Dr. Erika Saunders, Chair of the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hershey Medical Center
UPMC

“Our current wait for outpatient behavioral health, therapy services is approximately six to eight weeks for new patients. For an appointment with a child/adolescent psychiatrist the wait is approximately two to three months.”

– Melissa M. Brown, Psy.D., Licensed Psychologist and Senior Clinical Manager, UPMC in Central Pa.
WellSpan

“Average wait time for psychiatry is generally two weeks through our collaborative care model (more on that below). Average wait time for therapy (including psychology) is also around two weeks but can stretch out to as long as 8 weeks in some parts of south central PA.”

– Phil Hess, Senior Vice President, WellSpan Health and President, WellSpan Philhaven (WellSpan’s behavioral health wing)

All of them have had a rush of patients, many of them kids, seeking mental health services throughout the pandemic.

It currently takes weeks to months to see a therapist or phycologist.

The fastest reported was by Penn Medicine, which can get those with urgent needs in within a week.

How Wait Times Have Changed

How have wait times for mental health care changed throughout the pandemic?

Penn Medicine Lancaster General Health

“Due to increased demand for behavioral health services, wait times generally have become longer throughout the pandemic.”

– Caroline Thomas Barnhart, MSS, LCSW, Director, Behavioral Health Service Line, Penn Medicine Lancaster General Health
Penn State Health

“At the beginning of the pandemic, Penn State Health and many other psychiatric and psychological providers in the area transitioned to telehealth to be able to continue services. Under the Emergency Declaration from the Governor, the Commonwealth expedited regulatory approval for those services, which was crucial. We were able to continue services for about 75-80% of our patients uninterrupted. However, not all services can be done via telehealth, and for things like neuropsychological testing and neuromodulatory services which require an in-person appointment, the waiting times increased because of the time last summer when in-person services were not possible.”

– Dr. Erika Saunders, Chair of the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hershey Medical Center
UPMC

“Our wait times for both psychology and psychiatric services have increased slightly. There has been a consistent access to all services and we are currently providing in-person and telemedicine appointments for patients for psychiatry and therapy.”

– Melissa M. Brown, Psy.D., Licensed Psychologist and Senior Clinical Manager, UPMC in Central Pa.
WellSpan

“In 2019, we recognized the growing need for behavioral health services in our communities. In response to that growing demand in July 2020 we initiated the implementation of a collaborative care model to enhance access to behavioral health services across South Central PA. This collaborative care model is focused around supporting our WellSpan primary care practices in caring for patients with behavioral health needs, including access to psychiatry.

“In terms of overall demand, in calendar year 2020, WellSpan Philhaven provided behavioral health services to 54,000 unique individual patients. So far, in calendar year 2021, WellSpan Philhaven has provided behavioral health services to 23,310 unique individual patients. Annualized, this will result in serving 69,930 unique individual patients in calendar year 2021, which would be a 22% increase in the number of unique individual patients served compared to calendar year 2020.

“In addition to the change in wait times, we have also experienced an increase in individuals served using telehealth services. Changes to telehealth requirements, due to the emergency declaration, have increased the ability to serve individuals in a manner that is more conducive to their needs, decreasing geographic and transportation barriers that often prevent individuals from seeking or receiving services.”

– Phil Hess, Senior Vice President, WellSpan Health and President, WellSpan Philhaven (WellSpan’s behavioral health wing)

New programs and telehealth allow other health systems to sometimes squeeze in pressing appointments too.

However, securing a spot with a psychiatrist, who prescribes medicine, takes the longest.

“If you are really seeking access to medication management at this time, oftentimes a primary care provider can serve as an interim,” said Ernest.

Being persistent isn’t easy when you or a loved one needs help.

Still, Ernest says it’s necessary, since schedules are ever-changing.

“When we say call back, call back,” said Ernest.

Now that people are getting vaccinated, there’s a whole new set of stressors.

Providers agree high demand will likely last years, because of the pandemic’s long-lasting effects and conditions and traumas discovered during lockdown.

Influx of Patients

Was there an influx of patients for mental health care during the pandemic, and if so, by how much?

Penn Medicine Lancaster General Health

“Like our fellow mental-health providers, both locally and across the country, Penn Medicine Lancaster General Health has experienced increased demand for counseling, psychiatry and addiction medicine over the past year.”

– Caroline Thomas Barnhart, MSS, LCSW, Director, Behavioral Health Service Line, Penn Medicine Lancaster General Health
Penn State Health

“Yes, nationwide studies have estimated that as many as 40% of people have struggled with emotional and psychological symptoms that are impairing their functioning during the pandemic. We have seen a huge increase in the need for services of all types, particularly for children and adolescents. Nationwide, there have been documented increases in emergency department visits and overdoses. It’s hard to say by how much, because it has fluctuated during the different phases of the pandemic (locally and nationwide). We anticipate an increased need for mental health services for years given the social and economic consequences of the pandemic.”

– Dr. Erika Saunders, Chair of the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hershey Medical Center
UPMC

“We did see an increase in the number of patients seeking mental health care during the pandemic, with the most noticeable increase in the past four to six months. Also, we noted an increase in consistency of the patients attending their appointments.”

– Melissa M. Brown, Psy.D., Licensed Psychologist and Senior Clinical Manager, UPMC in Central Pa.
WellSpan

“During the initial phase of the pandemic we saw a slowing of new referrals but an increase in acuity and stress symptoms in individuals who were in care with our primary care offices and with new patients.

“As the pandemic progressed we saw a significant increase in demand for services for all age groups. In one two week period in February we received more than 200 requests for outpatient care. Common problems experienced during this behavioral health surge are stress, anxiety and depression ( grief and loss). Stress and anxiety secondary to uncertainty regarding the pandemic (fear of illness or work related) and social justice/political concerns. We continue to see a significant service demand for all ages. For children and adolescents, we have seen a 15 to 20% increase in demand, especially adolescents.

“Another tangible example of the increase in demand/need is the use of our web based self-help software application, MyStrength. MyStrength is a web-app designed to provide self-guided tools and resources to promote mental wellbeing. We offer it free to anyone who requests it. In the Fall surge in covid cases, requests increased from an average of 20 each month prior to COVID, to over 200.”

– Phil Hess, Senior Vice President, WellSpan Health and President, WellSpan Philhaven (WellSpan’s behavioral health wing)

One positive outcome of all of this is more resources.

“There are a lot of opportunities to get access to different support groups,” said Ernest. “There’s been a lot of different online resources that have been developed over the course of the pandemic.”

Future of Mental Health Care

Now that things are opening up and people are getting vaccinated, are some of the patients who got help for the first time during the pandemic no longer in need of care? Are mental health professionals seeing less patients? Is it expected that the majority of patients who got mental health care for the first time during the pandemic will continue or stop care?

Penn Medicine Lancaster General Health

“The effects of COVID-19 on mental health will likely be with us for months or even years to come. We expect the increased prevalence of behavioral health conditions seen during the pandemic, including post-traumatic stress, anxiety, depression, sleep disorders and substance use, will continue.

“We continue to experience consistently high demand for behavioral health services for both new and existing patients. Since March 2020, we delivered counseling services via telehealth. This month our counseling team has begun to resume in-person care. Interestingly, we have found that many of our patients prefer to continue utilizing telehealth, citing its convenience and the removal of transportation, scheduling or other barriers to accessing care.”

– Caroline Thomas Barnhart, MSS, LCSW, Director, Behavioral Health Service Line, Penn Medicine Lancaster General Health
Penn State Health

“Great question – it depends on why they are seeking care. For those seeking care because they had a specific stressor (like job loss) that resolves (eg. because they got a new job), some may not need ongoing care. Many people who lost family or friends due to COVID or during COVID are suffering from complicated grief or consequences of loss related to the pandemic, and could need support for a short time of focused therapy or a longer treatment if they have very complicated situation or multiple losses. However, for many people, the social stressors activate an illness such as depression, bipolar disorder, an anxiety disorder, or schizophrenia that will need on-going treatment. Ideally, focused treatment can resolve the acute episode and a person will enter a phase of remission that requires monitoring but not intense care.”

– Dr. Erika Saunders, Chair of the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hershey Medical Center
UPMC

“Patients who accessed services through the pandemic are continuing to do so. Many have been able to find benefit from the services which they were provided. It seems that patients might adjust the frequency with which they are seen, for example go from every other week to monthly. This provides them with a touchstone to connect with a provider and have a scheduled time frame for them to focus on should things become difficult for them again.”

– Melissa M. Brown, Psy.D., Licensed Psychologist and Senior Clinical Manager, UPMC in Central Pa.
WellSpan

“The impact that the pandemic has had on our communities mental health and emotional wellbeing has been significant. We know that in normal times, one in four people will experience a mental illness annually. The pandemic only exacerbated this and we have yet to see what the long-term impact the pandemic will have on the mental health of our communities.

“There were some patients who required or needed brief treatment due to acute short term concerns (stress, grief etc,) who either returned to their PCP or were discharged. The pandemic, as well as social justice/ racial disparity, have acted as a tipping point for individuals that were challenged but maintaining their functioning. We are just beginning to see what some of the longer-term behavioral health impacts of the last 16 months will be secondary to the various disruptions (social, employment, death/illness, education (at all levels), and economic). The pandemic also exposed a lot of longstanding health care disparities, behavioral health being one that is now being recognized and addressed. We anticipate a lasting increased demand for behavioral health treatment over the next 12-18 months due to the pandemic and possibly longer. “

– Phil Hess, Senior Vice President, WellSpan Health and President, WellSpan Philhaven (WellSpan’s behavioral health wing)

Pennsylvania Counseling Services, Penn Medicine Lancaster General, Penn State Health and WellSpan all have websites with various mental health resources.

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