PRINTER'S NO. 4119
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE RESOLUTION
No.
1109
Session of
2018
INTRODUCED BY TAI, THOMAS, FRANKEL, NEILSON, READSHAW, SIMS,
D. MILLER, SOLOMON, SCHLOSSBERG, TOOHIL, HILL-EVANS,
LONGIETTI, KINSEY, YOUNGBLOOD, KIRKLAND, STURLA, KORTZ,
A. DAVIS, COMITTA, BOBACK, FITZGERALD, DAVIS, M. QUINN,
VITALI, GOODMAN, DALEY, DeLISSIO, DeLUCA, WARREN AND ROZZI,
OCTOBER 1, 2018
REFERRED TO COMMITTEE ON HEALTH, OCTOBER 1, 2018
A RESOLUTION
Directing the Joint State Government Commission to conduct a
study on the mental health provider shortage in this
Commonwealth and to issue a report.
WHEREAS, The National Survey on Drug Use and Health estimates
that approximately 18.76% of adults in Pennsylvania, or
1,861,000 individuals, have a mental illness; and
WHEREAS, The National Survey on Drug Use and Health also
estimates that approximately 4.2% of adults in Pennsylvania, or
416,000 individuals, have a serious mental illness; and
WHEREAS, Mental health providers, including psychiatrists,
psychologists, clinical social workers and professional
counselors, render crucial services to residents across this
Commonwealth; and
WHEREAS, Adequate access to mental health care is essential
to maintaining the mental health of Pennsylvanians; and
WHEREAS, Despite the growing demand for mental health
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
treatment across the United States, a mental health workforce
crisis has been developing, largely due to a shortage of mental
health providers; and
WHEREAS, Pennsylvania ranks 35 out of all 50 states and
Washington, DC, for mental health workforce availability, with a
patient to mental health care worker ratio of 600 to 1; and
WHEREAS, Pennsylvania has a Statewide average of 179 mental
health providers per 100,000 people, which is below the national
average of 214 providers per 100,000 people; and
WHEREAS, The lack of readily available mental health
providers in Pennsylvania has negatively impacted access to
mental health care for a countless number of residents; and
WHEREAS, An estimated 53.2% of the adult population with a
mental illness in Pennsylvania did not receive treatment for
their mental illness in 2017; and
WHEREAS, Other factors contributing toward the mental health
workforce crisis include higher demand for mental health
providers, high turnover rates, an aging workforce and low
compensation for workers in the field; and
WHEREAS, The mental health provider shortage has led to an
over-burdening of current mental health providers to make up for
insufficient staffing, lower quality of care for consumers and a
lack of stability for patients due to frequent staff turnover;
and
WHEREAS, The shortage of mental health providers also has
direct and indirect costs on the economy, including a loss of
efficiency and productivity for employees and employers; and
WHEREAS, It is estimated that over the next five years, the
shortage of psychiatrists in the United States will result in
more than 4.2 million lost or less productive workdays each
20180HR1109PN4119 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
month, which is a major cost to employers; and
WHEREAS, The psychiatrist shortage in Pennsylvania alone is
estimated to result in over 163,000 lost or less productive
workdays each month over the next five years; and
WHEREAS, Untreated mental illness in the United States costs
the nation more than $70 billion annually, solely due to lost
productivity; and
WHEREAS, When accounting for the diverted resources of
individuals in law enforcement, education and health care who
are often the first responders to individuals experiencing
mental health emergencies, the cost of untreated mental illness
in the United States increases to more than $100 billion per
year; and
WHEREAS, The prevalence of mental illness in an individual
can impact their overall health, as individuals with serious
mental illness face an increased risk of having chronic medical
conditions; and
WHEREAS, Adults in the United States living with a serious
mental illness die on average 25 years earlier than those
without, largely due to treatable medical conditions; and
WHEREAS, Research has identified a definite connection
between mental health and the use of addictive substances, as
many patients with disruptive or uncomfortable mental health
symptoms tend to self-medicate by using alcohol, drugs or
tobacco; and
WHEREAS, Unfortunately, the use of drugs and alcohol does not
address the underlying mental health symptoms and often causes
additional health and wellness problems for the patient, while
also increasing the severity of the original mental health
symptoms; and
20180HR1109PN4119 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
WHEREAS, The mental health provider shortage is considerably
more prevalent in rural counties and a significant discrepancy
exists between access to mental health care in rural counties
compared to urban and suburban counties; and
WHEREAS, Pennsylvania counties that are considered
predominantly rural have some of the fewest mental health
providers per 100,000 people, with some counties only having a
small number of working providers; and
WHEREAS, While the mental health provider shortage is
pervasive, it impacts certain populations to a larger extent;
and
WHEREAS, In 2015, among adults with any mental illness, 48%
of Caucasians received mental health services, compared with 31%
of African Americans and Hispanics and 22% of Asians; and
WHEREAS, One in four older adults experience a mental health
issue such as depression, anxiety, schizophrenia or dementia,
which is expected to double to 15 million older adults by 2030;
and
WHEREAS, Adults 85 years of age and older have the highest
suicide rate of any age group, especially among older Caucasian
men who have a suicide rate almost six times that of the general
population; and
WHEREAS, Two-thirds of older adults with mental health
problems do not receive the treatment they need and have limited
access to current preventative services; and
WHEREAS, It is believed that telemedicine, which involves the
use of electronic communications and software to provide
clinical services to patients without an in-person visit, will
expand the mental health workforce by offering flexibility to
work from home and will enable collaboration between
20180HR1109PN4119 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
psychiatrists and primary care providers; and
WHEREAS, Increased access to more varied client populations
through telemedicine can decrease provider burnout and improve
mental health workforce retention; and
WHEREAS, The National Council for Behavioral Health
identifies six broad areas that require change to address the
shortage of psychiatrists, which include:
(1) Expanding the workforce providing psychiatric
services.
(2) Increasing efficiency of delivery of psychiatric
services.
(3) Implementing innovative models of integrated
delivery of primary care and psychiatric care in more
settings that have the potential to impact the total cost of
care for high-risk patient populations with co-occurring
medical and behavioral health conditions.
(4) Training psychiatric residents and the existing
workforce in delivering new models of care.
(5) Adopting effective payment structures that
adequately reimburse psychiatric providers for improved
outcomes of care.
(6) Reducing the portion of psychiatric providers who
engage in exclusive, private, cash-only practices.
and
WHEREAS, Encouraging the growth and retention of the mental
health workforce in Pennsylvania will ensure that more
individuals have access to timely and adequate mental health
screening and treatment for mental illnesses; therefore be it
RESOLVED, That the House of Representatives direct the Joint
State Government Commission to conduct a study on the mental
20180HR1109PN4119 - 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
health provider shortage in this Commonwealth; and be it further
RESOLVED, That the Joint State Government Commission prepare
a report of its findings that shall, at a minimum:
(1) Identify the factors behind the mental health
provider shortage in this Commonwealth.
(2) Make projections on the number of mental health
providers in Pennsylvania in 5 and 10 years.
(3) Determine how telemedicine can be used to extend the
mental health workforce in rural counties.
(4) Determine how Pennsylvania government entities can
encourage more individuals to enter and remain in the mental
health workforce.
(5) Make recommendations regarding:
(i) How to solve the disparity in the number of
mental health providers in rural counties compared to
urban and suburban counties.
(ii) Any other solutions to stop and reverse the
mental health provider shortage in Pennsylvania.
and be it further
RESOLVED, That the Joint State Government Commission report
its findings and recommendations to the House of Representatives
no later than one year after the adoption of this resolution.
20180HR1109PN4119 - 6 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22