A yearlong review of Centre County’s mental health system culminated this month with a 79-page report full of recommendations that advocates and task force members hope can serve as a nationwide model for a crisis care.
The research is complete, leaving one looming, overarching question: What comes next? Cost, staffing, timelines and legal nuances are just a few hurdles that need to be cleared.
The 3/20 Coalition, an advocacy group founded after 29-year-old Osaze Osagie was fatally shot in March 2019 by a borough police officer while serving a mental health warrant, openly wondered how many of the 21 recommendations would be implemented.
But the report from the Task Force on Mental Health Crisis Services does serve as a starting point for “giving mental health the priority it deserves,” secretary Melanie Morrison said.
“It has been our hope from the beginning that we could help be catalysts for change in regards to better countywide funding for mental health and a greater public understanding of where the needs are in resources and with affected community members,” Morrison said. “Families who have loved ones with mental health issues are exhausted caring for them while having to simultaneously fight for the services they need.”
The report includes 11 systemwide recommendations and ten key recommendations that range from changes in how police respond to mental health crises to the development of community resources and advocating for additional funding for in-patient hospital beds for adults and adolescents with substance abuse and mental health issues.
An outdated mental health law
Pennsylvania’s mental health law went on the books in 1976, a time when there was an increasing focus on the negative effects of various treatments.
The act is one of the most restrictive in the nation, requiring a person to be a “clear and present danger” to themselves or others to be involuntarily committed to a hospital.
Task force member and Centre County District Attorney Bernie Cantora has not been shy in saying the law makes it too difficult for people to receive help before tragedy strikes.
“The definition requires our system to have to wait until the person is either homicidal or suicidal, and then we call the police to intervene. It’s terribly unfair to the individual in need and can lead to deadly results,” Cantorna said. “It’s something that has to be addressed, has to be looked at. It’s a bipartisan issue.”
The joint task force labeled the law as “outdated” and said officials should advocate for a review and update.
The Treatment Advocacy Center, a national nonprofit that pushes to eliminate barriers to timely and effective treatment for those with severe mental illness, gave Pennsylvania a “C+” for its mental health laws. That ranking was 28th in the United States.
The Keystone State is one of three that has “vague or ambiguous criteria” and one of four that require “risk of unreasonably severe harm,” the center said.
The law is “due for updating and review,” task force member and Penn State Counseling and Psychological Services Director Ben Locke said.
“The circumstances that initiated this task force were tragic, and my hope is that we as a community will come together to avoid them happening again. Helping people with serious mental illness and their intersection with law enforcement and the health care system is very, very, very complicated,” Locke said. “My hope is that we as a community will stay fully engaged and committed to the process of fully vetting and exploring all of the recommendations that have come out of that committee so that we can get the best possible system in place.”
Pennsylvania Senate Majority Leader Jake Corman, R-Benner Township, largely deferred in a statement to committee chairpersons to drive policy changes.
“As a Senate leader, I provide our committee chairs leeway to work within their areas of expertise to create policy,” Corman said. “With the start of a new legislative session in January, the Senate Health and Human Services Committee will begin work on their legislative agenda for the next two years. Input from groups such as the mental health task force is helpful in the process of setting those policy priorities.”
State Rep. Scott Conklin, D-Rush Township, described an urgent need for the state’s legislators to address the state’s “underfunded” mental health initiatives.
He stopped short of pledging to introduce a bill, but said he and his colleagues “must come up with a plan.”
“Do we spend a few cents now or do we spend millions of dollars later? The path we’ve been on is doing nothing up front and spending the dollars at the end,” Conklin said. “It’s time that we invest in the front end to make sure that those in our community have the support systems in place.”
Changing the way police respond to mental health calls
Law enforcement agencies in Pennsylvania are often the first to respond to those in a mental health crisis, a front-line role they were never intended to fill.
And it’s not uncommon for those interactions to be fatal. Those with untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians, according to a 2015 Treatment Advocacy Center study.
The task force’s first systemwide recommendation was to create a countywide co-responder model, where law enforcement and behavioral health specialists jointly respond to calls involving addiction, alcoholism and mental health disorders.
The alternative recommendation was to create an entirely civilian mental health response unit.
The report also presents a recommendation to limit the amount of crisis intervention team-trained officers who respond to mental health calls. It was suggested by task force consultant James Fouts, who wrote “not all CIT-trained officers have the prerequisite compassion, empathy, communication skills and patience required for crisis intervention.”
About 97% of municipal police officers in Centre County received CIT training, which State College police Chief John Gardner has said is the “gold standard.”
No other county in Pennsylvania has a higher percentage of CIT-trained municipal police officers, according to the task force report.
The task force also recommended enhancements to Cantorna’s two-month-old behavioral and mental health diversionary initiative, including the creation of a mental health court in Centre County.
About one-third of Pennsylvania’s 67 counties have a mental health court. Centre County is one of five fourth-class counties — those with a population of 145,000 to 209,999 — that does not have a mental health court; four others do.
“The intricacies of mental health, mental health treatment and mental health compliance are not well understood oftentimes in general court proceedings, in general medicine and in general law enforcement,” Locke said. “I do think that we need to look very carefully at the idea of a mental health court in order to ensure that when those decisions are being made … they’re made by people who are fully informed of the very challenging details of mental health.”
When and how will recommendations be implemented?
There is a laundry list of questions that come with the report’s recommendations, and it’s not known when answers may come.
In statements when the report was released on Nov. 10, both State College Borough Council President Jesse Barlow and Centre County Board of Commissioners Chairman Michael Pipe applauded the work of the task force members.
“This report contains the critical steps that we must take to improve the mental health crisis services in Centre County,” Barlow said. ”We must extend every effort to implement these recommendations to ensure we make the proper enhancement to our mental health crisis services.”
But neither the county nor the borough felt comfortable addressing the plans further because they “have not adequately reviewed the report,” State College spokesperson Douglas Shontz wrote in an email.
Centre County’s commissioners “will not be discussing the report” until after Thanksgiving, county Administrator Margaret Gray wrote in an email.
That delay didn’t sit well with attorneys Kathleen Yurchak and Andy Shubin. They represent the family of Osaze Osagie, the Black man who was fatally shot by a white State College police officer and whose death was a driving factor in the creation of the task force.
“State College Borough has historically proven to be very good at preparing or creating task forces and having those task forces write wonderful reports full of great information and great recommendations,” Yurchak said. “But the proof is in the pudding — what’s going to happen next? Is this task force report going to sit there? The recommendations, are they going to be implemented? Where is the funding coming from? That’s what is most important to the family. Not that we have a lengthy report that has these well-written recommendations, but that they are implemented in a way that creates true reform.”
Added Shubin: “The time to talk is now over. It’s time for action before someone else gets killed.”
Some “critical” initiatives from the report that should be implemented, according to the Osagies, include:
The Osagies earlier this month filed a federal civil rights lawsuit against the borough and 10 unnamed police officers. The filing alleged their son’s death was the result of the police department’s systemic failures.
The family is seeking unspecified monetary compensation, but are also hoping to be a catalyst for meaningful reform, Yurchak said.
“One of the driving forces of their filing their lawsuit was to ensure that reform happened. In many cases, without the pressure of legal ramifications, reform doesn’t happen,” Yurchak said. “So when they made the decision to file their lawsuit, it was based primarily on making sure that this task force report didn’t just sit there and that reform actually occurred.”