The parent of a child battling substance use and mental health issues, Chris Potalivo said he’s found few residential options that could meet an array of various mental health needs in Centre County, a reality that mental health professionals say may not be easy to change.
Potalivo said he and his wife, Peg, have spent almost all of their savings in the past ten years trying to get their younger daughter the mental health treatment she has needed.
“We are well into six figures from trying to help out our daughter," Potalivo said. "And finally we had to come – it was very difficult for us to say: We just, we can't do this anymore. We just can't.”
Potalivo, who is retired from the U.S. Army and lives in Boalsburg, said a major expense was residential rehabilitation programs, which can cost between $15,000 and $35,000 a month. Those programs are not meant to be long-term, and as his daughter left them, she slipped back into substance use, which worsened her mental health.
“After the resident program, where they're making progress, there has got to be a facility for these people to go,” Potalivo said.
Potalivo said he had hoped to find a place where his daughter could live for more than a few months with full-time supervision even without health insurance, but couldn’t find one in the county. Instead, she is currently at the Centre County Correctional Facility after a DUI.
Fran McDermid, the director of program operations at Strawberry Fields, said she understands the shortage of residential mental health programs from a provider’s perspective.
Strawberry Fields is a county-funded organization with two community residential rehabilitation programs. One program is for as many as 19 residents with severe mental illnesses, who live in monitored group homes as they work toward more independent lives. The other program is smaller with less direct staff supervision.
McDermid said there is too big a gap between the more restrictive inpatient programs like those at Mount Nittany Medical Center or The Meadows Psychiatric Hospital and the more independent residential program at Strawberry Fields. Since there’s little middle ground, people get stuck in hospitals or jails.
“There's not enough programs with which to discharge people,” McDermid said. “And sometimes, people who are there, it’s their first episode with a mental illness and they’re not in a position to go home.”
The Meadows can serve up to 119 patients of all ages. Mount Nittany has 12 beds for adults with acute behavioral crises short-term. Pennsylvania allocates seven beds for Centre County at the Danville State Hospital. These capacities are stretched thin in a county with more than 160,000 residents.
Added to that, McDermid said Strawberry Fields is “way understaffed.” She said for a job that asks for a lot and can take an emotional toll, the pay is not great.
“I mean, somebody would really need to just say, ‘I really want to serve in a mental health residential program.’ And there's not a lot of people knocking on the door to do that,” she said. “We would love to open a thousand programs. How are we going to get people to staff them?”
McDermid said Strawberry Fields plans to start a new, more supervised program that would work specifically with people who have a hard time managing their symptoms or medications – a lot like what the Potalivos want for their child – if they can find adequate staffing.
Even with the challenges, McDermid wants those who need help to know they can get it even in an imperfect system.
Centre County Commissioner Michael Pipe said his fellow commissioners across Pennsylvania are making a push this year to restore a 10% cut to mental health funding that the state made about 10 years ago. A restoration would mean about $500,000 to add to the county’s mental health services.
“Really, the only way that we can increase beds, from my perspective, has been additional money from Harrisburg and a commitment to long term sustainability,” Pipe said.
He pointed to more than $2 billion in American Rescue Plan money the state is sitting on as a potential source.
Funding for a full spectrum of mental health services, varied by acuity of needs, duration and degrees of supervision, would be even more critical as the nation prepares to implement the 988 suicide prevention hotline by July, Pipe said.
Chris Potalivo said he hopes there’s a chance to break the vicious cycle his daughter seems to be caught in.
“Every time our daughter comes up where we think we're getting our daughter back, she slides back into this hole. It's like she dies in this nightmare where we've witnessed her dying at least a dozen times now,” Potalivo said. “Because there's nowhere for her to actively go to maintain that level. Invariably, she slides right back into that desperation pit.”
Peg Potalivo said she’s worried about leaving the burden of caregiving to her older child if she and her husband die before the mental health system improves.
“If we're both gone, my other daughter ends up with all of that,” she said. “That's a horrible way to live.”
