Pennsylvania has one of the more interesting public mental-health systems in the country — a Medicaid behavioural-health carve-out called HealthChoices that delegates management to counties, paired with a state office (OMHSAS) that sets policy and oversees long-term inpatient hospitals. This guide explains how it all works for people with schizophrenia.
In Pennsylvania, behavioural health for Medicaid enrollees is delivered through county-managed HealthChoices plans, overseen by the state Office of Mental Health and Substance Abuse Services (OMHSAS), with civil commitment governed by the Mental Health Procedures Act (Section 302).
Medicaid in Pennsylvania
Pennsylvania expanded Medicaid in 2015. Adults up to 138% of the federal poverty level qualify; people with disabilities qualify at higher incomes. The state portal is dhs.pa.gov. Once enrolled, members choose a Physical HealthChoices plan for medical care and are automatically enrolled in a Behavioural HealthChoices plan based on their county.
HealthChoices behavioural health
The Behavioural HealthChoices program is a Medicaid carve-out: counties (or county joinders) act as the "primary contractor" and manage behavioural-health benefits through subcontracted Behavioural Health Managed Care Organisations such as Community Care Behavioural Health, Magellan, PerformCare, and Beacon. Counties retain reinvestment funds from any savings — a unique feature that has funded innovative services like peer respites, supported housing, and crisis units.
Coverage includes outpatient psychiatry, antipsychotics, therapy, partial hospitalisation, ACT teams, mobile crisis services, and inpatient psychiatric care.
OMHSAS
The Office of Mental Health and Substance Abuse Services (dhs.pa.gov/OMHSAS) is the state oversight body. It operates Pennsylvania's state hospitals (Norristown, Torrance, Warren, Wernersville, and others), licenses behavioural-health providers, sets HealthChoices standards, and funds initiatives like first-episode psychosis programs.
Pennsylvania has a strong network of HOPE for Tomorrow and other coordinated specialty care programmes for first-episode psychosis, modelled on RAISE-CSC, including programmes at Penn, Pitt, and elsewhere.
Leading academic centres
- University of Pennsylvania (Penn Medicine) — Department of Psychiatry; the Lifespan Brain Institute and the PRIME Clinic for clinical high risk.
- University of Pittsburgh / UPMC Western Psychiatric Hospital — one of the largest academic psychiatric hospitals in the country, with major schizophrenia research.
- Drexel University College of Medicine — Department of Psychiatry.
- Temple University Health System — Episcopal Behavioural Health Crisis Response Center and outpatient services.
- Penn State Hershey Medical Center — central PA's main academic psychiatric centre.
Advocacy organisations
NAMI Keystone Pennsylvania (namikeystonepa.org) coordinates affiliates statewide. The Mental Health Association in Pennsylvania, the Mental Health Partnerships in Philadelphia, Disability Rights Pennsylvania, and the Pennsylvania Mental Health Consumers' Association are other significant organisations.
Civil commitment: the Mental Health Procedures Act
Pennsylvania's involuntary commitment law is the Mental Health Procedures Act of 1976. It is structured around numbered sections that families and clinicians frequently reference:
- Section 302 — emergency involuntary examination and treatment, up to 120 hours. Initiated by a physician's certificate, a county delegate's warrant, or in emergencies by a peace officer.
- Section 303 — extended emergency commitment up to 20 days, requires a judicial hearing.
- Section 304 — court-ordered commitment up to 90 days.
- Section 305 — additional 180-day commitment.
The criteria require clear and present danger to self or others within the past 30 days. The full text is on the DHS website.
Pennsylvania also has limited assisted outpatient treatment through Section 304 outpatient commitment, but it is used less frequently than in some other states.
Crisis services
Each county operates a crisis intervention service. Allegheny County has resolve Crisis Services (1-888-796-8226); Philadelphia has the Crisis Response Centers and the Mobile Crisis Teams. 988 is operational statewide and routes to county crisis lines.
Your loved one is in danger of self-harm, threatening violence, or unable to care for themselves — call 988, the county crisis line, or 911. Be specific about recent dangerous acts; this is what the 302 process requires.
Practical first steps
- If on Medicaid, identify your county's Behavioural HealthChoices contractor and call its member services line.
- Ask about coordinated specialty care for first-episode psychosis if onset is recent.
- Connect with a NAMI Keystone affiliate for Family-to-Family.
- For 302 questions, contact your county's mental health/intellectual disability office; it administers the warrant process.
This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a qualified mental health professional. If you or someone you know is in crisis, call or text 988 in the US, or your local emergency number.