Parents and providers urge Ways and Means to halt DMH cuts, warn closure of Pappas and Pacasset would worsen crisis

Parents, clinicians and unions told the Joint Committee on Ways and Means that proposed fiscal changes to the Department of Mental Health would deepen a behavioral-health crisis that already leaves children and adults waiting in emergency rooms for care.

"Pappas is like the human body: nurses are the heart, teachers are the brain," said Louis Bellows, a Pappas resident. "Without Pappas, I wouldn't be who I am today."

Several witnesses described rapid and accelerating discharges and the uncertainty surrounding a February plan to close or restructure Pappas Rehabilitation Hospital for Children in Canton and to pause operations at Pacasset Mental Health Center on Cape Cod. Clinicians and family members said alternatives proposed by the administration ' moving children into other hospitals or out-of-area placements ' would not replicate the intensive medical, educational and therapeutic wraparound Pappas provides.

"Families can find comfort in knowing their children are safely supported by individuals who treat them as their own," a Pappas staffer said. "Closing Pappas will cut available specialty beds and force families to travel hours for care — or receive none at all."

Unions and case managers warned separately that the governor's FY26 draft budget includes deep reductions to DMH's community-based case management workforce. Case managers described caseloads of roughly 20'40 clients and said halving the staff who maintain long-term relationships with people with serious mental illness would create severe service gaps and more costly downstream consequences such as hospitalization, incarceration and homelessness.

"A 50% reduction in case management will create wait lists for services that are already short-staffed," said a DMH case manager. "You can't replace trusted relationships with a revolving door of unfamiliar faces."

Hospital leaders and pediatric psychiatrists told the committee that specialized residential and intensive programs ' often the only safe alternative to prolonged emergency-room boarding ' are either fully subscribed or underused because referral workflows and capacity constraints prevent placements. Providers asked legislators to ensure DMH retains inpatient and intensive residential options for children, to restore FY25 funding levels and to require clear statewide referral timelines so hospitals can move patients to appropriate care.

Why this matters: Testimony emphasized human consequences and likely fiscal tradeoffs: removing inpatient or specialized residential capacity and shrinking community case management may reduce near-term line items but is likely to increase emergency and incarceration spending and reduce long-term recovery prospects for vulnerable children and adults.

Ending: Witnesses urged the Ways and Means committee to protect funding for DMH children'and adult services, pause any closures that lack clear transition plans, and require a workgroup that includes clinicians, family members and front-line staff to review alternatives before any final decisions.