Gov. Maura Healey’s proposed state budget cuts to the Department of Mental Health are raising concerns on behalf of some of the Pioneer Valley’s most vulnerable populations.

Cost-cutting proposals include slashing the number of DMH case managers across the state in half, from 340 to 170, as well as cuts to adolescent intensive residential services which Cutchins Programs for Children and Families say would shutter their Three Rivers Clinically Intensive Residential Treatment Program (CIRT) in Belchertown — the only remaining program of its level and intensity in the state for children aged 6 to 12.

“Where are these kids going to go?” asked Tina Champagne, chief executive officer of Cutchins Programs.

Champagne explained that Three Rivers offers intensive care for children with a significant level of need who are referred to the program through DMH.

The Three Rivers program has been around for 32 years, and should it have to close its doors, Champagne worries that emergency services will have to respond to more calls pertaining to acute childhood mental health crises, which they may not be as equipped to handle.

Similarly, Champagne said that when programs addressing mental health needs in childhood aren’t prioritized, this only means further adult mental health needs in communities in the future, as those needs don’t simply go away when they go unaddressed.

The budget cuts are aimed primarily at services seen as being underutilized, but Champagne emphasized that this distinction is misleading.

“They’re referring to these programs as underutilized,” said Champagne. “One of the ways that this has been framed is that underutilization means no need and that’s a problem.”

This perceived underutilization, Champagne said, actually comes from factors like the COVID-19 pandemic, which caused temporary disruptions and staffing shortages across the state, as well as disruptions from Three Rivers being relocated from Springfield to Belchertown in 2023. Additional contributors to this underutilization classification that Champagne noted are barriers between patients and programs caused by inefficiencies in admission and referral processes.

Champagne said that the proposed cuts will be “detrimental,” and even if programs like Three Rivers are eventually reinstated after being cut, it will take time and funding to bring them back up to their full force once again.

“Once you remove this, it’s not going to be easy to start back up again,” she said.

Other programs that would be reduced under the current DMH budged proposals that Champagne expressed concern about are the Program for Assertive Community Treatment for Youth (PACT-Y) and Flexible Support Services teams.

Cutchins has several other operations in the area, including the Northampton Center for Children and Families, a residential program that offers adolescents individualized treatment plans and counseling, New Directions School, a therapeutic educational program that offers behavioral, clinical, and educational services to student between 8 and 21, and an outpatient clinic, The Children’s Clinic, for children and families facing emotional and behavioral difficulties, as well as flexible support services offered to children and teens throughout western Massachusetts.

Case managers worry about instability, turnover

Cynthia Davis, a case manager in Springfield, has worked with DMH since 2015. Because of her seniority, she said her position is likely secure among the 170 proposed case manager cuts — but to her, nothing about the situation feels secure, especially for the vulnerable people she works with.

“I don’t think anyone is ever secure when the governor is proposing cuts of this magnitude,” said Davis.

According to a fiscal year 2026 budget presentation from the Executive Office of Health and Human Services, the proposed DMH layoffs would save the state $12.4 million. Officials said that “DMH is prioritizing critical needs case management intended to preserve access to DMH’s 24/7 continuing care operations.”

Opponents, however, say that the cost to patient health will be much greater.

With the number of case managers working throughout the state cut in half, Davis anticipates an uptick in mental health related police encounters, an increased reliance on crisis services, and overburdened vendor services — services that DMH has contracted with — which Davis said already have high turnover rates and are therefore often unable to give patients the sustained, individualized care that can make a world of difference.

For example, Davis has been case managing one individual since 2021, and in the past year that person has had five people serve her through DMH vendor services.

“One thing that case managers focus on is building healthy relationships,” said Davis, who later emphasized that case managers are “not just another outreach worker.” Case managers see their patients on a regular basis, not just taking them to appointments and picking them up, but often accompanying them to appointments and advocating for them as well.

Davis said that case managers sometimes offer individuals the first consistent relationship that they have had in their life — they become the first person they call in an emergency, they allow them to feel safe — and then cuts happen “and now, they have no one.”

Because case managers remain in their positions for sustained periods of time, Davis also noted that they bring experience and specialties that can be vital. For instance, Davis specializes in domestic violence and transition-aged youth. When services struggle with instability and turnover, Davis said “the high turnover rates come with inexperience.”

Of the 340 case workers throughout the state, Davis said all of them are carrying caseloads of roughly 20 to 25 people, and she worries for the individuals who could be set adrift by the loss of their relationships with their current case managers.

“It’s very scary,” she said, growing tearful, “and it hurts my heart to the core.”

Other proposed cuts included the closure of two state-run hospitals, Pappas Rehabilitation Hospital for Children in Canton and Pocasset Mental Health Center on Cape Cod, which Healey has since suspended plans for.

Alexa Lewis can be reached at alewis@gazettenet.com.