After two visits by high-ranking state officials in the last month, the Warren State Hospital board of trustees had plenty to talk about at Wednesday's meeting.
With two vacancies on the board and three other members absent, the trustees fell short of their five-member quorum and met in an informational session.
They could not take formal action, but had plenty to discuss.
In mid-April, Pennsylvania Secretary of Public Welfare Beverly Mackereth, State Sen. Scott Hutchinson, State Rep. Kathy Rapp, and Deputy Secretary of the Office of Mental Health and Substance Abuse Services Dennis Marion were among the visitors who participated in a discussion of mental health issues and the criminal justice system.
Two weeks ago, Marion returned, joining other state officials for a tour of the facility.
"They were impressed," Warren State Hospital CEO Charlotte Uber said. "They were impressed with the staff, the beauty of the campus.
"We're trying to maintain our campus with less staff," Uber said. "It's getting more and more difficult, but they're doing a great job."
On Wednesday, Uber spoke about the services residents receive prior to discharge.
"About 68 percent have some kind of a job while they're here," Uber said. "Seventy-nine percent of our people now have a community support plan."
Those kinds of programs help residents make the transition to the outside world.
Job experience is particularly important to one of the trustees.
He said the primary correlation between mental illness and crime is work.
"One thing that I have the impression that we miss is vocational rehabilitation - a fancy word for work experience," Keith Bell said. "Even 15 or 20 hours a week. Keeping a job is the end result."
"If people have time on their hands, they will often get into trouble," Bell said. "Check any facility you want - the criminal justice population has a minimal to non-existent work experience. The people we see in the criminal justice system have minimal experience in taking orders or instruction... being responsible."
"These people without that experience live lives of mental and physical inertia," Bell said.
The hospital takes that responsibility seriously, but funding is a problem, according to Board Chairman Dr. Raymond Feroz.
"Warren State Hospital has been committed to being a mental health recovery (facility) - living, learning, working," Feroz said. "Nobody ever paid for anything vocational in the mental health world."
"It's a critical element," he said. "That structure of a job, of a day, means so much."
Bell said he would like to see more measurements made of progress and trending practices. "I think we need to see, if we can, some measurement to back up what they're saying."
Trustee Bill McCarthy agreed and suggested that the mental health industry look to other industries for guidance. "I think that General Electric and Toyota are far ahead of health care," he said. "There's no science. Until we can measure things, it's just story-telling."