Six years ago, it seemed like a good idea: Close Topeka State Hospital and direct the savings to community mental health centers. The idea was to keep people out of state hospitals and in their own communities.

For a while, it worked. But advocates for the mentally ill now say the system is broken.

As local programs — including Lawrence’s Bert Nash Community Mental Health Center — struggle to fill the void left by the state hospital’s closing, county jails increasingly have become holding pens for the mentally ill.

“This is a national problem that’s going on here in Kansas like it is every other state,” said Steve Feinstein, president of the Kansas Chapter of the National Alliance for the Mentally Ill. “We’re seeing people who, a few years ago, would have gone to a state hospital or a local psychiatric unit, where they would have been stabilized and returned to the community. Now they’re ending up in jail because the local beds are full and the state hospitals are full.”

That’s certainly the case in Douglas County, Sheriff Rick Trapp said.

“The national statistics I’ve seen show 17 to 20 percent of the people in correction institutions have a serious mental illness. That’s pretty close to what we’re seeing,” Trapp said.

An example

One needn’t look far to find an example.

Katherine “Lani” Oglesby, 56, wound up in jail after causing a disturbance in May 2002 at Dr. Shelly McColm’s dental office, 12 W. Eighth St. She assaulted a police officer and later scratched a jailer.

“What happened was I had back surgery and the pain pills they gave me messed up my lithium,” Oglesby said, referring to the prescription drug she takes to control her bipolar disorder.

As community programs struggle to fill the void left by the closing of Topeka State Hospital, officials say county jails have increasingly become holding pens for the mentally ill.

“I ended up not taking my lithium, but in my mind I didn’t know I’d quit taking it, and that’s what messed me up,” she said.

Before going to trial, Oglesby was sent to Larned State Hospital for treatment and mental evaluation.

“The people working there really tried to help me,” she said. “But the problem was they kept saying I had to help myself, but I couldn’t help myself because my medication was all messed up. Once we got that straightened out, I got better.”

Oglesby, who’s well-known in Lawrence for her outspokenness on behalf of the city’s homeless, pleaded no contest and was sentenced to 80 hours of community service work.

She doesn’t blame the Bert Nash center for her recent troubles.

“What can I say? They try,” she said. “But it’s like anything else. What happens depends on how much money there is, and I don’t think there’s enough money.

“Maybe it’s supposed to be that way,” she added. “Because, you know, it’s always been that way.”

Wrong path

Advocates for the mentally ill say it’s good Oglesby had access to a state hospital. But it’s wrong, they say, she first had to spend time in jail.

“That was a great disservice to her,” said Elizabeth Adams, former executive director of the Kansas chapter of the National Alliance for the Mentally Ill.

Katherine Lani Oglesby, of Lawrence, offers her own experience of being jailed.

“I’m not bashing the hospital or (Bert Nash) because I’m sure they’re both underfunded and understaffed,” she said. “But there seems to be a willingness to say ‘OK, we’ll wait until these people wind up on the streets or in jail — then we’ll give them the services they need.’ That’s not acceptable; people ought to have access to the appropriate level of service when they need it.”

Adams recently accepted a position with alliance headquarters in Washington, D.C.

The Bert Nash center’s director of adult services, Patricia Stucky, said keeping people like Oglesby on medications was a constant, difficult challenge.

“We do a lot for people with severe and persistent mental illness, and we’re looking at doing more,” Stucky said. “But what happens so many times is that when people get to a point where they’re doing well, they don’t want to take their meds anymore. It’s really no different from somebody not wanting to take vitamins when they’re not sick.”

Bert Nash center workers cannot force someone in Oglesby’s situation to take medication, Stucky said. Also, not everyone who’s mentally ill and in jail belongs in a state hospital.

Statewide problem

“I see people all the time who need mental health services but who don’t need — and shouldn’t be in — a state hospital,” said Sharon Zehr, who runs the Bert Nash center program at the Douglas County Jail. “In fact, I don’t see very many who should be in a state hospital.”

¢ Association of Community Mental Health Centers of Kansas

Zehr disputed the notion that creating more state-hospital openings will reduce the number of mentally ill people in jail.

“There are people who need mental health services who, for whatever reason, aren’t accessing those services,” she said. “Either they’re not connecting with us or we’re not connecting with them — that’s where there’s a gap in the system. It’s not that we don’t have enough state-hospital beds; we can get them in a state hospital if that’s where they need to be.”

That may be true in Douglas County, but the alliance’s Feinstein said that wasn’t the case for most of the state.

“A lot of us came away from mental health reform and the closing of Topeka State Hospital feeling pretty good about in-patient services being available in the community, but that ‘glow’ has faded rather quickly,” he said.

Feinstein is chairman of a task force that’s studying the state’s need for in-patient hospitalization.

“We’re making progress,” he said, “but we’re not funded, so the going has been slow.”