Initiatives in recent years to move mentally ill people from state hospitals into less-restrictive, community-based treatment programs were well-intentioned and, in many cases, highly successful. However, even for people in community-based programs, in-patient care sometimes is needed and, without it, their conditions may deteriorate to the extent they pose a danger to themselves or others.

Unfortunately, the in-patient system for people in need of mental health care has declined to the point that agencies like Lawrence’s Bert Nash Community Mental Health Center are scrambling to find the treatment some of their clients desperately need.

The Bert Nash center was notified last week that both of the state hospitals that provide in-patient mental health care in eastern Kansas are full and will have to stop taking new patients. In the last year, Lawrence Memorial Hospital also closed its mental health unit; another Overland Park hospital did the same. The result is that Bert Nash is having a hard time filling its in-patient treatment needs at the same time the number of its clients needing such care is increasing.

LMH had valid reasons for closing its unit. State Medicaid reimbursements for mental health units are so low that the units are a financial drain on hospitals. LMH also was having difficulty hiring psychiatrists to provide in-patient care. It’s a community hospital and should do its best to meet community needs, but it also must be financially responsible.

If LMH could find the staffing to reopen its mental health unit, the local problem might be solved at least temporarily, but this issue clearly demands statewide attention and resolution. It’s great to move mentally ill people into community settings where they can reconnect with family, friends and society. State hospitals shouldn’t be used as warehouses for people who can function outside, but they are an important complement to the services provided by community programs.

Short-term in-patient care may be the lifeline some clients need to get back on track and back to their communities. In some cases, that care may be the only way to keep clients and those around them safe.

State hospitals are expensive to run, and cutting those costs was part of the motivation for their closure, but reducing the number of state hospitals doesn’t eliminate the state’s responsibility to people and communities. Private and community hospitals can’t be expected to provide care without sufficient reimbursement. Community mental health programs can’t be expected to manage clients without the assistance of in-patient resources. The state needs to revisit this issue and figure out the best way to provide the in-patient treatment that’s necessary to help people with mental illness and keep both them and those around them safe.