Wichita — Funding cuts to mental health services in Kansas have spawned layoffs at some of the state’s 26 health centers, many of them positions that help families in crisis manage day-to-day care, mental health advocates say.
There’s a $30 million budget hole for mental health for the current fiscal year, the Association of Community Mental Health Centers said last month — a figure that the Kansas Department for Aging and Disability Services does not dispute. In a sector that never saw its pre-Recession state funding restored, the new program cuts — which are expected to result in an estimated loss of 200 positions, association director Kyle Kessler said — are drawing warnings of more hospital admissions, emergency room visits and interactions with law enforcement.
“It leaves you vulnerable to being arrested again or back to the hospital or dead,” said Rick Cagan, executive director of the Kansas chapter of the National Alliance on Mental Illness. “I don’t mean to be dramatic, but this does happen.”
Without the state’s cash, some communities, and even recovering patients, are stepping up to do what they can to help, knowing that nationwide as many as one in 10 children will have a serious mental health issue and one in four adults will experience a mental health disorder in any given year.
“This will be studied over time,” Kessler said. “And people will be looking at Kansas as a cautionary tale about what happens when you reduce funding for mental health.”
The latest cuts include ending a health homes program, which monitored a person’s physical and behavioral health and made sure patients were going to their appointments and taking their medications. Kessler described the program as “next-generation stuff ... like losing your future.” Also eliminated was a Medicaid mental-health screening program that had aimed to keep people out of mental hospitals by diverting them to community-based outpatient services.
Another blow came with the state’s 4 percent Medicaid provider reimbursement rate reduction, as Kessler put it, “like losing the present because that is taking away services where physicians help people right now.
Mental health services in Kansas took an “enormous hit” back in 2008 and 2009 when they were cut by more than 50 percent, said Angela de Rocha, spokeswoman for the state’s aging and disability department. While the state has boosted money in subsequent years, she said, mental health funding has never recovered fully.
“It continues to be a challenge and we are working with all our partners to address it,” de Rocha said, noting the state has a “Continuity of Care” committee which meets regularly to look for solutions.
To cover the gap in coverage, people and communities are doing what they can. Thirteen cities are participating in the Johnson County Mental Health Center’s co-responder program, meaning mental health staff are on call to assist police when they come into contact with someone with mental illness.
Manhattan wants to do something similar, with the Manhattan City Commission and Riley County Law Board funding two co-responders to work with the Riley County Police Departments and Pawnee Mental Health starting next year.
“Families are frustrated and in tears because we do not have services necessary to take care of their loved ones,” said Manhattan Mayor Usha Reddi, who is also an elementary school teacher and NAMI board member. “It is becoming extremely difficult to keep or recruit staff to work with our neediest population. I see the impact in our schools.
“Our social workers are exhausted and the needs are immense.”
Christine Thompson was once diagnosed as bipolar; she is now in recovery and is the president of Manhattan-based Morning Star, which provides peer-support services for things like substance abuse and diabetics.
The group is now trying to get Medicaid certification for peer support services, and pursuing the possibility of developing a “respite center” which would provide a home environment where people can stay for a few days where they can manage their symptoms and divert them from getting into a mental health crisis.
“It is going to be a drop in the bucket, but hopefully we will be able to implement some of these measures,” Thompson said.
Even before the latest cuts, some walk-in health center patients have had to wait weeks before they could get a medical appointment to see a psychiatrist or other provider, Kessler said.
“There have been piecemeal attempts to patch things here and there, but we really have a system in great disrepair,” Cagan said. “And the thing about it is that individuals with serious health conditions are not going away, they don’t disappear ... They are going to show up somewhere as somebody else’s headache or they are going to end up being a danger to themselves or others.”