TOPEKA — More Kansans are seeking treatment for serious mental illness, and there are fewer places for them to go.
Blame the economy and state budget cuts, say mental health professionals. They briefed state lawmakers last week on what they call a growing crisis for the state's mental health safety net.
Twice this summer, Kansas' state mental institutions were forced to close their doors to voluntary admissions due to overcrowded facilities.
Johnson County Mental Health Center, for example, treated nearly 11,000 outpatient clients last year, compared to 6,500 in 2000. Director David Wiebe said the center receives 50 to 60 new patients every week whose illness was precipitated by economic stress — a job loss, home foreclosure, mounting debt or loss of insurance.
Meanwhile, the center lost $1.7 million in state funds.
"We are currently operating with 32 vacant positions," Wiebe said. "At the same time, we're seeing this unprecedented increase in demand. We saw an increase of nearly 1,000 patients from 2008 to 2009. We have a very stressed system."
Lawmakers reviewing the problem acknowledged there are no easy answers. There's little revenue available to improve the state mental health system. It's likely to be a key discussion when lawmakers convene in January to put together next year's budget.
"We've got to readjust our priorities to give the mental health system some relief," said Senate Vice President John Vratil, R-Leawood. "We can't allow this to continue and turn a blind eye."
Other states are struggling with similar problems. Thirty-four states — including Missouri — have a shortage of state hospital beds dedicated to the mentally ill, according to a study by the National Association of State Mental Health Program Directors.
In the last fiscal year, Kansas' three state mental hospitals were over capacity at least one-third of the time. One of them, Larned State Hospital, was over capacity for 302 days last year.
As a result of the overcrowding, the state halted voluntary admissions for a week in May and for four days last month. Those seeking treatment were put on a waiting list. The state has a legal obligation to find a place for those committed to a hospital by the courts.
"At a certain point it really becomes a matter of safety and the limitations of the physical space in the hospital," said Don Jordan, secretary of the state Department of Social and Rehabilitation Services. "Sometimes there's just no more place to put another person."
Mental health advocates warn of a potential bottleneck if the state doesn't find a way to provide services for those who need them. Those who can't get treatment at state hospitals often turn to local mental health centers already dealing with their own budget cuts.
Adding to the problem is the dwindling number of private hospitals that offer mental health services. Wichita, for instance, had seven inpatient mental health facilities in 1990. Now, it has one.
During fiscal year 2010, 600 Kansans voluntarily checked themselves into the state's largest public mental hospital in Osawatomie. There were 1,600 patients who were involuntarily committed.
To keep up with demand at state hospitals, the Legislature approved an expansion of Osawatomie State Hospital in 2007. Then the recession hit. State revenue sank, and the expansion was shelved.
"That was actually the first budget cut SRS made," Jordan said.
Private insurance can pay for those receiving treatment at state hospitals. Medicaid, patient co-pays and other sources also can help. But half of those seeking treatment have no insurance, and many don't qualify for Medicaid. That leaves the state stuck with the tab. The median length of stay for patients in state hospitals is 10 days.
The twin problems of higher demand and fewer resources stretch across the state.
The High Plains Mental Health Center serves residents in 20 western Kansas counties. More than $1 million in state funds was cut, and the center now runs a $40,000 deficit each month. Patients can wait up to two months for medication evaluations.
"If this were heart disease, we would be outraged," said director Walter Hill. "For some reason, with mental illness, it's OK that we don't have hospital beds."