Opinion Columns & Blogs

Lewis W. Diuguid: Untreated mental illness costing state

From 35 to 40 percent of the people in jails and prisons have a mental health diagnosis.
From 35 to 40 percent of the people in jails and prisons have a mental health diagnosis.

Now that the elections have passed, lawmakers going to Washington, D.C., and Topeka in 2015 should read a Kansas City area report released this year on the untreated costs of mental illness.

It’s $1.17 billion in Kansas, reports the Health Care Foundation of Greater Kansas City in partnership with the HSM Group. The estimate is based on 1 in 10 adults in Kansas having a serious mental illness and almost 40 percent of those going untreated.

Bridget McCandless, a physician and president and chief executive of the foundation, said the report is meant to increase awareness of the problem. “Mental illness affects all businesses, all payers and all organizations,” she said.

Serious mental illness includes major depression, schizophrenia, bipolar disorder and anxiety disorders. The stigma tied to mental illness plays a role in people not getting treated and in society turning its back on the problem, said Jennifer Sykes, foundation communications officer.

Lawmakers need to pay close attention to the numbers, because recurring budget cuts have reduced services for mental health hospital beds and treatment. Guyla Stidmon, executive director of the National Alliance on Mental Illness-Kansas City, said that because of service cutbacks, people have to be sicker to get treatment.

“We know the most successful treatment is if we can get early intervention,” Stidmon said. That’s not how things are now.

The report notes that possible outcomes of untreated mental illness are unemployment, increased emergency room use, suicide and incarceration. The jails and prisons in Kansas and throughout the country have devolved into the nation’s largest mental health treatment facilities, McCandless said. From 35 to 40 percent of the people in jails and prisons have a mental health diagnosis.

In Kansas, untreated mental illnesses result in 21,000 incarcerations a year, the report says.

“Some people are being incarcerated for reasons best treated in the mental health system rather than incarceration,” McCandless said. They’re getting picked up on charges of public nuisance, vandalism, petty theft, disturbing the peace and assaults – incidents that could be prevented.

“We’re fortunate to have treatment in the jails, but that’s not where it needs to be,” Stidmon said. A terribly high human cost tied to the arrests is linked to families providing the care. They often become victims.

Stidmon said families try, but they are not capable of handling such public safety issues. “There are not adequate mental health services, and it affects the whole community,” she said.

“It’s not an unfounded fear,” Stidmon said. “It’s actually there.”

Lawmakers have to realize this and restore funding to departments of mental health. Kansas legislators also need to approve Medicaid expansion so that more people get the health care services they need.

The Affordable Care Act would help more people get insured for mental health parity, but the problem comes back to access and the shortage of available services.

The report found that of the cost of untreated mental illness, $522 million in Kansas is borne by individuals. The remaining amounts are picked up by the private sector, state, local and federal governments.

“Unfortunately, mental health has been approached with a very reactionary response,” McCandless said. We see it in mass shootings. “Treating this only as an episodic disaster is a very bad approach to mental health care.”

Most people suffering mental illness aren’t a danger to others. But they do need help, and making people aware of the costs, which can be controlled with treatment, is a start toward positive intervention. We just have to have the will to act.

Lewis W. Diuguid is a columnist for the Kansas City Star.