Kansas invites tragedy with an inadequate mental health network

The soul-searching over the dire implications of overcrowding at the Osawatomie State Hospital should extend to Kansas’ entire mental health system.

Advocates argue convincingly that it is overburdened and underfunded at nearly all levels. A system that at one time was well regarded and innovative is staggering from high demand and too few resources.

The lack of options leaves families of mentally ill individuals in a fearful limbo. Police officers and jails end up dealing with people who should have access to doctors and hospitals.

The state is hard pressed to deal with people in psychiatric crisis, let alone the hundreds of citizens who need care for depression, bipolar illness and drug and alcohol additions.

As often happens, it took a tragedy to bring the extent of the problem into focus.

A 30-year-old man with violent tendencies was released from the overcrowded Osawatomie psychiatric hospital in May after a week’s stay. Three days after his release, Brandon Brown fought with 61-year-old Jerry Martinez. Both were living at the Haviland Care Center, a residential facility west of Wichita. Martinez died in early June.

State officials are investigating whether Brown was released too early from Osawatomie, a secure facility whose staff is trained to handle violent patients.

Osawatomie, which has room for about 200 patients, operated above capacity for much of 2014 and had to shut down beds after being ordered by the federal government to make upgrades. Nurses and other staffers reportedly work brutally long shifts to cope with shortages.

The pressure on Osawatomie might be alleviated if the state’s mental health treatment pipeline functioned better. But there are needs at almost every juncture.

A bright spot of Gov. Sam Brownback’s tenure has been the opening of centers in Kansas City, Kan., and Wichita to stabilize people in psychiatric and substance abuse emergencies.

But state funding for a network of outpatient community mental health centers — the first stop for many patients — has been cut in half since 2008. Patients often wait weeks for medications and a treatment plan.

Communities lack housing, caseworkers and other supports for people with serious psychiatric illnesses. As a result, too many people end up in expensive crisis settings, or in jail.

“We don’t have good options for people with severe mental illness and other disabilities,” said Rick Cagan, executive director of the Kansas chapter of the National Alliance on Mental Illness. “People have no place to go, and they’re going to places where they’re not going to be successful.”

A committee of state officials and mental health providers is meeting to identify gaps in the mental health system.

But there’s no guarantee the Legislature will fund a plan adequately. Money that should be going to improve the lives of Kansas residents has been forfeited to excessive tax cuts.

The refusal of the Kansas Legislature and Brownback to expand Medicaid eligibility creates more hardship.

More than half of the people treated at community mental health centers are uninsured, and 70 percent of them have incomes of less than $20,000, according to data from the Kansas Mental Health Coalition.

Expanding Medicaid is the single most important step toward relieving pressure on the state’s mental health system, advocates say. But the Republican governor and GOP-controlled Legislature will barely discuss the matter.

Until Kansas changes its priorities, it invites tragedies in its mental health system — not just terrible events like the death of Jerry Martinez, but the quiet tragedy of troubled people unable to live full lives.

This story was originally published July 10, 2015 at 6:10 PM with the headline "Kansas invites tragedy with an inadequate mental health network."