Radu Teodorescu: Mental health system, underfunded and overcrowded, fails

Dear Gov. Brownback,

Bells and cheers are becoming the background noise. Scents of vanilla and nutmeg are filling the air. Hungry and tired, at the end of my work day I feel like screaming from the top of my lungs: “God, how far are we going with this!”

As a hospital psychiatrist I have seen my share of pain and suffering around the holidays. From abandoned parents in squalor, to rejected children, from relapsing homeless substance abusers who do not belong in the Christmas picture, to the psychotic and agitated, who for some reason or another are deemed dangerous to society or themselves.

But the danger qualification is utterly meaningless in the context of the chaos in the Kansas mental health system.

Our emergency room houses people who are court ordered because they are homicidal, suicidal or delusional and who have to wait for a bed at the state hospital for days. Imagine being in the “safe” room without windows for five days when you are already agitated and psychotic.

We have people on the medical floors who need to be released after an overdose because there is no facility in Kansas to treat them involuntarily, and they refuse to sign into a psychiatric unit. Almost every week we have to make an educated guess on how high the risk is, and release some troubled folks who will possibly do this again. We try to get in touch with families, to make sure there is a follow up is the community. But in the end, we have to take their word for it.

State hospital beds in Kansas are at the lowest number ever due to overcrowding and underfunding, and a consequent scandal that involved a Medicare audit. Another frustrating problem is the patients with dementia or other incapacitating ailments and who do not have Medicaid and clog the hospital beds waiting for placement. The wait time is months in some cases.

I read about your mental health initiative after the Connecticut school shootings in 2013. Community mental health clinics are supposed to get more money to help in times of crisis. A few million I believe. Incarcerated mental health patients are supposed to be placed in the right environment. Jail court orders take priority over community court orders. So our ERs remain full of psychotic patients who did not commit any crime yet and who do not have the insight to get help.

A good portion of these patients lack enough housing, food or prescription coverage to ensure that basic human needs are met. By turning down federal funds for the poor and underprivileged, many of whom are labeled, or truly diagnosed, psychiatric patients, we are turning a blind eye on our fellow man. We are all paying the financial and (some of us) the emotional toll for that mistake.

Gov. Brownback, you do not want Syrian refugees. You fear radicalization and attacks on America. But the people I’ve described in this letter, those struggling every day, are more of a real danger to themselves, and others. When will they get any help?

Kansans are some of the nicest people I have met. Your callousness does not represent them. When did intolerance and indifference become the embodiment of our politics?

At this joyful time for many, let us think for a second about the pain and suffering in the shadows of our holiday lights.

This story was originally published December 22, 2015 at 5:19 PM with the headline "Radu Teodorescu: Mental health system, underfunded and overcrowded, fails."