Final Mental Health Care Position

Health: Mental Health Care in Kansas

Background: Over the past 30 years, and especially since the passage of the Mental Health Reform Act of 1991, Kansas has worked toward deinstitutionalization of people with serious mental illness, as state funding has been increasingly shifted from state hospitals to community mental health centers (CMHCs) and resources for independent living.

While integration of individuals into mainstream society is an admirable goal, service providers are failing to meet many significant needs. Community hospitals are closing inpatient psychiatric units, and the three remaining state hospitals are currently at or near capacity. The number of beds at state mental hospitals has decreased by 456 since 1991, while the state’s population grew 10.6% between 1990 and 2005. Even persons admitted for psychiatric care in community hospitals are limited to stays of three to five days, with 45 days per year being the maximum paid by insurance companies.

Nationwide, individuals with serious mental illness experience high levels of unemployment, criminal incarceration and homelessness. In Kansas, the state continues to cut back on the safety net of totally state-funded programs, which are the only hope some persons have for survival.

In 2005, the League of Women Voters of Kansas (LWVK) adopted a study of mental health care in Kansas to evaluate the significant shifting of care from state mental hospitals to community based mental health centers. This study confirms that the inadequacy of the current system has contributed to an increase in the population of the homeless mentally ill, to the incarceration of adult and juvenile offenders with mental illness, to preventable deaths among individuals with mental illness, and to the inability of service providers both to deal appropriately with individuals in crisis and to treat the physical and mental problems of individuals with severe and persistent mental illness. The following statement of position was approved by the LWVK Board in March, 2007 and was adopted by delegates at Convention 2007.

STATEMENT OF POSITION

The LWVK endorses a mental health system which decreases dependency on costly emergency services, reduces poverty and homelessness among people with mental illness, reduces rates of incarceration, supports healthy recovery, and strengthens families.

To address the inadequacies found by this study, the LWVK recommends the following improvements in the existing continuum of care:

1. Services provided along this continuum should be based on consumers’ needs.
2. The number of hospitals with psychiatric units and the overall number of beds for acute voluntary and involuntary psychiatric care must keep pace with needs statewide. The total bed count comprises the budgeted capacity of the State Mental Health hospitals and the bed capacity of community hospital psychiatric units.
3. Stable funding should be ensured for providers in the public mental health care system.
4. CMHCs should provide services that are more accessible and available by:
   a. allowing multiple points of entry,
   b. increasing preventive and early intervention services to the general and target populations,
   c. strengthening crisis intervention,
   d. collaborating with other agencies,
   e. using technology creatively, and
   f. offering treatments which demonstrate a measurable outcome
5. A seamless transition must be provided for the consumer from primary care in CMHCs to intermediate care in state-operated regional inpatient units, and on to more acute care in State Mental Health Hospitals that also function as centers of excellence for research and education.

To fund these programs, the League recommends that Kansas should:

1. maximize use of state and federal dollars,
2. implement full insurance parity for mental health care,
3. distribute funds in a manner that more directly links money with services provided,
4. develop new and innovative sources of revenue from both public and private sectors, and
5. develop a public awareness campaign to educate citizens about the critical needs of the mentally ill and the obligation of all citizens to respond.

To improve mental health care services, consumers must have:

1. a wide range of transitional and long-term housing options, from fully structured to fully independent,
2. wrap-around services including physical health care, dual-diagnosis treatment, geriatric treatment and employment/education assistance,
3. an outreach program for individuals experiencing homelessness and individuals resistant to treatment,
4. effective crisis intervention,
5. humane and quality mental health policies/services within law enforcement and justice systems, and
6. quality mental health services offered in correctional systems at every level.

Finally, the League supports the goals and recommendations of the President’s New Freedom Commission on Mental Health (New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report; DHHS Pub. No. SMA-03-3832 Rockville, MD: 2003).

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