Mental health talk breeds frustration

Dave Ranney

By A Contributor

Karen McCulloh spent much of Wednesday afternoon listening to state officials explain how Gov. Sam Brownback’s mental health initiative might work.

She said she didn’t hear much that she hadn’t heard before.

“We’ve all been to a thousand of these meetings where we sit around and talk about how we can all be more efficient, more faith-based,” said McCulloh, a former mayor of Manhattan who spent 10 years on the Riley County Commission before returning to the City Commission in April. “And it’s true, we can all do better. But it’s also true that you can only save so much money before you’re down to the bone and you’re just putting Band-Aids on things. You’re not really solving problems.”

Brownback has said his initiative is meant to strengthen the state’s mental health system and better serve those most at-risk of hospitalization or incarceration. To underwrite the plan, the governor has proposed redirecting $10 million that’s already being spent on mental health services.

Carla Drescher, assistant director of behavioral health services at the Kansas Department for Aging and Disability Services, said about half of the $10 million likely would be set aside for helping the state’s 27 community mental health centers care for the uninsured. The other half, she said would be used to create “recovery centers” in five multi-county regions across the state.

The recovery centers, she said, would provide crisis stabilization alternatives for patients who might otherwise end up in jail or in one of the state’s two hospitals for the mentally ill.

Drescher said it remained undecided which mental health centers would be charged with coordinating each region’s recovery center.

About 35 people – a mix of public officials, social service providers, mental health workers and advocates – attended the two-hour session put together by the department to collect input on the initiative.

No one objected to the governor’s call for additional services, but many challenged the plan’s lack of additional funding. “Everyone here recognizes the need for a mental health initiative,” said Riley County Commissioner Bob Boyd.“But that’s not the question. The question is how are we going to pay for it? And where is that (funding) obligation housed?”

The state, he said, appeared to be passing the obligation onto the counties.

“The state has done a large chunk of it in the past,” Boyd said. “But now, more and more, it looks like they are opting out. So does this fall back on the counties? If so, we need to educate the public to that effect.”

Several audience members told of patients returning to the region from stays at Osawatomie State Hospital without a plan ensuring they would have access to the medications they’d been prescribed. And it was not unusual for some of the patients to have to wait eight weeks for an appointment with a counselor at Pawnee Mental Health Center.

The mental health center, they said, had its hands full responding to patients in crisis situations.

Based in Manhattan, Pawnee Mental Health Center’s catchment area includes 10 counties: Clay, Cloud, Geary, Jewell, Marshall, Mitchell, Pottawatomie, Republic, Riley and Washington.

“I’ve been in my position for seven years now,” said Robbin Cole, the center’s executive director. “That whole time, the environment has been one of dwindling resources. We had layoffs in 2009 and again in 2010. We have 25 percent fewer staff today than we did in 2007.”

The center’s annual budget, she said, had been “about $14 million” in 2007; today, it’s close to $12 million.

“When the local stakeholders hear that we’re going to be doing more for the same amount of money, they sort of scratch their heads and go, ‘How?’” she said.

Cole said that while the governor’s call for putting $5 million into five regional recovery centers appeared to be well-intended, it also signaled a “move away from the long-held idea that treatment is best provided on a local level.”

The plan, she said, “feels like it’s moving from a system in which we have 27 regions (one for each mental health center) to one that has five, a system that’s more regional than local.”

Kansas in recent years has spent about $375 million annually on overall mental health services, including state hospital expenditures. Medicaid spending for mental health has increased since 2007, but state grants to the mental health centers to care for the uninsured have been reduced.

In per capita spending on mental health, Kansas ranks about 20th among U.S. states, according to information collected by the National Association of State Mental Health Program Directors.

The Rev. Patrick McLaughlin, pastor at the United Methodist Church in Manhattan, said he often allows a woman who is homeless and mentally ill sleep on a couch in the church office.

“We were all kind of hoping for a few more tangibles to take away, (from the discussion),” he said, “like ‘Here’s where we’re headed,’ or ‘Here’s what is promising that’s coming up.’ But I’m not sure that we’ve got anymore hope that things are going to be getting better anytime soon.”

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