There are far too many tragedies across our country that involve a person struggling with a mental illness who did not receive adequate treatment and support. Tragedies such as the events at Virginia Tech, Aurora, Colo., Chardon High School in Ohio, and the most recent example in Newtown, Conn., are painful reminders.
We must do what we can to make community-based mental health services affordable and accessible to all Kansans through the state’s publicly funded mental health safety net system. If we as a state fail to do so, the impact of mental illness will be devastating on the individual; our communities; and will cost our state more money in the long run.
Mental illness destroys countless lives every day, contributing to domestic violence, child abuse, drug addiction, homelessness and incarceration. Investing in mental health care and reducing its stigma could help prevent the devastating impact of mental illness on the lives of Kansans. We must act because it is the right thing to do. Investing in community-based mental health treatment can and will save our state resources, particularly at a time when we are evaluating the best return on our tax dollars.
The Community Mental Health Centers (CMHCs) are the state’s publicly funded safety net system for community-based behavioral health services, serving more than 130,000 Kansans in 2012. It is important to note that 53 percent of those served by the CMHCs are not insured. Mental Health Reform dollars are what the system relies on to serve the uninsured and underinsured Kansans, to ensure their essential mental health treatment needs. Those dollars have been reduced by 50 percent since FY 2008, yet the number of uninsured individuals who are presenting at our doors seeking treatment continues to rise.
When individuals with mental illness do not receive timely treatment, they decompensate and end up requiring higher levels of care, such as being admitted into a state psychiatric hospital, the most costly level of care. Without treatment and care, many end up in contact with law enforcement, jails, hospital emergency rooms or state psychiatric hospitals. Individuals who are able to be treated in the community will have improved quality of life for themselves and their families, and ultimately be more productive citizens. It is in the home community where the power of family and natural supports play an important role in the recovery process.
Cuts to Mental Health Reform funding continues to place the public mental health system at a breaking point. Every Kansan who walks through the doors of a CMHC is impacted by these budget cuts. The state has failed to keep its promise associated with the passage of the Mental Health Reform Act of 1990, that promise being to ensure Kansans have access to quality community-based mental health treatment when they need it and to receive it in their home community rather than in an institutional setting. Last year, the Legislature restored $5 million of the $20 million that has been cut from the public mental health system resources since 2008. That restoration was a great start to repairing this broken promise, and those resources need to be protected. But we as a state must do more.
According to the 2010 National Survey on Drug Use and Health (NSDUH), among the 5.2 million adults 18 or older who reported an unmet need for mental health care and did not receive mental health services in the past year, several barriers to care were reported. The top reason (44 percent) was they could not afford the cost of treatment.
It costs, on average, $428 per day for treatment at one of our state mental health hospitals; $80 per day to be incarcerated at Larned Correctional Mental Health Facility; $10 per day for community-based mental health treatment under Medicaid; and for those on Medicaid with the most chronic mental health conditions, the average is $22 per day. This is consistent with other data that confirms community-based treatment for mental illness is the best value. While it might seem prudent to some to reduce funding for community-based mental health programs to balance the state’s budget, the state definitely will pay more with offsetting costs that occur when someone with mental illness enters a state mental health hospital or correctional setting.
Research also tells us that treatment for mental disorders is associated with a 20-percent reduction in the overall use of health care services. At a time when the state is struggling with containing the costs of health care, it appears that paying for the cost of mental health treatment is part of the solution. Good mental health enhances the workplace (a high percentage of lost productivity, staff absences and errors on the job because of emotional problems, alcohol and/or drug abuse); children learn better in a school environment where early intervention of mental health services is available; effective community-based mental health treatment and support services, as well as newer medications, promote economic stability by permitting thousands of persons with serious mental illness to hold meaningful jobs and maintain productive lives in their own communities; and families stay healthier and grow stronger when affordable access to mental health services is readily available.
As the people of our state and nation continue to grieve, we must have purpose and direction to galvanize action. We must have a stronger commitment to our public mental health system and the Community Mental Health Centers.
We must urge legislators who are returning to Topeka this month to not only protect the current resources allocated to our state’s publicly funded mental health safety net system, but to make additional investments in the system by restoring more of the cuts that the system has sustained since 2008. We owe it to our communities. We owe it to the people of Kansas to ensure every child and adult has universal access to mental health treatment when they need it.
Michael J. Hammond is executive director of the Association of Community Mental Health Centers of Kansas, Inc.