Kansas has a mental health crisis



January 8, 2020 - 9:01 AM

Better pay and working conditions for mental health workers must be a priority issue for Kansas lawmakers in the 2020 session, which begins next week.

There are two primary mental health hospitals in Kansas, one in Larned and the other in Osawatomie. In late 2019, the federal government told the state it found deficiencies at an acute care unit in Osawatomie, and ordered it to develop a plan to rectify the problems.

The state has submitted a plan, but faces loss of federal Medicare payments in March if the government remains unsatisfied. Even if those immediate challenges are addressed, the 60-bed Adair unit is “not a therapeutic environment,” according to Gov. Laura Kelly.

That’s a polite way of saying patients aren’t getting the help they need.

Serious concern about treatment in one part of one mental health hospital is bad enough. In fact, though, the hospitals in Larned and Osawatomie are in generally in crisis, with too few workers and too many patients to handle effectively.

Recruiting employees to both facilities has been difficult for years, leading to massive overtime, burnout, and staff turnover. At Larned, almost 40% of positions were unfilled in the fall of 2019.

In December, Kelly’s office ordered salary increases for “direct care staff” at Larned, a move designed in part to help job recruiting and retention.

But it is only a start. “It’s a huge problem,” the governor told the Star’s Editorial Board in late 2019.

Lawmakers must act this year to make those raises permanent.

Kansas spends more than $114 million a year to operate the two hospitals, including $100 million from its general fund. On any given day, they hold more than 600 patients.

Osawatomie also faces challenges in hiring and retaining workers. Like Larned, it is located in a rural area. Asking workers to move to either community will continue to be difficult.

A task force report issued a year ago called for providing an additional 221 patient spaces in Kansas over a five-year period. The governor is expected to announce a plan later this month that would expand beds available in Osawatomie.

But the real answer may lie in decentralized treatment and community mental health centers, where employee retention is easier.

Expanding Medicaid would provide important options for patients, decreasing the load on the state’s psychiatric hospitals. That’s why it’s encouraging that Medicaid expansion talks are continuing in Topeka.

To be sure: Kansas will always need hospitals to care for mental health patients who need intensive, prolonged help. For those facilities, the state must step up and provide additional pay and benefits to make those jobs attractive.