TOPEKA — Law enforcement and community mental health centers have long played a role in assisting mentally ill Kansans, but amid reduced capacity at Osawatomie State Hospital, police departments and service providers are struggling to keep these issues from boiling over into their communities.
Five years ago, OSH imposed a still-active moratorium on voluntary admissions to the state-run facility. When the pandemic began, hospital administration reduced bed capacity from 60 to 44 to allow staff and other residents to implement social distancing and to allow for patient quarantine when necessary.
Those isolation chambers are not often being used, according to Cherokee County Sheriff David Groves. Without those beds, his department has had difficulties addressing the needs of individuals with mental health issues in their community.
He recalled a situation earlier this year with a suicidal woman in her 40s with whom his deputies had several interactions. Professionals with the local community mental health center, or CMHC, attempted to aid the woman on an outpatient basis but, as those episodes grew worse, it became clear she needed attentional at a mental health hospital.
“An all-too-common thing happened next. We were told there was no room available for this suicidal woman to receive help,” Groves said. “When this happens in my community, a difficult decision has to be made where none of the options are good.”
Does law enforcement keep the patient at a small rural medical hospital, knowing the patient is occupying a bed the hospital may need? Should the patient be transferred to the county jail, despite never committing a crime? Or should they just be released from protective custody?
Law enforcement and mental health service providers said Friday during a Special Committee on Kansas Mental Health Modernization and Reform none of these options will satisfy the patient’s needs. Instead, they will likely lead to more run-ins with law enforcement and further strain on community mental health centers.
Groves said beyond concerns with the quality of service his department can provide a mentally ill person, it takes a needed deputy out of commission, leaving them shorthanded in other areas.
In this woman’s case, a bed became available after the third attempt to find treatment. She was able to get the help she needs, but other individuals are not always so lucky.
“I think we all understand there are multiple reasons for the lack of bed space — funding, staff, facilities — but Kansans are counting on leaders to navigate around them,” Groves said to legislators. “Mental health professional and law enforcement officers in towns and cities across our state are asking for your help in removing barriers that keep us from providing timely help to those in need.”
Matthew Atteberry, executive director at Labette Center for Mental Health Services, said for counties like Labette, a lack of timely access to state mental health hospitals is one of the biggest frustrations for law enforcement, CMHCs and other stakeholders.
Throughout OSHs five-year moratorium, Atteberry has rarely seen any space at the facility. In some instances, the wait time could last up to five days.
Amid the pandemic, he said, there have been times when the wait list exceeded 20 individuals waiting for a bed to become available.
When backups occur, CMHCs are often forced to take the lead on patient treatment, Atteberry said.
“Like other communities and CMHCs, Labette County and Labette Center have risen to the challenge as best we can,” Atteberry said. “We send staff to where the committed person is being kept while awaiting admission to OSH. We seek reimbursement for this, but generally speaking, this is a financial loss for us.”
Andy Brown, commissioner of behavioral health services for the Kansas Department of Aging and Disability Services, said amid COVID-19, OSH began an expansion of a hospital wing in order to best implement infectious disease prevention. This further reduced capacity, Brown said.
On a more positive note, KDADS leadership, which oversees the state hospital system, is in talks to lift the moratorium soon, Brown said.
“We have sort of a plan for the intention to lift the moratorium on Osawatomie State Hospital,” Brown said. “That does include some expansion to the state hospital itself as well as our development of state institute alternatives.”
Atteberry noted KDADS and OSH staff have been sympathetic to this dilemma mental health centers like his are encountering, working to find a way to provide resources. As long as the moratorium is in place, however, uncertainty will loom large, he said.
“Prior to the moratorium, communities knew that individuals would be admitted to OSH when deemed necessary,” Atteberry said. “Now those same communities and CMHCs face the possibility that in any given situation admission may not occur for a significant amount of time and in some cases denied.”