Effective Mental Health Services Depend on Investing in a Quality Public Workforce

Guest post by Kansas Organization of State Employees
Sept. 14, 2017

Families and communities need an effective system of mental health services in order to thrive. Funding and staffing cutbacks in the state’s system in recent years jeopardize the ability of this system to accomplish its public mission of caring for people affected by mental illnesses. At the Kansas Organization for State Employees (KOSE), we work to ensure that state employees have the tools and working conditions they need to accomplish the public goals we set for them. Currently, Kansas state employees are being strained across the state and staff shortages in critical sectors are harming both employees and those they serve. Staff shortages have led to mandatory overtime, placing employees and those they serve at risk. [1] Legislators must address understaffing to guarantee the safety of all Kansans.

The state’s two psychiatric hospitals, Larned State Hospital and Osawatomie State Hospital, [2] highlight the challenges facing state employees and the threats posed to patients and other state programs. The Osawatomie State Hospital, created in 1866, began with the goal of treating those with mental illness to reduce incarceration among this population. [3] However, this noble goal came undone a century later. In 1990, the Mental Health Reform Act changed the landscape of mental health treatment in Kansas. It funded community mental health centers (CMHCs) and expected those centers to take patients that were currently at or would be coming to state-run psychiatric hospitals. [4] The hope was the state would reduce costs and the patients would receive better treatment. [5] However, problems soon emerged after lawmakers declined to fully fund the CMHCs, [6] which resulted in state-run psychiatric hospitals overburdened with too many patients [7] and not enough beds. Consequently, nearly 50 percent of Kansas adults with serious mental illness are not in treatment. [8]

With the start of the Great Recession in 2007, funding for CMHCs was cut further and state employees were faced with the responsibility of even more patients. [9] Governor Brownback’s 2012 tax cut exacerbated the problem by cutting funding to mental health services. [10] Three years later, Osawatomie State Hospital was decertified by federal officials due to safety concerns, resulting in nearly $1 million in lost federal funding per month. [11] These factors put more pressure on hospitals to prematurely release patients. [12]

While state hospitals were trying to save costs by releasing patients early, other understaffed programs in Kansas were affected by their decisions. For years, local hospitals and the criminal justice system have been working with Kansans needing mental health treatment. In 2013, it was estimated that 38 percent of incarcerated adults in Kansas had a mental illness. [13]

In 2017, the Legislature voted to increase the funding for Osawatomie State Hospital by $4.7 million, while months earlier Governor Brownback had suggested cutting an additional nearly $20 million from the state’s psychiatric hospitals. [14] Despite the additional funding, which is a good first step to alleviate bed shortages, understaffing remains a problem throughout Kansas, resulting in an increase in mandatory overtime. [15] Staff members at the State Hospitals have worked, at times, more than 40 hours of overtime per week. [16] The overreliance on overtime places both state employees and patients in danger.

Legislators must address understaffing and act to adequately fund state services. While the 2017 reversal of Governor Brownback’s tax plan stopped the bleeding in Kansas, it is up to the Legislature to repair the damage done by years of cuts and divestments by guaranteeing state programs are funded to protect state employees and those they serve.

[1] http://cjonline.com/news-legislature/2016-01-16/documents-reveal-appalling-overtime-larned-state-hospital
[2] http://cjonline.com/news-legislature/2016-01-16/documents-reveal-appalling-overtime-larned-state-hospital
[3] http://www.khi.org/news/article/osawatomie-state-hospital-once-a-leading-light-for-mental-health-care
[4] http://www.khi.org/news/article/osawatomie-state-hospital-once-a-leading-light-for-mental-health-care
[5] http://www.khi.org/news/article/kansas-mental-health-system-under-increasing-stres/
[6] http://kcur.org/post/higher-patient-count-unsteady-state-funding-made-waves-osawatomie-state-hospital#stream/0
[7] http://kcur.org/post/higher-patient-count-unsteady-state-funding-made-waves-osawatomie-state-hospital#stream/0
[8] http://cjonline.com/news-state/2015-04-11/mental-health-needs-unmet-many-kansas
[9] http://kcur.org/post/higher-patient-count-unsteady-state-funding-made-waves-osawatomie-state-hospital#stream/0; http://www.khi.org/news/article/staff-departures-create-dangerous-situation-at-osh
[10] http://www.khi.org/news/article/budget-cuts-devastating-mental-health-system-providers-say
[11] http://www.khi.org/news/article/security-concerns-central-to-halted-medicare-payments-for-osawatomie-hospit; http://www.kansascity.com/news/state/kansas/article72214667.html
[12] http://www.kansascity.com/news/politics-government/article29095024.html
[13] http://cjonline.com/news/2016-10-25/inmates-mental-health-needs-skyrocket-kdoc-works-adapt
[14] http://www.kansas.com/news/politics-government/article155534289.html; http://kcur.org/post/brownback-budget-plan-cuts-nearly-20m-state-psychiatric-hospitals-0#stream/0
[15] http://www.kansas.com/news/politics-government/article155534289.html; http://kcur.org/post/brownback-budget-plan-cuts-nearly-20m-state-psychiatric-hospitals-0#stream/0
[16] http://cjonline.com/news-legislature/2016-01-16/documents-reveal-appalling-overtime-larned-state-hospital; http://www.khi.org/news/article/staff-departures-create-dangerous-situation-at-osh

ClayEffective Mental Health Services Depend on Investing in a Quality Public Workforce