Our state has failed to provide enough funding to community mental health centers to truly meet the need for care. Individuals with the most severe, persistent mental illness are those most likely to fall into service gaps, often ending up homeless, in the corrections system, or in nursing homes.
The nursing homes charged with serving mentally ill Kansans are the focus of a recent report from the Disability Rights Center, which poses good questions about funding priorities and care in the mental health system.
On any given day, more than 500,000 people with mental illness — excluding dementia, reside in U.S. nursing homes, with over half of those individuals younger than 65, according to a Harvard Medical School study. Many experts believe these facilities, despite their best efforts, are not designed or well-equipped to meet the needs of this population.
Most experts now agree that it is more effective and saves money to treat people in living community group homes, with family members or independently. These community-based services are the best approach for most people.
However, the Disability Rights Center report points out that our funding priorities do not always reflect what we know about community-based services being the better solution. The good news is that over the past few decades, the overall percentage of mental health funding has shifted from institutional care in favor of community-based services. Unfortunately, during drops in revenue in Kansas, community-based mental health services have borne the brunt of cuts. Significant cuts to mental health spending starting in 2014 have disproportionately impacted community-based services, driving down actual dollars available to the state’s network of 26 community health centers while increasing caseloads.
At the same time, Kansas spent more or about the same on nursing home care, despite a small decrease in mentally ill Kansans placed in nursing homes.
For years, we have asked community mental health centers to serve more people with less, but there is good news from the recent legislative session. The Kansas Legislature allocated $5 million additional dollars in state aid for the coming fiscal year, an important step towards closing the gap between available dollars and need.
The Disability Rights Center report found that 69 percent of their residents surveyed wanted to leave nursing home placements in favor of the community, but for many of these residents, the community simply lacks the support they likely need to be successful. The lack of support that keeps mentally ill people trapped in living situations they did not choose or prefer is problematic.
People living with mental illness should be provided the same right to self-determination the rest of us enjoy whenever possible. Our failure as a state and a nation to provide for our most vulnerable in the community is a poor excuse for keeping people in institutions.