State budget cuts worry advocates who deal with mental illnesses
At a time when economic distress and war have increased the need for mental treatment, experts say, budget cuts are bringing a fragile mental health system to its knees.
Kansas is among the top 10 states in such cuts, a national study reported today.
The National Alliance on Mental Illness started the study after a man shot Rep. Gabrielle Giffords in Arizona and killed six people. Authorities have said 22-year-old Jared Loughner was mentally disturbed and acting increasingly erratic in the weeks leading up to the Jan. 8 attack that wounded 13.
Since 2009, it found, about two-thirds of states have cut a total of more than $1.8 billion in key mental health spending.
Kansas has cut almost $19 million, or about 16 percent of money for mental health care for the uninsured or those not covered by Medicaid.
That percentage ranks Kansas as seventh among states. Kentucky ranked first with cuts of almost $194 million, or about 48 percent.
Missouri was among about one-third of states that increased such spending. It added almost $17 million, or about 4 percent.
Kansas Gov. Sam Brownback’s proposed budget also calls for $15 million more in such cuts to mental health care.
His spokeswoman, Sherriene Jones-Sontag, said he has put in place a team of highly qualified people to study innovative ways to manage limited resources.
“With a nearly $500 million budget deficit in fiscal year 2012, our state faces very difficult decisions,” she said.
Advocates for people with mental illnesses and some lawmakers are fighting Brownback’s proposed cuts.
“Budget cuts mean people don’t get the right help in the right place at the right time,” said Rick Cagan, director of the National Alliance on Mental Illness in Kansas. “Local communities suffer and families break under the strain. Some people end up on the street or dead.”
Mike Fitzgerald, the alliance’s national executive director, said people notice mental illness after things such as the Giffords case or the Virginia Tech killings.
But “the reality is every day there are less serious tragedies because of untreated mental illness,” he said.
Ill people lose jobs, families break up, children have problems in school, and sick people get help at expensive emergency rooms or spend time in costly jails or prisons, experts say.
One in 17 people in the nation has a serious mental illness — and half go untreated, the alliance reports.
And more cuts are ahead, Fitzgerald said.
The federal-state Medicaid system pays for about half of mental health care nationwide, the alliance reports. A federal budget stimulus that picked up much of the state shares of that cost ends June 30. Kansas and other states are already looking at ways to cut millions from Medicaid costs.
The unrelated $15 million more in the governor’s proposed cuts include $10.2 million for the 27 community mental health centers and $5 million for Family Centered Systems of Care, which goes to treat uninsured severely mentally ill children.
David Wiebe, director of Johnson County Mental Health, said the proposal would mean a $1.5 million cut from his operation, on top of $2 million cut since 2008.
He estimates he would have to eliminate 30 jobs, and some ill people would not get needed help. It also would work against a Johnson County effort that has taken a national lead in a planning to keep those with mental illnesses out of jail, he said.
The county planning project done by law enforcement, corrections, the district attorney and mental health experts was named a national demonstration project by the U.S. Department of Justice.
Peter Zevenbergen, president and CEO of Wyandot Inc. in Wyandotte County, estimated the additional cuts would cost his group $1.4 million, on top of $4 million in state cuts over the last four years.
“Kansas is being very short-sighted,” he said. Costs will increase as more people go to expensive jails or emergency rooms, he said.
Rob Siedlecki, acting secretary of the Kansas Department of Social and Rehabilitation Services, said the situation is constantly shifting as Kansas lawmakers consider the $15 million in cuts and officials study cutting $200 million or more from Medicaid.
“We will deal with all of that as it comes,” he said. “We will work with the mental health centers and try to prioritize those services.”
Fitzgerald, the National Alliance on Mental Illness director, said that will be going on nationwide.
“You need to find what treatment and services work best,” he said. “You need to find early intervention services.”
More police are getting alliance training on how to deal with people with mental illnesses, he said: “The police are on the front lines.”