Following the shooting at Sandy Hook Elementary School in Newtown, Ct., President Barack Obama called for a national dialog on issues affecting mental health. In response to that call the Eisenhower Presidential Library hosted a Kansas Town Hall discussion featuring six experts in mental health and community corrections on Thursday evening.
A reoccurring theme that several panelists touched on during interviews prior to the meeting was that the cost to treat mental illness dwarfs the cost of dealing the repercussions related to the lack of treatment.
Meredith Butler, director, 8th Judicial District Community Corrections, said, on average, it costs about $3,000 a year to supervise an individual in the community as opposed to $30,000 to house an individual in prison, which is where many people with substance abuse and mental illness issues end up.
Once in prison, there is no access to mental health care, except for sexual offenders. But even with those, it is only a limited number of offenders who are treated.
“Eight-five percent of those who go to prison are going to be released,” she said.
They spend their time in prison, with an untreated mental illness conversing with other criminal-minded individuals before they’re released back into the community.
“The largest mental health facility in any community is the county jail,” said Rick Cagan, executive director, National Alliance on Mental Illness (NAMI) Kansas. “We are paying a price. They are in jail for a reason; they did something to be incarcerated. They may get some treatment but jail is not the best place to get your mental health care. (County jails) are not in the business of mental health treatment.”
Quoting from a study released by the Healthcare Foundation of Greater Kansas City, Cagan said the annual cost of untreated mental illness in Kansas is $1.7 billion. Most of that is in the form of indirect costs to employers and individuals.
“Typically people who are not getting the help they need can cost us more money than if they have primary care treatment,” he said.
While it is evident that expanding funding for access to mental health treatment would reduce external costs, there remains a belief that providing that assistance and preserving a safety net is not the role of state government, said Robbin Waldner Cole, executive director, Pawnee Mental Health Services, who has seen steady decreases in funding for community services.
“State aid has not changed since 2002. For 12 years it’s been at $10.3 million – to support the community health centers so they can provide the 24-hour-a-day, 365-day-a-year services,” she said. “Mental health funding to help pay for people who are uninsured or underinsured has been reduced to $15.8 million this year. That was at a high of $31 million in 2007.”
She said the intent of the community mental health system is to provide prevention activities, treatment activities and recovery activities. But, fewer dollars translates into fewer activities, which translates into more people with mental illness not being treated and costing local communities fiscally and socially.
Tied to the financial issues is the issue of making the services accessible to those who need them. Butler used a town like Herington as an example. They don’t have the services there, which means someone who requires treatment needs to find it outside of their community.
“How are people supposed to get to the services?” she asked.
A vicious circle surrounds these patients. Often because of their mental illness, ability to work is sporadic, access to a vehicle is limited; if the mental illness is related to substance abuse maintaining a driver’s license may be difficult.
“We need to attend to the gaps in the mental health treatment system to make sure individuals who are affected get the help they need when they need it,” Cagan said.
The numbers show that those who need the help represent a significant part of the community. One in 10 children is affected by a serious emotional disorder, and about 1 in 17 people suffer from a seriously debilitating mental illness, he said. Of those, 60 percent of the adults and 50 percent of the children are not in treatment.
“This is a problem, if we have other medical issues we tend to them, (health) affects our well being,” he said.
With a national dialog increasing about the need to examine the accessibility of care for people with mental health and substance abuse issues, Cole said her desire would be “That the state of Kansas demonstrate though its policies and its funding that it is committed to preserving the mental health safety net that is the community health system for all Kansans.”