Kansas Health Institute | Information For Policy Makers. Health for Kansans.

MANHATTAN — Cynthia Arganbright, 46, was afraid to go home for fear of what she might find.

“It was my husband,” she said. “He’s bipolar, and he’d been having trouble with his medications. He was abusing them. If I went home, I didn’t know if he was going to yell at me or if I was going to find him dead.”

In December 2009, Toby Arganbright, 33, had been a patient at Osawatomie State Hospital for 19 days.

“When he got out, I couldn’t believe it,” Cynthia Arganbright said. “He was so loaded up (on medication) he was in a daze, he could barely talk. He couldn’t walk straight. His mouth hung open. He kept drooling.”

By April, he was back in the state hospital, his third stay there. But he had to wait to get in because the hospital was full and admissions were being limited to those in crisis.

Living on a roller coaster

“After about the third time he heard that, he put a butcher knife to his stomach and said, ‘Somebody better get me to the hospital or I swear to God I’m going to gut myself right here and now.’”

Cynthia Arganbright suffers from depression, is prone to anxiety attacks and is legally blind. She blamed her husband’s outburst to an “adverse reaction” to the medication he was taking.

“I tell you, it’s like I was living on a roller coaster,” she said.

Now, her husband is back home from the hospital again and Cynthia Arganbright said she’s trying to get him assigned to a case manager at Pawnee Mental Health Services in Manhattan, so that he can get more attention from mental health professionals.

“He sees a therapist for 30 minutes every other week, which we pay for – that comes out of our pocket,” she said, noting that the payments are based on a sliding scale to takes into account the couple’s limited income.

“He can’t get case management because he’s not on Medicaid, which means if he got it, we would have to pay for it,” Cynthia Arganbright said. But we can’t afford both.”

Cynthia Arganbright because of her various health problems has been on federal disability since 1982; her husband since 2005.

He is unemployed. She works part-time at Morning Star Inc., a program that helps people learn to live with their mental illness.

“Because we’re married and I work, we make too much to qualify for Medicaid,” Cynthia Arganbright said.

They are on Medicare, but it does not cover case management because it’s not considered medically necessary.

Despite her husband’s earlier hospitalizations, his behavior remains erratic, Cynthia Arganbright said.

“He’s like a little kid who gets all irritated when he doesn’t get what he wants and right now what he wants to do is spend money, even though we don’t have any,” she said. “When he does spend money, he can’t account for it. It’ll be gone and he won’t know where it went.”

New charges for services

A year ago, the Pawnee Mental Health Center would have provided Toby Arganbright with case management services at little or no cost. But state spending cuts forced the agency to start charging for services that aren’t covered by Medicare or Medicaid.

Though frustrated, Cynthia Arganbright said she doesn’t fault the mental health center.

“I think they’re doing everything they can do, the problem is they can’t do enough,” she said, “and part of that’s because they don’t have near as many people as they had a year ago.

“I would never say anything bad about Pawnee Mental Health Center,” she said. “They’ve saved my life a couple times and if it wasn’t for them I wouldn’t be able to have the job I have now.”

Pawnee Mental Health Center Executive Director Robbin Cole declined comment on the Arganbrights’ difficulties, citing confidentiality restrictions.

But the budget cuts, she said, have forced the center to lay off workers.

“On Jan. 1 2009, we had 320 staff,” Cole said. “Today, we have 240 – that’s for a 10-county area. And in the fiscal year that started July 1, I’ll have $1.2 million less state funding in my budget than I did in fiscal 2007.

“When I hear people say they aren’t getting the services they think they need all I can say really is that we’re doing the best we can with the resources we have,” Cole said.