Mental health initiative to target people headed for jail or mental hospitals

Details of plan to be worked out over next two or three months

0 | Legislature, Health Care Delivery, Mental Health

— A new mental health initiative proposed earlier this month by Gov. Sam Brownback would target services to mentally ill people considered most at risk of being jailed or sent to a state hospital.

Additional details of the plan, which is still on the drawing board, were described today at a a meeting of the Mental Health Coalition of Kansas by Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, and also in a separate meeting of the Senate Ways and Means Committee by Secretary Ray Roberts of the Kansas Department of Corrections.

Sullivan oversees the state's mental health system, including the state hospitals and the state grant programs for community mental health centers.

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Kansas Department of Corrections Secretary Ray Roberts.

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Roberts is the boss of a de facto mental health system. Though the prisons are not formally recognized as mental institutions, a large percentage of the inmates have been diagnosed as mentally ill.

"Thirty-eight percent of the adult inmate population is mentally ill; 14 percent have severe or persistent mental illness," Roberts told the senators.

He also said the number of mentally ill prisoners had increased 126 percent since 2006.

'A pressing issue'

"Our mental health beds are always full...it's a pressing issue. The governor is very aware and supportive of that. It's one of the critical issues in our system," Roberts said.

His comments were in response to questions from Sen. Steve Fitzgerald, a Leavenworth Republican. The main purpose of Roberts' appearance before the committee was to describe and endorse the governor's proposal to merge the Juvenile Justice Authority with the corrections department.

"I believe you have become responsible for dealing with our inability (as a state) to address our mental health problems," Fitzgerald said, referring to the high percentage of mentally ill people kept in lock-ups.

Fitzgerald's district includes Lansing, home to one of the state prisons.

Roberts said the governor's new mental health initiative, among other things, would target services to mentally ill people on parole.

'Intense case management'

Almost at the same time, but on the other side of Topeka, Sullivan was meeting with the mental health coalition describing similar but different details of the governor's initiative.

Brownback and Sullivan first gave a rough outline of the initiative about two weeks ago at a Kansas City press conference.

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Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services.

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Brownback then said he wanted to put together a plan for improving mental health services for the state’s “most at-risk and challenging populations.”

He acknowledge the move was prompted in part by the Newtown, Conn. school shooting last month that left 20 children and six adults dead after an apparently deranged and heavily armed man attacked Sandy Hook Elementary.

Mental health advocates said they welcomed the initiative, especially since it seemed to spare additional cuts in state grants to local mental health centers. But they also have said they've been wondering which populations would be considered the most ‘at-risk’ and the most ‘challenging.’

Sullivan answered that question today.

He said the plan would target services to children and adults who have “frequent” encounters with police or are frequently admitted to a state mental hospital. Also targeted would be adults leaving prison, children exiting foster care, and adults who are both mentally ill and developmentally disabled.

The new initiative, he said, would stress “intense case management,” crisis intervention, peer support, family support, more employment opportunities for the mentally ill, and better coordination among local programs and the state hospitals.

A new task force

Sullivan said would appoint a task force within the next two or three weeks to help design the initiative, which doesn’t have a name yet.

Brownback has proposed spending $10 million on the initiative, but Sullivan said that funding would come from $5 million currently spent on the Family Centered Systems of Care program and $5 million from a grant program that community mental health centers use to cover the cost of caring for the uninsured. The administration earlier had considered cutting that $5 million in spending.

The Family Centered Systems of Care program has been funded with money from the state’s tobacco master settlement agreement. It is geared toward providing supports to families with mentally ill children.

The governor’s new plan, he said, would draw $5 million from the State General Fund, which he characterized as a “more stable source of revenue” than the tobacco settlement fund.

Sullivan said the $5 million would be spent on services “fairly similar” to those already being provided, “but with more outcomes."

He said he was aware that 6,000 Kansas families have come to rely on the services they get through the Family Centered Systems of Care.

The second $5 million from the initiative, he said, would go back into the grant program for community mental health centers.

Sullivan said he hoped the planning task force would divide the state into “five to seven regions” to ensure access to in-crisis services throughout the state but the services would be provided through the state’s 27 community mental health centers.

He said he would ask the task force to spend two to three months assembling its plan. The task force will include advocates for the mentally ill and will not be limited to service providers, he said.

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Rick Cagan, director of the Kansas chapter of the National Alliance on Mental Illness.

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Evaluating the system

He also said he would ask the Governor's Mental Health Services Planning Council to spend several months evaluating the state’s mental health system.

“He hasn’t figured out the details of what it is he wants to do. He's been pretty transparent about that,” said Rick Cagan, executive director of the Kansas chapter of the National Alliance on Mental Illness. “But he’s also made clear that he wants advocates to have a place at the table. That’s a good thing.”

Sullivan is scheduled to discuss the state’s mental health system with the Senate Ways and Means Committee at 10:30 a.m., Thursday, Room 548-S at the Statehouse (map).

The Governor's Mental Health Services Planning Council is scheduled to meet from 9 a.m. to 3 p.m., Jan. 29, at the KNEA building, 715 SW 10th, Topeka (map).



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