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Mental Health, Story Five: The Future

By Kelley Weiss

http://stream.publicbroadcasting.net/production/mp3/kcur/local-kcur-634266.mp3

Kansas City, MO –

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Many of Missouri's poor and severely mentally ill living in group homes are having their money mismanaged, living in squalor and at least five residents have died from alleged abuse or neglect. Some do not even have a home and live on the streets or go in and out of the revolving door to jail. In this final story KCUR's Kelley Weiss looks at the future of mental health care and some of the plans to fix the broken system.

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A few years ago Sgt. John Bryant faced a family crisis he could have never imagined.

John Bryant: "My youngest son has severe emotional problems he actually lives in a facility out in Paola Kansas. Probably about five years ago he tried to kill my wife with a butcher knife."

Bryant says his son is 17-years-old now and can't live at home and today, the almost 20-year-veteran of the Kansas City Police Department, devotes much of his time teaching fellow officers Crisis Intervention Training, or CIT, to help the mentally ill on the streets of Kansas City. He says CIT officers went on 500 calls last year. The director of the Missouri Department of Mental Health, Keith Schafer, says he wants more of this kind of crisis response statewide.

Keith Schafer: "If we address those people who are in crisis most often it will take the pressure off the system to respond to people who are in crisis situationally or with the right intervention early on wouldn't have that repeated problem. We can make a big difference in the next five years."

Schafer is expanding this response by building Assertive Community Treatment, or ACT, teams that include a CIT officer, social worker and mental health provider to target the mentally ill who are always on the street or in jail.

The department set aside almost $5 million for these teams but most providers say that's not enough money to run the program. And, the police are concerned their increasing role in mental health crisis response will not get enough support and it could take away from other duties.

The mentally ill living in group homes are also in crisis. KCUR's investigation found that that since 2004 the state has fined group homes statewide for the deaths of at least five residents and state reports show repeated violations of money mismanagement, medication errors and lack of oversight. To respond to this problem, Schafer says DMH will apply for federal housing grants to move patients out of group homes and into the community.

And, Schafer says the whole system could be more effective if the state contracted with non-profit hospitals to provide care - similar to how the state contracts with private group home operators. Jackson County Public Administrator, Rebbecca Lake Wood, says that's a dangerous proposition.

Rebbecca Lake Wood: "If the direction that the state intends to go in privatization mirrors the private models for group homes we're all in a lot of trouble."

As a guardian, Wood knows group homes well - she places hundreds of her clients in them and she says the few state group homes are cleaner and safer than the private homes. But, Wood says these changes are not enough. She says the mentally ill are still forgotten at the state capitol.

Here's a good example, in June, when I interviewed Keith Schafer and Dr. Joe Parks, DMH's medical director, neither director knew the basic break out of their budget. They were not aware that there had been a shift in funding priorities for their department. In addition, Schafer says two departments regulate group homes. He says bureaucratic red tape makes it a challenge to enforce regulations. He also says advocates do not lobby effectively and even Missouri Lt. Governor Peter Kinder says they're not loud enough on Capitol Hill.

Rebbecca Lake Wood says you can't expect advocates to fix a broken system and the misperception about the mentally ill.

Rebbecca Lake Wood: "They're scary, their illness makes them scary. We choose to turn our backs on these people and we always have."

Guyla Stidmon: "I was pretty discouraged a few years ago and thought I need to get out of mental health but I do see a light."

That's Guyla Stidmon the executive director of Kansas City's National Alliance on Mental Illness, or NAMI. She says there's hope the stigma that all mentally ill are crazy is fading.

Guyla Stidmon: "If people realized that persons with mental illness are not just a blight on society, that they are citizens that can offer a lot we would really see that change."

Sgt. John Bryant worries that change won't come soon enough. He patrols the streets and encounters the mentally ill in crisis almost every day as a cop. Keeping his emotions in check, he admits he's reminded of what could happen to his paranoid schizophrenic son, who will turn 18 in two weeks and have to move out of his current facility.

John Bryant: "It's extremely heart breaking for me because I see the conditions that they're living in or the way they are acting or that they've hurt themselves and I think this could be my son, or a family member or a friend of mine and that weighs heavy on me."

Bryant knows that as often as he rescues mentally ill patients from the street and takes them for treatment or to jail it's only a band aid. He says, if the state does not make mental health care a priority these patients - including his son - could end up living in squalid group homes, victims of neglect, abuse, theft or even death.

Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.

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