By Kelley Weiss
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Kansas City, MO – Missouri's state mental health hospitals will now be smoke-free. These facilities are later than other general hospitals to implement a tobacco ban. One reason for this is because of the complexities surrounding mental illness and smoking. KCUR's Kelley Weiss reports.
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Hardly anyone disagrees - smoking is addictive and it kills. That's why Dr. Joe Parks, the Missouri Department of Mental Health Medical Director, pushed to make state mental health facilities smoke-free. This will encompass 11 state facilities, impacting about 1,500 patients and more than 4,000 staff and Parks says will have low costs. Most of these hospitals give acute care to patients who stay for about 10 days. Dr. Parks acknowledges that while patients can get nicotine replacement during this time making people quit smoking for 10 days is most likely not going to cause them to kick the habit for good.
Dr. Joe Parks: "We're not thinking people are going to think, 'Oh gee now I see the light, I'm quitting.' This is mostly about being able to offer a decent treatment environment where our limited staff can focus their time on treating the mental health problem instead of moving people and their smoking products around."
Parks says he wants hospital staff to focus on improving treatment for patients instead of ushering them for smoke breaks several times a day.
But, Dr. Tim Dellenbaugh, works at Western Missouri Mental Health Center, a state hospital in Kansas City, and is associate professor of psychiatry at the University of Missouri-Kansas City, says about half of people with persistent mental illness smoke, that's double the number of people who don't have mental illness. And, he says, for people with schizophrenia, up to 90 percent are smokers. Why so many? Dellenbaugh says it's hard to say definitively and that's worrisome.
Dr. Tim Dellenbaugh: "We are embarking on a smoke-free environment without really having any good data about how we should treat psychiatric patients who do want to stop."
Dellenbaugh says there is some research for schizophrenics who smoke. It shows that smoking hits their nicotine receptors in a different way. Smoking actually allows them to do sensory gating or block out background noise better. Dellenbaugh says this is important because of the hallucinations and voices commonly associated with the illness.
Guyla Stidmon, executive director for the National Alliance on Mental Illness of Greater Kansas City, advocates for the mentally ill. She says that research shows that many people with mental illness use smoking as a coping mechanism.
Guyla Stidmon: "Smoking seems to help that stress and helps them cope with the nervousness that is caused by the medications in addition to just the symptoms of the illness."
Stidmon says although she wants to see more of the mentally ill stop smoking and improve their physical health she has doubts about the smoking ban. She says when people are in need of acute psychiatric care they are in crisis and already have to give up many freedoms to get treatment.
Guyla Stidmon: "This is just one more thing that is taken away from you at that point in time."
With such short term treatment in many cases, Stidmon, says she can't see the clear benefit to the mental health consumer.
Denise Jolicoeur is the program director of the University of Massachusetts Medical School tobacco treatment program. The University of Kansas Medical Center brought her to Kansas City this week to help train area mental health providers about smoking cessation. She brings this philosophy of leaning on cigarettes to aid treatment for the mentally ill.
Denise Jolicoeur: "We can do better. To rely on tobacco and nicotine to treat those illnesses is not a fair assessment of the skills of mental health case workers."
Kimber Richter, associate professor at the University of Kansas department of Preventive Medicine and Public Health, also is involved in this week's training. She says while it is challenging to train staff at hospitals to help patients quit, and sometimes for the employees themselves, it's worth it.
Kimber Richter: "The wonderful benefit of having tobacco free facilities is that it gets hospitals into the business of treating smoking."
Across the country about 40 percent of public mental health facilities have gone smoke-free. But, as the experts agree banning smoking at hospitals is one step but there is a still a lot of work to be done to help the mentally ill permanently kick the habit.
Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.
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