WICHITA, Kansas — Kansas performs worse on key measures of mental health than anywhere else in the U.S.
A new report by Mental Health America tracking mental illness and the ease of accessing care found high rates of addiction among young people and mental illness and suicidal thoughts among adults put Kansas in last place.
“What that indicates, to me, is a call to action,” said Mary Jones, president and CEO of the Mental Health Association of South-Central Kansas. “It tells us that Kansas isn’t adequately covering the mental health needs of its citizens.”
The report, based largely on data from 2019 and 2020, found 9% of Kansas youth had a substance use disorder, more than any other state. Over a quarter of adults had a mental illness and over 6% had serious thoughts of suicide, both well above national averages.
Only three states scored lower than Kansas on access to mental health care.
In part, that’s because the state doesn’t have enough psychiatrists, therapists and other mental health care workers to go around. Compared with a national rate of one provider for every 350 people, Kansas only had one for every 470 people — and experts say the shortfall is particularly dire in rural areas.
“The workforce shortage is a significant issue,” said Jones. “One of the things that we see across the state is that our workforce leaves the state for other, higher-paying jobs.”
The Mental Health Association of South-Central Kansas, which offers psychiatric services and residential housing for people with mental illness, has been operating with nearly a third of its staff positions unfilled because it can’t hire enough people.
That shortage, Jones said, “has been going on for years — but it hit a crisis point during the pandemic.”
She said increasing insurance reimbursement rates for behavioral health care to bring them closer to rates for physical health care could make it easier to hire and keep workers.
Kansas also got low marks on insurance rates and the ability to afford mental health care.
Around 18% of adults with mental illness in Kansas had no insurance, compared with 11% nationwide. And only around 7% of youths with severe depression received consistent treatment for it, compared to 28% nationwide.
“Kansas also had a high rate of adults with mental illness reporting unmet need,” said report co-author Maddy Reinert, senior director of population health at Mental Health America. That “means they felt a need for treatment that they weren’t able to access.”
Mental Health America pointed to Medicaid expansion as one step low-performing states like Kansas could take to improve access to mental health care.
“Medicaid is the largest payer of mental health services in the country,” said Debbie Plotnick, executive vice president for state and federal advocacy for Mental Health America. “States that have not expanded tend to have much lower access.”
Research indicates that, for people with depression, Medicaid expansion is associated with greater access to care — even in areas with a shortage of mental health providers — and a lower chance of delaying medication due to cost.
Even so, experts caution that insurance coverage alone doesn’t always make mental health care affordable.
“There are a fair amount of people who are insured, but they can’t afford to go get treatment unless it’s absolutely necessary,” said Jones. “They don’t want to go to ongoing therapy appointments because the cost is so great.”
Plotnick said Kansas needs to better enforce legislation requiring insurers that cover behavioral health care to do so at parity with medical health care. A recent federal report found many insurers routinely violate those rules, which state regulators play a large role in enforcing.
“Federal parity laws,” she said, “get their teeth at the state level.”
Rose Conlon reports on health for KMUW and the Kansas News Service. You can follow her on Twitter at @rosebconlon or email her at conlon@kmuw.org.
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