Kansans struggle with access to mental health care. But the state is retooling its coverage
Community mental health centers in Kansas are becoming certified. That means more money for providing services, which could bring expanded programs.
TOPEKA, Kansas — Sherie Keegan would have adopted a child from the Kansas foster care system, but the girl’s mental health needs were too much. Keegan worried whether the help she needed to care for such a troubled child could be found near Paola, Kansas.
“I was begging, I was pleading, I was doing absolutely everything that I could,” she said. “I reached out everywhere and anywhere I could.”
Keegan would spend hours in the emergency room with the child. Eventually, she let the child move on to her next placement, hoping a different part of the state would have the mental health care needed to actually help the child.
That girl is now on a path to age out of the system — a young adult emerging from a troubled childhood with few loved ones to help her cope.
“She could have had a family,” Keegan said.
Keegan has fostered about a dozen kids in the past year. She tries to take in higher needs kids.
But a lack of mental health services has been a problem for “darn near every one” of the children. When one became violent, she ran into waitlists for mental health services.
In fact, Kansas has among the highest rates of mental illness in the country while it offers some of the worst access to mental health care.
The pandemic didn’t help. Reports of anxiety and depression jumped from 11% in 2019 to 40% in 2020.
But clinicians and advocates see hope in remaking its network of community mental health centers into certified community behavioral health clinics. It’s more than a rebranding. The reimagined centers are eligible for higher Medicaid reimbursement rates — meaning they’ll have money to treat more people.
That can spur hiring. Certified centers also need to provide a base level of services, like crisis intervention, which will standardized mental health care across Kansas.
Amy Campbell, a lobbyist for the Kansas Mental Health Coalition, said the transition is the most significant change to the state’s mental health services in decades.
A special committee formed by the Kansas Legislature studied mental health coverage in Kansas for a few years. A report to the Legislature found rising suicide rates, a lack of beds, issues hiring and retaining staff and low Medicaid reimbursement rates which tightens budgets at agencies.
“Those are very concerning characteristics of our system,” Campbell said. “However, having the CCBHC model move forward does create a bright future for many of those communities.”
The old model
Some centers have already become certified while others are still going through that process.
Lisa Southern, the executive director of Compass Behavioral Health, hopes her center serving 13 counties in southwest Kansas will be certified in July.
That center is also the only 24/7 provider in the area. Community mental health centers also can’t turn people away for an inability to pay.
That can stretch staff thin, and Southern said the demand means programs aren’t available to people. Instead of seeing a therapist every two weeks, for instance, someone might see a therapist once a month.
“I wish,” she said, “there was more access.”
Southern said the higher reimbursement rates could help attract more staff. She hopes certification helps the center hire community educators and expand peer support staff. Those two roles could increase the visibility of the center while working to reduce the stigma of getting help.
“We’ve never been able to make a budget on a wish list,” Southern said. “It’s always been, you know, how can we scrape by with the bare minimum. … I'm guessing in future years, making the budget will be easier.”
Southern said she isn’t sure what certification will look like because she hasn’t gone through it. Joan Tammany doesn’t have to imagine.
Tammany, executive director of Comcare, said her center was one of the first to be certified.
The center added a team of caregivers that identifies high priority patients and checks in on them to make sure they get care. Comcare was able to restore a program that finds people work and then makes sure they can manage their mental health issues while working.
Comcare had dropped that effort because of the cost. Now it will also be able to expand its crisis response from two mobile units to eight, thanks in part to the new model.
“There is just so much excitement and pride around this,” she said.
Campbell, with the Kansas Mental Health Coalition, knows the solutions to the state’s issues aren’t this simple. Take the staffing shortage, for example. Certification means staff can be paid better wages. That, in turn, should make it easier to recruit and retain workers. But certification doesn’t convince people to join the field in the first place.
“I do believe that this is good progress,” Campbell said, adding that there is bipartisan support in the Legislature to address the problems of mental health care. “Those things do make me feel optimistic.”
Blaise Mesa reports on criminal justice and social services for the Kansas News Service in Topeka. You can follow him on Twitter @Blaise_Mesa or email him at email@example.com.
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