Mental health waiting list could remain for several months

July 13--A waiting list for mental health admissions to Osawatomie State Hospital could remain until October.

The state's restriction on hospital admissions is forcing patients with serious mental health or substance abuse issues to wait in local emergency rooms for beds to open up at the state-run hospital in eastern Kansas.

The waiting list concerns local officials and mental health advocates, who say it is putting vulnerable patients at risk.

"They get emergency treatment in the emergency room, but it's not the kind of psychiatric treatment that they need to recover and stabilize," said Jason Scheck, director of outpatient services with Comcare, Sedgwick County's mental health department.

The Osawatomie waiting list began on June 25 after the Kansas Department for Aging and Disability Services issued a moratorium on new admissions, which it is allowed to do with psychiatric institutions under state law. Osawatomie State Hospital now only admits new patients when someone is discharged.

Safety concerns regarding suspended ceilings from the Centers for Medicare and Medicaid Services forced the hospital to start renovating its building, which limited bed space at Osawatomie down to 146 beds. The hospital is licensed to serve 206 patients.

Although the renovations are ahead of schedule, the moratorium will likely remain in place until the construction is scheduled to finish on October 1, said Angela de Rocha, a KDADS spokesperson.

"Our first concern is that (patients) are in a safe place when they go on the waiting list and then our second concern is to get them in the hospital as quickly as we can," de Rocha said.

Osawatomie is located in Miami County, about 165 miles northeast of Wichita near the Missouri border. It serves 46 counties in eastern and central Kansas, including some of the state's most populous counties.

Community mental health centers, like Comcare in Sedgwick County, screen patients and monitor their transfers to Osawatomie, said Kyle Kessler, executive director of the Association of Community Mental Health Centers of Kansas.

"We were doing our best to make sure people were being treated at state hospitals who really needed to be there when we had 40 more beds than we do now," Kessler said. "That hasn't changed."

The waiting list had two or three patients on it for the first week of the moratorium, de Rocha said.

However, the waiting list spiked to 13 patients on the Tuesday morning after the Fourth of July weekend. De Rocha said long summer weekends always have strained the hospital's admissions system.

"About half of our patients are people with what we call dual diagnosis, who have a mental health disorder as well as substance abuse issues," de Rocha said. "These kinds of things tend to be exacerbated over long holiday weekends."

The waiting list to get into Osawatomie had declined to five patients by this Monday morning.

Scheck said Sedgwick County typically sends two to four involuntary admissions to the hospital in a typical weekend. Comcare only sends patients to Osawatomie who lack the capacity to consent to treatment and could pose a serious threat to themselves or others, Scheck said.

Some mental health advocates say these patients can be harmed by long waits in emergency rooms.

"They are not staffed appropriately with folks who can provide the supportive environment for someone who is in a lot of mental anguish," said Rick Cagan, executive director of the state chapter of the National Alliance on Mental Illness.

Scheck said one patient had to wait more than two days in an emergency room department to be admitted.

Cagan said the current moratorium and waiting list are symptoms of a strained mental health care system.

"It's a tough situation for the state, given the limitations the feds have put in," Cagan said. "But for a long time, we've failed to have a serious conversation about the capacity of our state mental health hospitals."

"Now the problems are coming home to roost."

De Rocha said the state has done a good job keeping the waiting list as short as possible. She said the waiting list may go away altogether because the demand for admissions fluctuates day to day.

"If there's nobody on the waiting list and we have a bed open, the person goes right (to Osawatomie) so there's no moratorium," de Rocha said.

Osawatomie will not admit patients who request to be there voluntarily unless there is no one on the waiting list and the number of total patients drops below 131, according to KDADS regulations.

De Rocha said the Legislature did allocate $3.5 million to KDADS to pay for alternate hospital beds away from Osawatomie.

Cagan said the waiting list is only part of the problem.

"People are leaving the hospital for whom there is not adequate support in the community," Cagan said.

"We had a bad situation to start with and now it's worse," he said.

Reach Daniel Salazar at 316-269-6791 or dsalazar@wichitaeagle.com. Follow him on Twitter: @imdanielsalazar.

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