Cuts cause ‘unnecessary suffering,’ raise risk of crisis
By RACHEL COLEMAN
• Leader & Times
In the few years she’s lived and worked in Liberal, Southwest Guidance Center director Dr. Leslie Bissell has done more than adjust to life on the High Plains.
“I’ve really fallen in love with this community,” she said. Bissell, a native of Akron, Ohio, attended college in her home state before heading to Illinois for her master’s degree. She completed a PhD in Terre Haute, Ind., where for the first time she became part of a rural community and “discovered I really had a heart for community-based mental health care,” she said.
That affection fuels Bissell’s determination to put the pieces together when it comes to providing mental health services to people in the four-county area served by Southwest Guidance Center. People in Haskell, Meade, Stevens and Seward counties exemplify the “can-do” Kansas attitude, Bissell said. Yet those traits sometimes conflict with seeking help when it’s needed.
“The very thing that gives Kansans, Southwest Kansans, the ability to stay here — that stick-to-itiveness, that helping each other, that community sense, that attitude that we do it ourselves, we help other people, we pull ourselves up by our bootstraps, not showing weakness — all of those things that were so important in helping establish this area kind of fly in the face of mental health stigma,” Bissell said. “Unfortunately, it’s still seen as a weakness to be depressed. Or it may even be a sin.”
A graduate of prestigious evangelical Christian Wheaton College, Bissell isn’t knocking religion.
“As someone who very much values the faith community, and who values mental health, I want to get those two worlds talking to each other, collaborating with each other, supporting each other,” she said. “Faith is another type of relationship, and it’s relationships that heal.”
In America today, Bissell said, it’s clear many people are in need of that sort of healing.
“One in four Americans could be diagnosed with mental health challenges each year,” she said. “But it often takes people up to 10 years to get help.”
Depression, one of the most treatable illnesses, causes a great deal of unnecessary suffering. And more serious problems, such as those that have resulted in highly-publicized crisis like the Sandy Hook Elementary School shooting and a recent self-immolation on the national mall in Washington, D.C., too often go untreated.
In the aftermath of such tragedies, Bissell said, it’s easy to identify the need for mental health services.
“The ability to finance it is, unfortunately, disappearing,” she said.
Less than a week after attending the Governor’s Mental Health Task Force roundtable event in Dodge City, Bissell is still trying to figure out how to make all the pieces fit together: the need for mental health care, the regional and cultural barriers to seeking help, the dwindling sources of funding.
Kansas’ mental health system has been in place for about 50 years, and functioned well, Bissell said, with additional mental health reform programs 10 years ago building the network.
Five years ago, however, political and economic changes sliced funding by more than half, “and this past legislative year, the governor proposed cuts of $10 million (statewide),” Bissell said. That was “prior to Sandy Hook. After the Sandy Hook Elementary disaster, he decided to change his mind and not cut it.”
Even though the funds are still marked for mental health issues, the money has been reallocated to new projects. In a report to her board, Bissell noted that money once designated for family-centered care “is now up for grabs.” Instead of focusing solely on children with mental illness, and their families, a fund of $5 million must now stretch to provide care for people in five costly categories:
• People who are frequent users of psychiatric hospitalization.
• People who have frequent contact with law enforcement.
• People who struggle with both mental illness and substance abuse.
• Children who are in danger of being placed out of their homes.
• People who are being released from prison or juvenile justice custody.
Moreover, individual community mental health centers — Southwest Guidance Center included — must now combine funding into regional disbursements, then give it back to various programs intended to address local issues. It’s a messy and confusing prospect, Bissell said:
“The Mental Health Initiative had good intentions, but the practical application is uncertain. Part of the challenge is, no one knows what this new system is supposed to look like.”
The Dodge City event, sponsored by Gov. Sam Brownback, offered mental health professionals from the western half of the state a chance to share experiences and real-life stories. Its goal? To understand regional differences and challenges; learn about local “best practices” and successful programs; and determine what’s needed to help individuals with behavior health issues succeed in their communities.
“It was nice to hear from so many people with different perspectives,” Bissell said. “One of the consumers from our area was able to voice both her frustration and her recognition of the support the guidance center has given her family. It brought out the challenges of having services available in Spanish, the lack of providers. It was good. It felt like a balanced conversation. It was a respectful conversation.”
Even so, the talk circled around one consistent problem: how to stretch not nearly enough money to meet ever-growing needs.
Bissell and her peers are worried that “jails are going to be used more, hospitalizations are going to be used more, and if you just look at the dollars, it’s more costly,” she said. “That $25-a-day community mental health service, it just doesn’t matter to them, whoever ‘they’ are, the budget-makers. I’d never want to be in their shoes, but the reality is, they make cuts and we can only make the budget go so far.”
When that happens, Bissell said, Kansas grit might motivate people to tough it out. But in too many cases, families and individuals become brittle and break.
“I don’t want to see people suffer unnecessarily,” Bissell said. “My personal opinion is that it may take more tragedies for people to realize that the prevention work we do, the services we have to cut back on, have an impact on the number of crises.”