Mental Health – A Plan Forward

July 6th, 2022

The question I’m asked most frequently during my campaign for Sedgwick County Commission is: “What will you do to address the mental health problems in our community?”

It is the topic of conversation at many of our house events and campaign stops.

It is the issue where most of our citizens find incredible confusion and lack of clarity.   

It is one of the biggest, most complex needs we face as a community.

Sedgwick County Commissioners are entrusted with public health and the crisis we face deserves a clear plan forward.  1 in 5 adults in America experience a mental illness each year.  That number is staggering and includes conditions ranging from anxiety disorders and depression to psychosis and debilitating disease.  The mental health of our community has been in decline for a generation and the crisis has deepened and widened post-Covid.  

Does it impact our community?  Does it even require an approach from government?  The economic costs in lack of productivity due to mental disorders is estimated to be in the billions of dollars.  The costs society are bearing to care for our severely and persistently mentally ill is growing.  The suicide rate, particularly with children and young adults ages 13-25 is climbing.  I believe we have both an economic and moral imperative to address the challenges and expand resources to our citizens.  

Our shared goal should be to increase resources and reduce barriers for mental health needs in our community.  The following is a general plan that includes both immediate and long-term strategies:

Immediate Actions

[1] Rethink COMCARE

COMCARE, a division of Sedgwick County government, is a Certified Behavioral Health Clinic offering a variety of mental health and substance abuse services to our citizens in the community.  The department has an annual budget close to $45 million and a staff of over 500 full time employees.  COMCARE plays a critical role in our county and has experienced significant challenges over the last several years.  The primary challenge is staffing.  The organization currently is 200 Full Time Employees (FTE’s) short and is only operating at 60% staffing capacity.  Although the staff is working hard to keep pace, the personnel shortage has resulted in incredible inefficiencies and lack of services provided.  

The complex challenges at COMCARE range from wage competition, facility constraints and a lack of qualified personnel capacity currently in the market.  The latter poses the largest challenge facing COMCARE.  

The current approach is to focus on staffing COMCARE back up to 500 FTE’s.  I don’t see this as a viable or practical strategy.  I believe it’s time to “Rethink COMCARE” and creatively look at how we best service the incredible needs in a growing mental health and substance abuse crisis.  There are several other organizations in the community that are overlapping services to the same population of needs.  This provides for an opportunity to collaborate these services and offer tangible support to other organizations in the field in order to better meet community needs.  This streamlining and collaboration of services allows for a refocus of structure at COMCARE and relieves some of the bottlenecks and pressures that are crippling the department.  Staffing back to full capacity is not a practical or realistic expectation in the short term. We simply don’t have the human resources and we shouldn’t ask our community to wait for service.

[2] Mobile Mental Health

I would advocate for immediate deployment of mobile mental health services. There is a current model in the field that has proof of concept but is being limited for lack of resources. I would suggest reorganizing current resources and placing the expansion of mobile services as one of our top financial and staffing priorities.  

A second mobile team called ICT-1 has been in a trial phase with some success.  This is a multi-disciplinary, co-responder program between Sedgwick County, the City of Wichita, a mental health professional, a law enforcement officer and a paramedic. This team is uniquely suited to respond to a mental health crisis, but the cost to operate and the lack of available staff pose significant challenges.  I believe we can accomplish the desired results solely through the Comcare mobile mental health teams.  Their data confirms that law enforcement support was requested on only 2% of calls.  

[3] New COMCARE Crisis Center

Funding is currently set aside for a new Crisis Center at COMCARE.  This facility would house a 24/7 hotline, 24/7 walk in capabilities, inpatient services and expanded detox functionality.  There have been several ideas in discussion on how we best serve our community, but progress has been stalled for a variety of reasons.  I believe implementation of a new Crisis Center is the first of many dominos that needs to fall in the process of expanded services.  I would press the County to move forward with site selection immediately.  I would also suggest a multi-disciplinary model that incorporates other organizations and service providers that are able to assist in meeting these growing community needs.  

A future “campus” that incorporates services to our homeless and substance abuse populations would then be a logical next step.  The implementation of the new Crisis Center will be the catalyst that gets traction and movement in the space as well as serve as the centralized command center for our community mental health and substance abuse response.  

Those three objectives would be the initiatives that I would press for immediately. These would help alleviate some of the current bottlenecks that are restricting progress and resource deployment, and would represent a significant step forward in our community.  The following are long term objectives that will take greater community collaboration and strategic vision:

[4] Regional Mental Health Hospital 

There have been multiple conversations in the recent year about the need for a new, state funded and operated Mental Health Hospital that has a 50+ bed capacity.  In 1990, we had approximately 1,000 inpatient state mental health hospital beds available.  By 2018, that total was down to only 256 beds.  I would strongly advocate that the county and state work quickly to get on the same page so we can move forward with the site selection process. There are multiple options available and the need continues to grow while we wait for decisions to be made.  This hospital would alleviate the bottlenecks in care while also support our county jail that has patients in detention awaiting space in Larned or Osawatomie.   I envision a similar model to the other state-run hospitals, but would suggest a multi-disciplinary model like what we see at the Sedgwick County Child Advocacy Center.  This broad and comprehensive approach would bring incredible capacity and resources to the region as we work to better meet the needs of our citizens.  

[5] Behavioral Science Center

We have to address the lack of pipeline for future qualified mental health professionals and social workers in our community. The COMCARE staffing crisis has resulted from a combination of insufficient wages and the lack of qualified workforce in our community.  There are discussions of cooperative opportunities between KU and WSU on a Behavioral Science Center that will be a long-term catalyst to better servicing our needs. We have to reconsider our approach to attracting and retaining experts in these fields and I would be a strong advocate from the County for this project and other measures that help strengthen the workforce in this specialized field of behavioral science. 

[6] Preventative Strategies

The overlaps with mental health and substance abuse are unavoidable. We need to work as a community to look upstream and address problems early in the cycle with effective preventative measures. This includes foster care reform, reinforcement of rehabilitation/reemergence strategies in our county jail, and expanding resources for those in our community that are uninsured so that they may take advantage of residential treatment options and medical detoxes.  I’ve been working in the foster care reform space for a few years and see the effects of childhood trauma long term; nearly 70% of foster children end up in our criminal justice system.  There is a long term, detrimental community impact if we don’t retool our preventative approaches.  This effort is not about making money, but saving money long term.  

[7] Virtual Communication and Information Hub

Identifying bottlenecks and inefficiencies will help us to better collaborate with providers and service our citizens.  Multiple community providers and stakeholders in this space will require some sort of shared database and communications system.  I would work to identify the stakeholders in the community and work to build coalitions to address this technological need.   

[8] Economic Awareness

We discount the role that a healthy economy plays in the mental health of our citizens.  A stable job provides income and relief from financial stress.  In many instances it also allows for access to insurance to get the treatment needed.  I will never lose sight of the role our economy plays in the overall health of a community and its citizens.  

That’s a broad overview of a few initiatives that I believe I can get across the finish line in this community to help those of us that are in need.  Approximately 160,000 people in the metro area experience a mental health issue every year.  The current approach and resources are not effectively addressing the needs and our community must have effective leadership that can deliver progress.  That’s my critique of the current Commissioner in my district and that’s why I’m running to be a voice for mental health and substance abuse progress in Sedgwick County.  

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