Kansas’ shortage of mental health hospital beds a factor in violence against workers

A patient in mental health crisis undergoing treatment at the overcrowded Ascension Via Christi St. Joseph in Wichita brutally attacked a nurse checking his vital signs.

“He comes off the bed and grabs her neck and he is intent on squeezing the life out of her,” said Robyn Chadwick, president of Ascension Via Christi St. Joseph. “Before he completely had his hands tight around her neck she was able to get out a squeal.”

Her cry for help summoned other staff members who subdued the patient at south-central Kansas’ largest provider of acute mental health services. The violent incident was a symptom of overcrowding in the Ascension hospital’s emergency room and a reminder of the longstanding shortage of bed space at state mental hospitals in Osawatomie and Larned, Chadwick said.

She endorsed construction of a 50-bed behaviorial health facility in Sedgwick County, a proposal under consideration Tuesday by a House and Senate committee.

The catch, Chadwick said, was additional hospital beds wouldn’t automatically close the statewide gap in access to mental health services because of staffing shortages plaguing health care facilities in Kansas.

She recommended the state invest in development of nurses, social workers, counselors and other health workers by offering in-state tuition rates to nonresidents, creating student loan forgiveness programs and modifying licensing and certification protocol to allow reciprocity with other states. The state needs to expand eligibility for Medicaid to provide wider insurance coverage of lower-income individuals and generate revenue for hospitals struggling to recruit and retain staff, she said.

“I have great anxiety and trepidation about adding a 50-bed hospital,” Chadwick said. “I don’t know how we would staff it.”

Sedgwick County officials requested an appropriation of $40 million from the Legislature for construction of the regional behavioral health facility. In addition, Gov. Laura Kelly recommended the state budget include $15 million to support the project.

Separately, Ascension Via Christi St. Joseph submitted a proposal to the Legislature for $22 million to expand its emergency room. The objective is to incorporate a 20-bed psychiatric safe area at the hospital to better segregate patients in the emergency room, she said.

Rep. Kyle Hoffman, a Coldwater Republican on the joint committee studying mental health bed space issues, asked Chadwick whether it was necessary to add a new state psychiatric hospital and expand at Ascension Via Christi. Chadwick said hundreds of Wichita hospital beds devoted to patients with mental health challenges had been lost during the past 30 years.

“I truly believe both are needed,” Chadwick said. “We will stay in this business, but we need your help to do it.”

Laura Howard, secretary of the Kansas Department for Aging and Disability Services, said the state concentrated in recent years on investments in community-based initiatives that included crisis stabilization centers and mobile crisis teams working to divert people from in-patient hospital care.

Funding approved for renovation at Osawatomie State Hospital will increase bed capacity there from 163 to 218 within 18 months, she said. Expanding Larned State Hospital wasn’t practical because the local labor supply was insufficient to staff more beds, she said.

However, Howard told legislators the sustained high volume of people with serious mental health conditions was straining health care systems and law enforcement agencies. A new state hospital in Wichita could be justified because nearly 20% of patients admitted to the state hospitals at Osawatomie and Larned come from Sedgwick County, she said.

“There’s a lot of reasons why Sedgwick County makes a lot of sense if we’re looking at the cost of adding beds,” Howard said.

Amy Campbell, who works for the Kansas Mental Health Coalition, said Kansas had too few hospital beds for people requiring acute psychiatric care. In 2019, a report recommended Kansas add 131 to 172 beds to treat patients with chronic mental health challenges.

“We must have in-patient beds within our mental health system in order to properly serve people who have serious mental illness,” she said.

She said the Legislature for many years ignored budget requests for more hospital staffing, modernization of facilities and bed capacity.

Rep. Henry Helgerson, D-Wichita, said details remained to be worked out before the Legislature signed off on a new state hospital. He said construction and operating budgets needed to be hashed out and questions remained about whether the hospital staff would be state employees.

This story was produced by the Kansas Reflector, a nonpartisan, nonprofit news organization covering state government, politics and policy.