Limited capacity at the state’s largest psychiatric hospital and other factors are forcing some Kansans who need mental health treatment to wait in hospital emergency rooms. Sometimes for days.
One year after Osawatomie State Hospital temporarily stopped admitting patients for the first time in its history, the number of people waiting for mental health treatment is up.
And an increasing number of them are waiting in hospital emergency rooms.
Osawatomie State Hospital — one of two state-run inpatient facilities for adults with severe mental health issues — halted admissions in late June 2015 after it reduced its capacity from 206 to 146 so that it could complete renovations ordered by federal officials.
The hospital is now admitting new patients but only when its population falls below 146. The reduction in usable beds has resulted in longer wait times for patients who need the intensive inpatient treatment.
Federal officials ordered the Kansas Department for Aging and Disability Services to renovate areas of Osawatomie State Hospital because of concerns about patient safety. The hospital closed a 60-bed unit in April 2015 to start renovations, but it has yet to reopen.
In December, the Centers for Medicare and Medicaid Services cut federal payments to the hospital — about $1 million a month — after finding additional safety concerns. KDADS has focused on meeting requirements to receive those payments again.
Waiting up to four days
The longer wait times have forced an increasing number of Kansans to seek mental health treatment in hospital emergency rooms. Officials at Wichita-based Via Christi Health say the demand for mental health services has climbed steadily since last year.
“We have, I think, consistently seen a rise recently,” said Chris West, the administrator for Via Christi’s behaviorial health programs. “We did see it last year, but not at the level we’re seeing it this year.”
Increasing wait times for beds at Osawatomie is one of the reasons for the spike in ER visits, West said, noting that some Via Christi paitients have had to wait more than four days.
Cindy Samuelson, spokeswoman for the Kansas Hospital Association, said wait times for beds at Osawatomie are an increasing concern among the association’s members. Representatives on its behavioral health task force have reported patient waits ranging from 20 hours to 96 hours, she said.
West said four people were waiting in Via Christi’s emergency room for admission to Osawatomie as of Thursday morning, including one person who had been waiting for three days.
Statewide, 18 people were waiting for treatment at Osawatomie State Hospital as of Thursday morning, said Angela de Rocha, KDADS spokeswoman. Five of them were in a correctional facility or had failed to comply with court-ordered outpatient treatment, she said.
John Worley, superintendent of Osawatomie State Hospital, said fewer than 10 people were waiting for beds statewide for most of the period between July 1 and Nov. 10, 2015, though the waiting list did hit 14 a few times.
Since Nov. 11, 2015, the waiting list typically has been in the double digits, and it isn’t clear why, Worley said. It hit a high of 27 on June 15 but has fallen to as low as three at times, he said.
“Having 18 on the list would be a bit high against the averages, but not unusually so,” he said in an email.
Growing demand for services
It isn’t just the state hospitals that are running out of room. West said Via Christi’s behavioral health center, which has 60 beds for adults, can take patients waiting for admission to Osawatomie. But he said its beds also often have been full in recent months.
Part of the issue, West said, is that an increasing number of the people seeking treatment for behavioral health problems at Via Christi have had more significant needs.
“That higher level of treatment often takes longer,” he said. “Oftentimes they do these extended boarding times in the ED (emergency department).”
Via Christi has five beds in a designated psychiatric assessment center in its emergency department, West said, but sometimes patients in mental health crisis have to be placed in other safe rooms when those five are full.
"It's not the right level of care to have these people waiting."
Via Christi’s emergency department has nurses trained to work with psychiatric patients, along with a clinical social worker and a “protection worker” whose job is to calm patients. Even so, he said, it’s not an ideal treatment setting for people with behavioral health needs.
“It’s not the right level of care to have these people waiting (for a state hospital bed),” he said.
Susan Burchill, spokeswoman for Wesley Medical Center in Wichita, said Wesley hasn’t seen an increase in the number of people waiting in its emergency department for a space at Osawatomie State Hospital.
However, she said, it is a challenge for physicians to find private or public facilities that have space for inpatient psychiatric patients. That has increased wait times for inpatient psychiatric care, Burchill said.
Heartland Health Monitor is a reporting collaboration based at KCUR in Kansas City, Missouri.
