By RACHEL COLEMAN
• Leader & Times
As mental health care services in the state struggle to survive, so do many Kansas who face depression.
Data released this month showed that the number of suicides reported in Kansas increased in 2012 by 30 percent. More than 500 people in the Sunflower State ended their lives.
In Southwest Kansas, the statistics are even more troubling in light of dwindling resources for those with mental health issues. The practicing psychiatrist in Garden City announced he will resign at the end of October; the psychiatrist based in Elkhart has reached retirement age; there is no psychiatrist living in Liberal, and the licensed nurse practitioner who works at Southwest Guidance Center is able to come only one day a week.
“I don’t know how much longer the area can sustain this,” said Leslie Bissell, SWGC director and doctor of psychology. “Beginning in November, everyone involved in mental health care in the area will be aggressively recruiting a psychiatrist.”
The need is real. In the four-county area served by SWGC, about one person a day requires intervention services.
“We average between 25 and 30 screens a month,” Bissell said. “This is a person in crisis, where either they or someone with them has identified them as saying they want to harm themselves or someone else, or they’re doing some behavior that puts them at risk.”
Bissell, or another staff member holding master’s degree training or higher, must respond to such calls immediately.
“At 2 a.m. if someone is at the emergency room, talking about wanting to kill themselves, I have to provide services, regardless of whether they can pay for it or not, regardless of whether they qualify for Medicaid or not — and I want to,” said Bissell. “That’s what we’re here for.”
People willing to seek professional help are then referred to the psychiatric unit at St. Catherine’s Hospital in Garden City. It’s the nearest option for private care in the area, since Southwest Medical Center closed its psychiatric unit in 2009. Patients who clearly require care but are unwilling to make the decision to seek help are involuntarily taken to Larned State Hospital.
“I would say 60 to 80 percent of the people who go to Larned are not known to the mental health care community,” Bissell said. “They’re not people we’ve seen, who are being treated, who have a history or family members that can provide more information.”
That’s a key detail, she said, because with people known to the mental care system, “we can usually intervene early, before it reaches a crisis.”
Bissell has sought to creatively address the lack of psychiatric care in the region. Southwest Guidance Center is exploring a partnership with the Iroquois Center in Greensburg. It’s possible the psychiatrist there might provide a few hours of long-distance treatment via televideo once a week.
“That’s very much in its infancy at this point,” Bissell said.
A more direct and effective way to prevent suicides in Seward, Haskell, Stevens and Meade counties would be widespread training in Mental Health First Aid. The Guidance Center has offered the national program in Liberal for three years, Bissell said.
“It’s a lot like regular First Aid,” she said. “That’s focused on helping keep someone alive until the paramedics come. This helps ordinary people understand the most common types of mental illness and gives them a five-step action plan to help.”
“One of the biggest deterrents to someone making a suicide attempt is to ask bluntly, ‘Are you thinking of killing yourself?’” Bissell said.
Knowing how and when to ask, though, can be intimidating. Many people fear that merely asking about suicide could be seen as suggesting the idea. Others worry that the question will offend.
Mental Health First Aid, Bissell said, can provide family, neighbors and friends with basic skills and the confidence to make a difference when doing so might be a matter of life and death.
The class, targeted at two age groups, is offered four times a year through the Guidance Center. There’s one for adults, and another for those who work with youth ages 12 to 21.
“That one is helpful for parents, teachers, church workers, in understanding what are typical adolescent behaviors and what might be a sign of something more serious,” Bissell said. She noted that some forms of serious mental illness, like schizophrenia, often remain hidden until late adolescence, when symptoms begin to manifest.
Law enforcement personnel have taken the class, and so have employees at Seward County Community College. Bissell hopes to expand on those core groups in order to train a cross-section of citizens in Liberal and the area.
“It will make a huge difference if we have people out there who know the basics, people who can visit with a friend or a coworker, and notice, ‘Hey, they’re not who they used to be,’ and then recognize when help is needed,” she said. Among the potential Mental First Aid trainees are church groups, civic clubs, “anyone who deals with the public: secretaries, hair stylists, teachers, teens, 4H members, Big Brothers and Big Sisters, anybody who has an interest in people. This is about relationships.”
In addition to its four-a-year training schedule, SWGC will offer special classes in Mental Health First Aid to any groups interested. The cost is $30 per person, “which basically covers the materials they receive to take home,” and the course can be completed in 12 hours.
The more people learn about mental illness and become willing to talk about it, the less stigma will be attached to dealing with its challenges, Bissell added.
“One in four Americans can be diagnosed with some form of mental illness. Often it’s depression, which is one of the most treatable things. There are a lot of people out there suffering needlessly,” she said.
And while the perception remains that people suffering from mental illness pose a threat to the community, the truth is that they are more likely to harm themselves.
According to the Kansas Department of Health and Environment, the most common method of suicide by Kansans is firearms, followed by suffocation and poisoning.
“One year does not make a trend, and hopefully we will not have the same repeat next year,” said Liz McGinness, a member of the Sedgwick County Suicide Prevention Coalition, in a statement to the Associated Press.
AP reported that “in Kansas, suicide is the second-leading cause of death for those 15 to 24 and for those 25 to 44, after unintentional injuries. Johnson County had the most suicides in 2012 with 92. Sedgwick County had the second most, with 88.
Some public funding for mental health has decreased while the suicide numbers increase. The community mental health center in Sedgwick County, for example, has lost 53 percent of its state funding since 2009.”
If residents of the four-county area served by Southwest Guidance Center make a serious effort to implement Mental Health First Aid, Bissell said, the story in Southwest Kansas can be a different one.
For information about Mental Health First Aid classes, contact the Guidance Center at 624-8171, or visit the website www.MentalHealFirstAid.org.