<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602352002677.png" alt="With reduced capacity at state hospitals and stricter regulations, emergency room staff at Citizens Health have struggled with psychiatric patient overflow in addition to regular patients. (Submitted to Kansas Reflector)" />
 <figcaption>With reduced capacity at state hospitals and stricter regulations, emergency room staff at Citizens Health have struggled with psychiatric patient overflow in addition to regular patients. (Submitted to Kansas Reflector)</figcaption>
 </figure>By NOAH TABORDA <a href="https://kansasreflector.com/2020/10/10/kansas-ers-burdened-by-worsening-mental-health-crisis-overflow-from-state-hospitals/">Kansas Reflector</a>TOPEKA — Emergency rooms 
across Kansas are seeing an increase in people with behavioral and 
mental health issues seeking care amid the pandemic, and the medical 
facilities lack necessary resources or staff dedicated to serving these 
patients.Many of them are awaiting 
an open bed at Osawatomie State Hospital or Larned State Hospital, both 
inpatient psychiatric facilities operated by the Kansas Department for 
Aging and Disability Services.When the pandemic began, 
Osawatomie State Hospital reduced capacity from 60 to 44 to allow staff 
and other residents to implement social distancing guidelines and to 
ensure separate housing to monitor COVID-19 symptoms in new admissions.Larned State Hospital 
followed suit in May when beds were reduced from 90 to 72 to allow for 
single occupancy amid concerns the disease would spread quickly if a 
patient were to test positive.In August, capacity was 
raised back to 60 beds at Osawatomie, but Larned remains at 72 beds. 
Some patients have found themselves housed in the emergency room for 
days at a time while hospital staff look for an open bed at an inpatient
 facility.“Most mental health 
patients in western Kansas already get taken care of by ER staff,” said 
Jenny Niblock, chief clinical officer for Citizens Health in Colby, 
which has struggled with overflow since Larned reduced capacity. “These 
are family practice physicians that also need to take care of every 
other patient that might come into the ER, so there isn’t the staff to 
dedicate to sitting with these patients and taking care of them 
long-term.”Since the pandemic began 
in March, hospitals across the state have reported higher numbers of 
patients seeking behavioral health treatment, as well as an increase in 
the severity of psychiatric cases. With reduced capacity at state 
hospitals, issues already present with mental health treatment have been
 exacerbated.As of Sept. 14, an 
estimated 32.5% of Kansans are experiencing symptoms of an anxiety 
disorder or depressive disorder, according to a<a href="https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm"> survey conducted by the National Center for Health Statistics</a>.The same survey shows 31.1% of Kansans did not get the care needed or had their care delayed amid the pandemic.This delay in service, at 
least for Citizens Health, could be in part because many inpatient 
facilities require a COVID-19 test before they accept a patient, Niblock
 said. While Larned does not require a COVID-19 test, many inpatient 
facilities do.However, Niblock said, 
rural hospitals like hers do not have access to rapid testing. As a 
result, the Colby-based medical center often must hold patients for 24 
to 48 hours while they await the test result.Even if the test comes 
back negative, finding a bed can be difficult for rural facilities like 
Citizens Health, where the nearest inpatient facility is a two-hour 
drive away and the nearest outpatient facility is three hours away.“Rural mental health 
patients already have a huge disparity in access to mental health 
inpatient and outpatient services,” Niblock said. “If all beds are full,
 we may need to look as far as five hours away for the necessary care.”The overflow of behavioral health patients camped in ERs is not limited to rural Kansas.Lauren Lucht, executive 
director of behavioral and mental health for The University of Kansas 
Health System, said its Kansas City emergency department has seen an 
uptick in acute presentation of patients in need of psychiatric care.Since the pandemic began, both their Marillac Campus and Strawberry Hill inpatient units have been full, Lucht said.“COVID-19 has brought on 
an increase in stressors, anxiety, social isolation, depression and 
substance use,” Lucht said. “All of these things have contributed to an 
increase in patients presenting to our ED for admission to one of our 
inpatient facilities or for an emergency hold until a patient is 
accepted into a state hospital bed.”Making things worse, 
community supports for mental health patients have dwindled during the 
pandemic, Lucht said. She said this has made post-discharge placement 
back into the community with adequate outpatient services more difficult
 than ever.In response to the growing
 need for services and the shortfall of beds needed to accommodate 
patients, KU Health System has partnered with KDADS to discuss how to 
rectify the issues.Cara Sloan-Ramos, 
spokeswoman for KDADS, said the department has adapted quickly to delays
 caused by reduced capacity. She added the need across Kansas 
communities for inpatient psychiatric treatment is on KDADS’ radar.“KDADS continues to work 
to use the additional funds recommended by the governor and approved by 
the Legislature to add capacity at OSH, expand the use of regional 
diversion beds and eventually lift the moratorium on voluntary 
admissions at OSH,” Sloan-Ramos said.Patients needing a bed at 
OSH often end up at Lawrence Memorial Hospital, said Derek Hurst, 
director of the integrated crisis team for Lawrence Memorial Hospital 
Health.Since the pandemic began, 
Hurst has seen an increase in the length of stay and severity of cases 
for people waiting for a bed at OSH. Hurst’s focus is on preventative 
services.The Lawrence hospital 
created an integrated crisis team to help reduce the utilization of 
state hospitals. Staff help connect patients with services before they 
require a stay at either state hospital, something Hurst said is 
necessary to mitigate the<a href="https://kansasreflector.com/2020/10/05/kansas-mental-health-crisis-exacerbated-by-rising-stress-worker-pay-disparity/"> state’s mental health crisis</a>.“The state hospital system
 has been stressed for a long time and needs some revitalization, but 
also throwing a bunch of money at a hospital is not going to solve the 
problem,” Hurst said. “What helps solve that problem is prevention, and 
the way to do that is making sure you have robust programs and funding 
at mental health and behavioral health services in your community.”

Kansas ERs burdened by worsening mental health crisis