JEFFERSON CITY, Mo. — More than 250 people are waiting in Missouri jails to be transferred to a mental health treatment facility, but the state is investing in a new plan to try and speed up the process.
Delays within Missouri’s mental health system have not only impacted incarcerated individuals, but there’s also hundreds of people in the Division of Developmental Disabilities waiting to access residential care. Director of the Department of Mental Health Valerie Huhn said money is not the answer.
“I have a wait list for services right now, and it’s not because I don’t have the funding to support those services,” Huhn said. “It’s because I don’t have the workforce to deliver those services.”
It’s a constant battle for the state’s mental health department, with a shortage of workers causing many Missourians to wait months to receive services. According to DMH, there are 658 individuals in the Division of Developmental Disabilities waiting to access residential services. Of those 658 individuals, 28 are waiting in hospitals.
“We’ve got a lot of really sick individuals, whether it be with mental health, extreme behaviors, developmental disabilities, that get stuck in our hospitals because the community or the family can no longer support them the way they had supported them,” Huhn said.
For the first time in a long time, Huhn said things are starting to look up following an 8.7% raise earlier this year and an increase for those working overnight.
“We are finally, for the first time, paying a meaningful shift differential for people who work between 7 p.m. and 7 a.m.,” Huhn said.
Compared to last year at this time, the department has made big strides in hiring. Huhn told the House Subcommittee on Appropriations for Health, Mental Health and Social Services in September 2022, the department had more than 1,700 vacancies. Currently, she said the DMH is short roughly 500 employees, causing many facilities to hire temporary workers.
“We’re still using contracted staff,” Huhn said. “It’s not going down as quickly as we would like it to go down, and it predominately is in those, what we would consider our health care field, so it’s our licensed clinical social workers, our psychiatrists and psychologists.”
There are currently 259 individuals waiting in county jails for a bed to open up at a mental health hospital. Earlier this year, the General Assembly approved a new “jail-based competency restoration” program, allowing the department to treat arrested people while incarcerated or on an outpatient basis if the person can safely be released.
“I don’t think as a state we’re going to get the number of people we need to do all these services,” Huhn said. “We’ve got to start thinking creatively.”
In this year’s budget, there is $2.5 million set aside to provide mental health treatment services and case management for competency to stand trial restoration at jails in St. Louis City, St. Louis, Jackson, Clay and Greene counties.
Huhn said she loves the idea of technology and what it means for DMH and also for individuals.
“I think technology is probably one of the most underutilized ways that we can help people get support successfully and live their best independent lives and we are just really on the edge of adapting technology in this state and across the country,” Huhn said.
Lawmakers also approved spending $300 million to build a new mental health hospital in Kansas City in the next four years. When asked if she’s concerned about staffing the new facility, Huhn said the department doesn’t struggle in the Kansas City area.
“We do already operate a state psychiatric hospital in Kansas City, and they are very well staffed, so they are not one of mine where I’ve really struggled to get staff in,” Huhn said. “I want to make sure everybody understands that wage is very important, and you have to be paying a competitive wage, and we are definitely more competitive than we’ve ever been, but it’s everything else you do as a provider, an agency and a state.”
According to Huhn, licensed clinical social workers, nurse psychologists, and psychiatrists are the professions with the most open positions in the department. Licensed clinical social workers are responsible for managing a patient while they are in a facility to help them return to society. Earlier this month, during a mental health commission meeting, the DMH said the vacancy rates for licensed clinical social workers were very high, with nearly 70% of positions either vacant or filled with non-licensed mental health professionals.
A concern for Huhn as the director of the state’s mental health department is kids.
“We’ve got to do a better job of supporting our families who are supporting our kids,” Huhn said. “Connection is so important for kids, and we really have to keep pushing the importance of connection because when we keep kids connected, we can hopefully avoid substance use disorder, we can identify a mental illness earlier and then on the developmental disability side, the earlier we can engage them in an active, meaningful life, the better their life is going to be.”