THE FIRST 18 MONTHS OF MENTAL-HEALTH REFORM IN KANSAS

Objective: The effects of the first 18 months of implementation of the Kansas Mental Health Reform Act were evaluated. The act designated co mmunity mental health centers as gatekeepers for admission to mental h ealth services, created screening and diversion services for state hos pital admission, allocated state hospital bed days to each center, and reallocated funds from hospitals to communities. Methods: Data from t he catchment area in which reform was implemented in the 18-month stud y period, January 1991 to June-1992, were compared with data for that area before reform, and with data for the two state hospital catchment areas in which reform was not yet implemented. Results: In the catchm ent area in which reform was implemented, state hospitalization decrea sed by about 29 percent, and state mental health funds allocated to th e area's mental health centers almost doubled, Service utilization by patients discharged from the state hospital was higher than in the oth er two catchment areas, and most indicators of living status and vocat ional or educational involvement reflected improvement. Conclusions: T he first 18 months of implementation suggest that state-level systems change can decrease state hospitalization and improve the utilization of community services while improving the quality of life for people w ith severe and persistent mental illness.