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Iowa must act to alleviate mental health care deficit

Silent epidemics often are insidious, eating away at society from within while the voices of victims go unheard and advocates are muted.

Such is the case with mental illness. Because of the associated stigma, those afflicted rarely receive the required resources.

Their plight has been particularly precarious in Iowa, which ranks among the worst states in the nation for treatment — 47th in psychiatrists, 44th in mental health workforce availability and 51st (including the District of Columbia) in the ratio of state psychiatric beds to residents.

Yet serious mental illness is not an anomaly in Iowa. It afflicts 123,000.

According to the Cedar Valley Mental Health Planning Coalition, it is taking its toll in Black Hawk County:

One in four — 29,000 adults — will experience a mental health issue.

One in 17 — 18,000 adults — will develop a serious mental illness.

One in five — 5,500 children — will experience a diagnosable mental health issue.

One in 10 — 2,750 children — will have a serious emotional disturbance.

Fortunately, Cedar Valley groups are confronting the crisis, as Christinia Crippes reported in her five-part series on mental illness last week in The Courier.

Black Hawk County Sheriff Tony Thompson estimates three out of 10 county jail inmates have an underlying mental illness and shouldn’t be incarcerated, but have nowhere else to go. It costs taxpayers $70 per day or $8,400 for four months.

He supports less restrictive and inexpensive options. The county also has become involved with Stepping Up, a national initiative with programs to reduce the number of inmates with mental illnesses.

The Cedar Valley Mental Health Planning Coalition, backed by the United Way, is working to identify and treat youths with mental illnesses and reduce the strain on hospitals.

The Black Hawk Grundy Mental Health has expanded mental health services in the Waterloo and Cedar Falls schools with a funding assist from the United Way. The coalition also is working on a mental health screening process — possibly when students have physical and hearing and vision tests.

“The earlier you can get treatment, the more you can reduce the chance for more complex issues later in life,” said Debbie Roth of the Cedar Valley United Way.

Gov. Terry Branstad put more pressure on local mental health providers when he closed the Iowa Juvenile Home in Toledo, Independence Mental Health Institution pediatric unit and the Clarinda and Mount Pleasant mental health institutions.

Iowa now has two state beds per 100,000 residents compared to the national average of 12.

Not to worry, Department of Human Services officials said, because the state has 730 public and private unit crisis beds — 24 per 100,000 residents. Except a Psychiatric Times study recommends 40-60 combined.

Covenant Medical Center and Unity-Point-Health-Allen Hospital’s shorter-term mental health units are frequently full. Chris Latta, Covenant’s interim director for behavioral health, said about 60 percent of its beds are regularly occupied by people from outside hospitals.

“Historically, weekends, you have just about as high of a likelihood of winning the lottery as you do finding a psych bed in the state of Iowa,” Latta said.

The state’s ever-dwindling resources have put Tom Eachus, Black Hawk Grundy Mental Health Center executive director, in a quandary.

“Sometimes it’s almost like which fire do I put out first? The people in Tony’s jail? The kids in the school? … The people cycling through the mental health units? Which fire do I stomp out first, or try to stomp out?

“I’ve been through, in the last 28 years, three or four DHS reorganizations, and every time they reorganize to save money, none of that money they save from closing like Clarinda MHI ever got transferred to the community,” he added. “I think it goes back into the state coffers to do other things, but we don’t have any more psychiatrists than we had 10 years ago. We don’t have any additional services.”

Help may be coming from an unlikely source — Congress.

In July, the House passed the Helping Families in Mental Health Crisis Act, 422-2, to increase the availability of psychiatric hospital beds and boost treatment for young mental health patients. It awaits Senate approval.

Rep. Tim Murphy, R-Pa., introduced it after the Newtown, Conn., school massacre.

“We are ending the era of stigma,” he said. “Mental illness is no longer a joke, considered a moral defect and a reason to throw people in jail. No longer will we discharge the mentally ill out of the emergency room to the family and say, ‘Good luck, take care of your loved one, we’ve done all the law will allow.’ Today the House voted to deliver treatment before tragedy.”

Iowa lawmakers should heed his words and cease being laggards on this issue.

In doing so, they can take a cue from Cedar Valley initiatives — possible mental health screening in the schools and developing alternatives to incarceration — while making Iowa more attractive to mental health professionals.

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