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Iowa's failure to address mental health affects more than jails

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Jeffrey F. Bullock, guest columnist

Erin Murphy’s recent story (“Iowa sheriffs at the front lines of mental health crisis”) does an excellent job of defining part of the tragic shortcomings of Iowa’s mental health care system.

Noting Gov. Terry Branstad effectively ordered the closing of two state mental health institutions last year, Murphy reported that Branstad and numerous advocates believe many mental health patients are better-served by community-based care, but the closures did not shift vital resources to the local level. Instead, an estimated one in three people being housed in Iowa jails actually need mental health care.

Murphy’s story made it clear that the issue is hardly a partisan one.

John Miller, a Black Hawk County supervisor and Democrat, said county jails “have become the mental health institutions for the state.” Scott County Sheriff Dennis Conard, a Republican, observed that “the entire system seems to be broken.”

As a state and a people, we are better than that.

In fact, the problem is hardly a new one; it began in the 1980s with a national push for “deinstitutionalization.”

I’ve been asked what stake a university president has in mental health care and discussions to improve it. Just like our jail system, colleges and universities are beset by challenges created by a mental health system that does not work.

By many estimates, more than 25 percent of our population struggle with brain health challenges ranging from anxiety and depression, dyslexia or dyscalculia to schizophrenia. According to ACT, the Iowa City-based college entrance testing firm, 70 percent of entering freshmen are not prepared to do C-level college work. A significant contributor is attributable to the 33-to-50 percent of college-age students who require medication for various disorders — anxiety and depression being king and queen, respectively. Early intervention would diagnose the problem and provide treatment long before these conditions metastasize into more aggressive brain-health/mental-health issues.

Yet, that is not happening. For a variety of reasons — fear of rejection, ridicule or stigma being at or near the top of the list — discussions about mental health stay in the proverbial closet. It is also for those reasons and others that brain health issues often go undiagnosed and worsen.

One reason they should not go untreated, however, is because of a lack of dedicated resources or an unwillingness by state officials to fix the problem.

Patrick Kennedy, son of the late Sen. Edward Kennedy, was in Dubuque recently to headline a mental health awareness fundraiser. Kennedy shared his history of mental illness, which was undiagnosed for years, and how it had been the source of much pain, disappointment, and embarrassment to him and his family.

His telling of his life story and coming to grips with his disease was one of the most courageous acts of public disclosure that I’ve ever witnessed. Kennedy’s book, A Common Struggle: a Personal Journey Through the Past and Future of Mental Illness and Addiction, will be a comfort and inspiration for many people who either cope with or try to provide support for those who live with diseases of the brain.

Interestingly, my upbringing, world view and politics could not be more different from Kennedy’s. Yet, what we do share is a commitment to making better the lives of those who endure this common struggle. In response to the question — “Why are you so interested in this subject?” — I’m interested because more than one-third of the students I see daily on my campus face significant challenges created by anxiety, depression or other mental health issues. I care because members of my family are challenged by this illness. And, finally, I care because Jesus took the time to care about it.

As Murphy reported, Iowa has the fewest state psychiatric hospital beds per capita in the nation — two beds for every 100,000 residents. When it comes to the number of mental health professionals, the statistics aren’t any better.

It is incomprehensible that residents in almost two-thirds of Iowa’s 99 counties do not have access to a local psychiatrist.

In this state, we invest in centers that specialize in the treatment of cancer, heart disease, diabetes, eye disease and more. Yet, somehow, treatment centers for diseases of the brain — the one organ of our body required to facilitate the function of all other organs — are woefully lacking.

It is time to recognize the scope of challenges created by mental health issues in Iowa — and finally get serious about creating solutions.

• Jeffrey F. Bullock is the president of the University of Dubuque. His Blog: “Leadership Matters for a Changing World” can be found at www.jeffbullock.com

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