More on line at MHIs than union jobs

Iowa lawmakers are considering a deal that would keep two government-run mental health institutes operating through December while the state seeks to shift its care obligation to private providers.

While there's little doubt the move is preferable to the summer shuttering that was set in motion by the Branstad administration, leaving Iowans with fewer options for care, it remains unclear whether private options will be able to provide adequate care for those who historically have been helped by the state-run facilities.

Particularly in the case of the patients who are a part of the geriatic-psychiatric unit in Clarinda, many who become patients at state-run mental health institutes have already sought or attempted to receive care from private providers.

Due to clients' inability to pay or conditions that surpass the expertise or ability of private providers, the state-run facilities have become caregivers of last resort for many of the state's most vulnerable. Without them, family members say, loved ones would likely need to seek treatment outside of Iowa, adding more strain and hardship to already difficult situations.

That reality, not the presence or absence of union jobs, should be at the heart of discussions regarding the future of mental health care services in Iowa.

Years ago Iowans made a commitment to those who needed such care, placing a requirement in the state's code for government-run facilities in four state regions. Renegotiations of that commitment must be open and comprehensive, so that Iowans are able to weigh the pros and cons of various options. To date, the Branstad administration's unilateral decision to close the facilities has been neither.

We all have a stake in the outcomes of high-quality care. This is especially true when those seeking such care could harm themselves or others.

Attitudes about what constitutes high-quality mental health services are changing. Best practices now are vastly different from what was considered in the patients' best interests even a decade ago. In the future it is very likely state-run institutions will no longer be a part of the landscape; set aside in favor of smaller community-based care facilities.

Squabbles centered on union jobs or and general discussions of privatization don't move the state forward and they surely don't serve the Iowans we all have committed to protect and serve.

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