Mental health system needs more than an address change

A statewide system of mental health services might not be a bad idea. At least it would even out inequities in the 99-piece crazy quilt that is our county-based system now. But throwing another layer of government at the problem won't automatically resolve larger issues in mental health.

And, frankly, state lawmakers' willingness to play political football with public safety (the state's contract attorneys still aren't being paid for defending indigent clients in criminal court) makes me nervous about handing them the reins to mental health services.

Gov. Terry Branstad called this week for a state-based system of mental health services balancing access, cost and quality. House Republicans are working on their own plan.

There's no mistaking, cost is an issue. Already we spend more than $1.3 billion each year to fund a social safety net that can seem more holes than net.

State leaders made the right decision decades ago when they moved most severely mentally ill people out of large state institutions. But the comprehensive community-based system that was supposed to replace state hospitals never did materialize.

Instead, we have a chronically underfunded, uneven and inadequate network strung together by a few dedicated people. “I've been doing what I've been doing for 25 years,” Margaret Stout, Executive Director of the National Alliance on Mental Illness' Iowa chapter, told me this week. “I can tell you we started out with a system that was broken.”

Now, absent that comprehensive community-based mental health system, we're seeing a reinstitutionalization of the seriously mentally ill. Increasingly, our prisons are functioning as the last stop in a broken system.

Ignoring community mental health needs costs our communities far more in the long run - in productivity, public safety costs and tragedies like the recent murder of Keokuk County Sheriff's Sgt. Eric Stein.

Nearly 40 percent of the state's prison inmates have been diagnosed with a mental illness, and the number is rising. It's an inefficient, inhumane and costly patch. That's what really needs to change.

As Black Hawk County Sheriff Tony Thompson, who says more than 60 percent of his jail's population is mentally ill, recently told a Gazette reporter: “We're a county jail. We're not a mental health facility. We're not a treatment center.”

So, sure, turn mental health services over to the state. But while they're tinkering with the system, lawmakers should tackle the big fixes, too.

Comments: (319) 339-3154; jennifer.hemmingsen@sourcemedia.net