Ensure safety net for mentally ill

It could make financial sense to close the state mental health institute in Mount Pleasant and redistribute its services among three other such institutes throughout the state.

Department of Human Services Director Charles Krogmeier has said closing the facility would save the state about $1.7 million a year - not huge, yet still important in a time when every dollar must get scrutiny.

But when legislators take up the proposal, they must be sure that shuttering the Mount Pleasant facility won't negatively affect the state's overall delivery of mental health services. They also must consider the shortcomings in those services that have been identified by providers, advocates and Iowa citizens in recent months.

State leaders have no choice but to cut state spending. Still, addressing concerns about poor funding and coordination of mental health services also is critically important. The state's mental health system serves some of our most vulnerable state residents, and legislators must make equally sure that population is well served as efficiencies are identified.

Krogmeier's recommendation to close the Mount Pleasant facility came at the request of lawmakers looking to cut state spending.

The Mount Pleasant facility is smaller than mental health institutes in Independence, Cherokee and Clarinda; closing it would cause the least economic harm and be disruptive to fewer patients' families, according to the recommendation.

Consultants also recently recommended closing the Mount Pleasant as well as the Clarinda institutes, finding that services at those two facilities could be consolidated at other institutes or contracted out to other service providers.

But a task force charged with studying the issue has recommended against closing any state mental health institute until shortcomings in community-based services are addressed.

A stronger network of community-based providers is needed to ensure that Iowans with mental illness receive the help they need, that task force found.

The state already is short on private inpatient beds for mental health treatment, Margaret Stout, executive director of the Iowa chapter of the National Alliance on Mental Illness, has said.

There is not enough access to community-based critical care, she says, driving more people than necessary into the state mental health institutes in the first place.

Community-based services for people with serious mental illness generally are preferable to institutional settings when that's possible. State departments must be efficiently run.

But the state's mental health institutes provide critical services to some of the state's most vulnerable residents.

Legislators must be certain any changes they make don't leave them without an adequate safety net.