Iowa bill gives those with mental illness options

A bill making its way through the Iowa Legislature would change how law enforcement and mental health professionals handle an individual with a serious mental illness who does not comply with his or her court-ordered outpatient treatment.

Supporters of the bill and legislators said Senate File 2259 gives patients options and relieves pressure points in the mental health system.

Under current Iowa code, a person with a serious mental illness - schizophrenia, bipolar disorder or major depressive disorders - who fails to comply with their court-ordered treatment, such as an appointment with a psychiatrist, can be involuntarily recommitted to inpatient treatment by a judge.

This can be costly and cause problems, said Kent Jackson, director of UnityPoint Health-St. Luke's Behavioral Health Services: It forces sheriff's departments to transport the individual to the closest open psychiatric bed, which can be up to six hours away; it costs the hospitals money; and it's not always the best option for the patient.

Jackson worked with Sen. Liz Mathis, D-Cedar Rapids, to write the legislation.

Injectables an option

Under the amended code - which passed in the Iowa Senate and has a counterpart in the Iowa House being moved along with the help of Rep. Ken Rizer, R-Marion - the patient would be given an option of being treated with appropriate medication, including injectable antipsychotic medicine, by a mental health professional at an outpatient psychiatric clinic or hospital, or being recommitted to the hospital or inpatient facility.

'I'm optimistic this will get the same support in the House as it did the Senate,” Rizer said. 'If they get the mental health treatment they need ...

and stay on their meds, they're not a danger to themselves or society.”

Antipsychotic injectables are long-lasting, Jackson said - one to three months - and are highly effective in treating schizophrenia. According to the National Alliance of Mental Illness, antipsychotics reduce or eliminate psychosis symptoms by impacting dopamine levels.

Jackson said both Cedar Rapids hospitals, at least two pharmacies and AbbeHealth are able to administer the injectable medications, which are easier for patients than oral dosages in that they don't have to remember when to take them.

'Giving someone an option other than commitment is always a good thing,” said Maj. John Godar at the Linn County Sheriff's Office. Godar also is the president of the Iowa State Sheriffs' and Deputies' Association.

'And anything that can relieve the time, effort and cost” put on sheriff departments 'is a good thing,” he said.

'The state needs a serious intent to have more beds available,” he added. 'A lot of the problems in our communities are mental health issues. We need more resources.”

More psychiatrists

Godar and Jackson said the change is a step in the right direction when it comes to improving the state's mental health landscape. But the two added that Iowa still needs more mental health professionals and psychiatric beds.

The state has a severe psychiatrist shortage, according to a 2013 survey. About two-thirds of practicing psychiatrists are clustered in the most populated ares of Iowa - Polk, Linn and Johnson counties - while 68 counties do not have a practicing psychiatrist.

In August 2015, the Iowa Department of Human Services launched a database to track available psychiatric beds, and on Monday Gov. Terry Branstad announced the creation of 10 new psychiatric residency positions at Des Moines hospitals.

Branstad said the state has put up $2 million annually to help fund a match program to recruit and retain psychiatric professionals in Iowa. Residency programs will be formed at Broadlawns Medical Center, UnityPoint Health and Mercy Medical Centers, all in Des Moines, in coming years - aided by legislation intended to reduce barriers for medical residency programs to receive funding and to increase the ability for significant investments into more costly residency programs like psychiatry.

Organizers hope the residency programs will encourage more physicians and mental-health specialists to establish practices in Iowa upon completion of the training.