Impact of potential Iowa mental health institute closings ‘terrifying’ for hospitals

DES MOINES - The prospect of a proposal to close two of four state mental health institutes (MHIs) is 'terrifying,” mental health professional from Cedar Rapids told state lawmakers Wednesday.

For Kent Jackson, administrative director of behavioral services at St. Luke's UnityPoint, it's a fear of the unknown.

'I've simply been unable to see a plan and that's part of the problem,” he said after he and Dr. Al Whitters, medical director of Mercy Medical Center Behavioral Services, talked to the Senate Human Resources Committee for more than an hour. 'This is a huge, huge, huge situation where there's not a plan or if there is a plan, it's not widely known.”

Closing the Mount Pleasant and Clarinda mental health institutes is under discussion because Gov. Terry Branstad's budget does not include money to their operation beyond July 1. Instead, the governor and Department of Human Services have talked about implementing the mental health redesign lawmakers previously approved and working with community providers to provide mental health services. The mental health institutions in Cherokee and Independence would remain open.

The MHIs play a vital role in the continuum of care for Iowans with mental health needs, Whitters said. Psychiatric beds at most hospitals are always full, he said, and the MHIs' specialty units are needed to handle violent patients.

He was assaulted in the past year and Jackson said three of his doctors have also been assaulted.

'Before that I couldn't remember having any (assaulted) and I've been there nearly 30 years,” Jackson said.

They attribute the violence and its frequency to substance abuse, to medications that don't work, rules that prevent doctors from prescribing longer-lasting injectable drugs to outpatients and to 'high-metabolizers” whose bodies process medications very quickly.

Overall, Jackson said it's hard to quantify the impact closing the MHIs would have on community hospitals like those in Cedar Rapids.

'It's a cumulative impact,” he said, when beds are lost and money is taken out of mental health services.

'To say what the impact is, it's terrifying to think about it,” Jackson said.

He encouraged lawmakers to think about how they would want their family members treated.

'I think a lot of times payers, government entities, make decisions about these people and they don't really understand them at all, they don't know what they're doing, they don't,” Jackson said.