New state committee to look at children’s mental healthcare

DES MOINES - Tammy Nyden has a son who has dealt with myriad mental health issues, including autism, Tourette syndrome, depression and manic behavior.

While trying to get help for her son, Nyden became frustrated with the system in place for children's mental health care in Iowa - or the lack of one.

Ever since, Nyden has been active in a movement to improve and streamline the way Iowa children receive critical care for mental illnesses. She serves on the Children's Mental Health Committee for Iowa's chapter of the National Alliance on Mental Illness (NAMI) and soon will serve on a new state committee that will be tasked with suggesting reforms to state lawmakers.

Nyden said the NAMI committee was formed more than two years ago 'by parents who are just so frustrated by the lack of a mental health care system for kids.”

The primary goal of the committee is for Iowa to have 'an organized statewide network that effectively partners with elected officials to ensure effective children's mental health policy and implementation.”

'We are basically doing what the state should have done,” Nyden said.

The state redesigned its mental health care system in 2013. Counties and private providers previously worked together to deliver services. Now the state is divided into 15 multiple-county regions, each of which offers at least the same core services.

During the transition, a work group comprised of public and private officials and experts was established to make recommendations regarding children's mental health care. In November 2013, the group published its report with five recommendations, none of which the state has acted on.

'We're so frustrated that nothing's getting done for the children,” Nyden said.

Iowa children with mental health care needs are served by Medicaid, the state program hawk-i or private coverage, according to Department of Human Services spokeswoman Amy McCoy.

No action on proposals

The 2013 Children's Disability Services Workgroup made five recommendations:

' Establish a Children's Interagency Coordinating Council to ensure state agencies work together to serve the state's children with mental health needs fully and efficiently

' Create an Iowa Children's Advisory Council, a group of stakeholders to work with the Interagency Coordinating Council on implementing programs and reforms

' Consolidate or eliminate redundant children's mental health committees

' Establish a minimum set of core mental health care services that should be available to all children

' Convene a task force to make recommendations about tools to assess a child's function level.

No action has been taken on any of the recommendations.

'I think there were some misinterpretations of the good work that the first work group did. And I think those misinterpretations were made by some legislators, quite frankly,” said Iowa Sen. Liz Mathis, D-Cedar Rapids, who served on the first work group and is a communications officer at Four Oaks, a not-for-profit agency devoted to child welfare, juvenile justice and behavioral health. 'I don't think that the work had the support that it really needed.”

A new state work group is being formed to once again examine issues of children's mental health care.

Mathis said the new group will work off the first's recommendations, and she is hopeful its recommendations will be better received than those from the first group.

'We need to put small groups of legislators together and brief them on what's going on, give them periodic updates on the work this group is producing and their objectives and try to win favor in a bipartisan way,” Mathis said.

The NAMI committee has been putting together its own report, which it will release in September at a news event at the Capitol.

A draft of the NAMI report shows many of the same recommendations of the 2013 state work group, including the advisory and coordinating councils and the baseline services.

'We're drawing attention to the fact that despite these recommendations (of the 2013 state work group), nothing has happened,” Nyden said. 'A lot has happened, but not for the children.”

Cost is a factor

Nyden acknowledged that some of the reforms being called for require investment. She pointed north to Minnesota, where the state invested $46 million this year in mental health services to add new services and address a shortage of pediatric beds.

Nyden said if the children's mental health care discussion must come down to money, it's a wise investment because treating people while they are young can prevent more exorbitant costs to the state down the road in the form of more acute care and incarceration.

'So even if you don't care about the people, which unfortunately must be the case if you look at our policies, if you look at the bottom line, it's not very smart,” Nyden said, not to fund services for children.

Nyden said reducing waiting lists in Iowa should be a priority. She said she has had to wait 12 hours to get care for her son and knows of a family that was forced to wait three days for a psychiatric bed.

Action is being taken outside the Capitol. In Mason City, Four Oaks recently opened a 32-bed Psychiatric Medical Institute for Children. And in Scott County, a Tennessee-based for-profit company is proposing a 72-bed psychiatric hospital that could include beds for children.

Any state funding for new services, reduced waiting lists and other children's mental health care programs must be approved by state lawmakers and the governor.

Nyden is hopeful the work of the NAMI and state work groups will convince state officials of the need for a more robust and streamlined children's mental health care system.

'If we can get everyone together - the families of the children, the parents, the caregivers, the providers, the educators - if we can all speak in one voice and basically stay on the issue, don't let it fall away, I believe the children will get the attention the adults did get and needed,” Nyden said.