Column: Mental health no place for cuts

It seems as if at least one of Iowa's Mental Health Institutes is not long for this world.

Legislators already had their eye on shuttering one of the four facilities - the state's last stop for people with serious mental disorders.

Now, a recently released, 100-plus page Iowa Efficiency Review report recommends that we close down two in order to shave $26.8 million off the books in the next five years. It proposes the state close facilities at Mount Pleasant and Clarinda, moving most of their services to Cherokee and Independence.

Under the plan, the state would outsource long-term psychiatric care for the elderly to private nursing facilities. Community providers would absorb the 50 substance abuse treatment beds that now are at Mount Pleasant.

Two institutes can provide just as many services as four do now, consultants say. That may be true.

Problem is, what we've got now is not enough.

I'm not talking about the buildings themselves, but the acute psychiatric care and substance abuse treatment the state is able to provide.

Fact is, the Public Works consultants' plan doesn't take into account the gaping disconnect between what we've got and what we need. That may not have been their charge, but it's something legislators need to remember when they start to look at cuts next month.

Consultants based their bed-shuffling recommendations on historical data from the state Department of Human Services. Shari Holland and Amanda Grantham, who worked on the report, told me Friday their numbers allow for a $1.6 million annual reimbursement to those community providers and about $1 million a year for the nursing care.

But, after hearing from the public throughout the state, Ro Foege, chairman of a special task force that's been studying the Mental Health Institutes, has said the community mental health infrastructure simply isn't there.

It's a chorus we've heard for a long time now: Our community-based system is a broken patchwork - underfunded, understaffed and uncoordinated.

If legislators do close a Mental Health Institute, the money they get from the sale or lease should go straight into community mental health or disability services, the committee wrote in their draft recommendation, due next week.

At least. Efficiencies are necessary and budget cuts a must. But - especially with the difference between what we've got and what we need - mental health is no place for a money grab.

Jennifer Hemmingsen's column appears on Wednesdays and Saturdays. Contact the writer at (319) 339-3154 or jennifer.hemmingsen@gazcomm.com