Iowa’s mental health system needs overhaul

By Sioux City Journal

----

Iowa is falling short in providing mental health services. Challenged by myriad problems, the mental health system in our state is in need of overhaul.

We do not fault dedicated men and women within the mental health profession for the problems. To the contrary, we wish to see more appreciation and support for their work.

Iowa's fragmented county-based system of mental health services creates inequities in quality of care and funding. (For example, according to the 2007 Task Force on Iowa's Physician Workforce conducted by the University of Iowa College of Medicine, no psychiatrists served the extreme Northwest Iowa counties of Lyon, Osceola, Sioux, O'Brien and Plymouth, but 10 served Woodbury County and 41 served Polk County.) Waiting lists for services have formed in some counties. While problems are more acute in rural counties, even urban counties face cuts to mental health services due to tight state and county budgets.

Shortages plague the system. Iowa ranks near the bottom in the nation for psychiatrists per capita. The number of state Mental Health Institute beds in Cherokee, Clarinda, Independence and Mount Pleasant declined 60 percent between 1992 and 2010. The number of hospital beds for mental health patients declined in the state from 802 in 1996 to 672 in 2009. ...

Gov. Terry Branstad has referred to “Iowa's 99 different mental health systems,” according to an IowaWatch story in the March 13 Journal. As Mercy Medical Center-Sioux City spokesman Jim Wharton said to us in a recent editorial board meeting, the current system “is not patient- or family-friendly.”

Difficult and complicated as it might be, our state can, should - and, it appears, will - do better.

The last time the Legislature studied mental health in any kind of substantive way was 1996, but we are encouraged about the potential for change because of deserved high-profile attention the issue is getting this year.

Within his budget for next year, Branstad proposed no reduction in funding for mental health care. The House, in fact, proposed an additional $25 million in funding to help reduce county waiting lists. Support appears to exist among both Republicans and Democrats and within both legislative chambers for a move to a more state-based mental health system, although differences exist in terms of specific details. The Department of Human Services and the Iowa Hospital Association are on board and pushing for needed improvements, as well. ...

We support a move from the county-based system of mental health services to a more consolidated, more uniform state-based system under which we believe services for the mentally ill would improve in terms of delivery, coordination and funding.

The Legislature should spend the next year hammering out the specifics of such a new approach to mental health services with the goal of holding a full debate and vote during the 2012 session.