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Iowa’s mental health treatment system has been making headlines in local and national media — for all the wrong reasons. In a ranking by the Treatment Advocacy Center of all 50 states and the District of Columbia, Iowa ranks dead last in the number of psychiatric treatment beds available per capita. The dearth of beds in the state is no mere abstract concept.

(Sept. 2, 2016) Iowa’s mental health treatment system has been making headlines in local and national media — for all the wrong reasons. In a ranking by the Treatment Advocacy Center of all 50 states and the District of Columbia, Iowa ranks dead last in the number of psychiatric treatment beds available per capita.  The dearth of beds in the state is no mere abstract concept.  As a result of offering only two beds per 100,000 in population, those in need of treatment routinely face exceptionally long waits for admission, if they are admitted at all.  Iowa’s closure of facilities and failure to supplement with community treatment options results in an inefficient system, providing subpar treatment on an untimely basis, at the highest cost to taxpayers.  

In addition to a lack of psychiatric treatment beds, many related problems are on the rise:

• Iowa ranks near the bottom at 47th in the number of psychiatrists licensed to provide care
• Individuals with untreated mental illness are increasingly being shunted to jails and prisons, creating enormous challenges for law enforcement. According to Iowa law enforcement, as many as 38% of people in jail at any given time are there for untreated mental illness and should not be there

A lack of community-based residential treatment facilities prevents release of some from inpatient care who would otherwise be ready for discharge, further crowding an already overloaded system.

The decision to cut the mental health budget and shutter psychiatric facilities has also led to an explosion in state costs for crisis care.  

“One of the biggest drivers of emergency care is mental health,” said Jeff Wilkins, a physician at UnityPoint Health-Allen Hospital’s emergency department. “That may be that they have a heart failure or diabetes or coronary disease, and we know that those patients who have a concomitant mental health diagnosis are twice as likely to visit the ER, use eight times as much resources in the dollar amount as someone who doesn’t have a concomitant mental health diagnosis.”

Iowa policymakers’ response to this crisis has thus far been sporadic and meager. In response to a large influx of individuals with mental illness into its criminal justice system, a one-year mental health court pilot program was created in Scott County. Yet this modest effort does nothing about those with serious mental illness being swept into the criminal justice systems in the other 98 counties in the state.  

To stem the tide, Iowa legislators must listen to law enforcement, medical professionals and legal experts and commit resources more commensurate to the scope of the problem.  In reflecting on the current state of crisis, it’s time to acknowledge how their short-sighted decisions created the problems they are attempting to solve.  

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