As many of you would agree, Iowa is an amazing place to raise a family and establish community roots—unless you or someone you love has immediate mental health concerns. The reality for our great state is that we are in the midst of a mental health care crisis.
After the closing of two of the four state mental health facilities in 2015, many have realized the devastating effects of a lack of providers and a lack of available psychiatric beds. Iowa consistently ranks among the worst states in the country for mental health services—this from a state often found at the top of lists of the best states to live. We might be productive, happy, well-adjusted people, but we do not give our mental health treatment the absolute priority it deserves.
Iowa recently received a D- rating in its mental health services from the Treatment Advocacy Center, who rated all 50 states. The report stated that Iowa has one of the worst psychiatric bed availabilities with 1.2 beds for every 100,000 adults, far from the national average of 12 beds per 100,000 adults. It also condemned Iowa’s unorganized system of treating prison inmates with severe mental illness.
People have begun to raise awareness and pass legislation to begin to address this issue by expanding mental health services, but it simply does not go far enough. Iowa needs to create a centralized mental health system to ensure that evidence-based programs are consistently available throughout the state. The state must also increase the number of psychiatric beds, both for citizens and inmates, and work on organization for reporting. Data collection and analyzation are critical when assessing the effectiveness of specialized programs.
Rural communities like ours have suffered the most with the lack of available mental health care, and law enforcement have struggled with increased transportation distances to the limited available psychiatric beds. We simply cannot afford to not make this a priority. There shouldn’t need to be a tragedy before addressing the absolute need for the overhauling of the system.
Governor Branstad’s 2016 privatization of Iowa’s Medicaid program moved more than 600,000 Iowans into managed care plans, which resulted in cuts for services—especially for the most severely disabled and mentally ill.
Many of the problems Iowa and other states are experiencing were supposed to be addressed by the federal Mental Health Parity and Addiction Equity Act. The 2008 law’s goal was to make mental health care as accessible as primary care. But the law has been dismally enforced, and mental health care is four to six times more likely to be out of network than other forms of care.
This can largely be attributed to lower reimbursement rates: A mental health professional, on average, receives 20 percent less than other providers. The lower reimbursement rates are creating a lack of professionals in the pipeline as well. Many are choosing different specialties because of the low reimbursement rates, and the ones who are coming into the field are becoming less likely to take Medicaid patients. The reality is this: we have to push back with what the insurance companies are doing. Mental health is just as deserving of reimbursement rates that are the same as any other health concern. We cannot continue this culture of hierarchy when it comes to our complete health. Our society will be a healthier and more functional place to be if we can eliminate stigma of mental health issues and concerns.
I believe every resident of this community has in some way been affected by mental health concerns. This is real and it truly is a matter of life and death. Both sides of the political aisle in Iowa seem to recognize the need for reform and we have seen some incredible progress so far, but we must continue to push our elected officials to do more. Help by raising your voice in this election year; this is not a conservative or liberal issue—it is a human issue, and we are dealing with lives that are valuable and worth saving.
-Marcy Taylor is a graduate social work student at Our Lady of the Lake University