Voices of the Petition to Move Mental Health Care Forward in Iowa

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As you know, the petition to find an alternative to simply shutting down two state mental hospitals in Iowa is just getting under way.  I took a chance just by sending an email to them announcing the petition. It’s against University of Iowa policy to use university Outlook email to send messages  for “personal or political” purposes, given the sensitivity of the connections between the governor and the Iowa Board of Regents for the state’s universities.

Just for the record, my personal and political purpose for this action is to attempt to improve access to inpatient psychiatric care for Iowans.

I was gently reminded of this policy–but I was not asked to retract the message. I had next to no signatures until I sent that message. After I bent that rule, the petition signature counter couldn’t keep up with signers.

I thought it would be nice to share some of the comments that signatories had. Most of them are the members of The University of Iowa Hospitals and Clinics Department of Psychiatry but all are welcome who believe that enhancing access to inpatient psychiatric care for those with persistent, severe mental illness is the right thing to do.

They are taking chances and maybe bending the rules by speaking out.

Adam Nardini (psychiatry resident): This is a complicated issue, no doubt. Perhaps dollars could be better utlized than they are currently, but closing the beds without other plans in place will simply put more people with SPMI in the homeless shelters and the prisons. I would urge the Governor and his staff to work with psychiatrists who are “on the front lines” to think up better options.

Royce P. Gray (psychiatry resident): As someone who already works with this patient population and tries to find placements for them, all the beds at our facility and around the state of Iowa oftentimes are already full. I cannot imagine how we would meet the healthcare needs for these patients if we had even fewer resources to work with than what we already have. To say that UIHC has the resources to compensate for two facilities closing shows a complete lack of understanding of the constraints that UIHC Psychiatry is already operating under.

Sonia Slevinski (Clinical Research Manager UIHC): I have experienced first-hand the effect of a closure initiative in another state – please don’t do it here!

Kay Evans (ARNP): I recently heard someone say that we would not close ICUs for medical care so why are we closing the MHIs. I think long term planning would be to look at a a modern state of the art facility to serve those with persistent severe mental illness. The idea that all of our patients should be able to live in the community only demonstrates the lack of awareness of the needs of this population.

Alex Fenzel (Support Services Specialist UIHC): Thank you for organizing this. I couldn’t believe my eyes when I saw Branstad’s initial announcement, especially given the current state of mental health in Iowa and across the nation.

Lynda Green (ARNP): Closing Mental Health Institutes is not the answer. Having better access to mental health care is crucial to serving the people of Iowa.

Beng Choon Ho (Professor Psychiatry): Activism – FINALLY! Thanks for organizing this, Jim!

Kellie Johnson (Support Services Specialist, psychiatry ambulatory care): I don’t understand the Govenor’s thought process. We need more access to Psych services, whether it be in-patient or out-patient, not less.

Samuel Kuperman (Professor Psychiatry; Ida P. Haller Chair in Child Psychiatry): With the increase in the suicide rate in Iowa by 17% from 2012 to 2013, the Govenor wants to close roughly 45% of the Mental Health beds in Iowa. This makes no sense at all. 

Hanna Stevens (Assistant Professor Psychiatry, Child and Adolescent Division): There is already a severe shortage of inpatient mental health beds in the US. In 2005, Iowa ranked 4th from the bottom of public inpatient bed availability. These closures would reduce resources for Iowans even more.

Liz Smothers (Secretary, Department of Psychiatry): It’s disgusting to think one man can cut off so many ill people. Perhaps Branstad can host a few families he has tossed under the bus.

Nancy Andreasen (Professor Psychiatry, Andrew H. Woods Chair of Psychiatry): Given the tremendous numbers of people with mental illness (1% of the population with schizophrenia, 20-30% with mood disorders), closing psychiatric hospitals is both cruel and dangerous. Already too many people with mental illness have been shunted into jails, where they do not get adequate care and may be misunderstood and abused. This is a very costly alternative. We need more good inpatient and transitional facilities, not fewer.

So this is just a cross-section of dedicated professionals and concerned people who worry about the direction mental health care could be going in Iowa.

I bent the rules to show the world the kind of high–caliber people we have in Iowa. I hope Governor Branstad knows about it. I hope the Board of Regents finds out about it. I have a lot of hope.

Good people know when rules need bending.