A Regionalized Redesign of Mental Health Services in Iowa

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September 28, 2014; Sioux City Journal

Like most states throughout the country, Iowa saw a significant deficiency related to their mental health services. Iowa, like communities throughout the United States, saw significant shortages in the number of patient beds and psychiatric physicians and increased challenges in treating children with mental health issues. To solve this, state officials decided to recalibrate its approach to serving those in need of mental health services.

According to a recent article in the Sioux City Journal, Iowa now has fifteen multi-county mental health regions, a process that “started roughly three years ago with state legislators who sought to create a statewide balance of available services and spending and create efficiencies by pooling resources.” These regions are responsible for offering “a baseline of mental health services, including outpatient therapy, community living support and support for employment.” The state believes that by combining counties into regions, the new model will create efficiencies and savings that would then free up funds to reinvest in services and lower property taxes.

With all regions taxing Iowa residents at the same percentages, others in the state are worried about whether there will be funding adequate to provide the services in this new model. Patty Erickson-Puttmann, who leads social services in Woodbury County, stated, “I understand everybody wants to control property taxes, but I also understand that you have to decide what your priorities are. If we’re being told we have to expand services, we have to expand (patient) populations, we have to make (treatment) community-based, there’s no longer going to be institutional funding…then those things cost more than what we were doing. As a state, we have to determine what our priorities are.”

Deanna Triplett, who leads the Iowa Behavioral Health Association, agreed about the state funding streams to mental health, stating, “We’ve had an underfunded system for a long time.”

Additionally, there is concern about whether there is enough staff and beds to go around. Lori Elam, who leads a region in eastern Iowa, said that there’s “a severe shortage of psychiatrists in Iowa, as well as all over the country. There’s still a wait time to get in to see a mental health provider…. It’s frustrating that we don’t have any change in (number of) providers, we don’t have any new doctors, no new beds. That’s still an issue for all the regions across the state.”

Most of the comments after the new model went into effect have been positive. Rick Shults, Iowa Human Services’ Division Administrator of Mental Health and Disability Services, said in a statement that “the regions went into effect July 1st, and so far we’re hearing positive feedback and excitement about how the redesign may help bring even more new services to the regions in years to come.”—John Brothers