The National Alliance for the Mentally Ill (NAMI), an advocacy organization of families of the mentally ill , recently presented a "report card", grading all fifty states on the services they provide for serious memtal illness. The nation as a whole only earned a "D" from NAMI, but Iowa's rating was even lower - the Hawkeye state was one of the eight states to receive a failing grade.
This information was presented at the Citizen's Advisory Board Meeting Friday at the Cherokee Mental Health Institute. The states were scored on 39 specific criteria, divided into the four subcategories of "Infrastructure", "Information Access", "Services", and "Recovery Supports."
The narrative of the NAMI report on Iowa said : "Iowa is a prime example of what President Bush's New Freedom Commission on Mental Health meant when it reported that the nation's mental healthcare system is 'fragmented and in disarray' . It must be among the most convoluted mental health systems in the country."
The report was especially critical of Iowa's policy of "legal settlement", which requires that individuals be county residents and free of the need for mental health services for at least a year before their new county is responsible for paying. "These restrictions," the report continued, "often lead to inordinate, potentially catastrophic delays in getting services when they are needed." The report was also concerned about the state's lack of a statewide system to collect and share data between agencies. They also note, however, that the state is in the process of updating the statewide data collection system, and hopes to have it installed by the end of 2006. This step, they feel, will be "an important, fundamental step forward."
The NAMI report also expressed surprise that Iowa's mental health authority (the DMHD) did not appear to be actively engaged in strategies to expand access to services for people with serious mental illness who live in rural areas of the state - noting that 89 of Iowa's 99 counties are classified as "rural."
The report also stated that employment and housing "do not appear to be prominent on DMHD's radar screen." The report noted that DMHD does not appear to be involved with readily available supported employment services, either through funding or coordinaton with Iowa Vocational Rehabilitation Services.
Finally, the report noted significant problems with an overall lack of inpatient psychiatric beds for people with acute treatment needs, and suggested that the state needs more than the current four state mental health hospitals.
The report concluded with this statement:
"Iowa's mental health system is in serious trouble. The state needs to move forward with a bold restructuring of its mental health system, which should include removal of legal settlement rules and increased access to mental health services that work for Iowa's residents wit serious mental illnesses."
MHI Superintendent Tom Deiker presented the report and led group discussion. Deiker noted that the MH/DD Commission presented recommendations to restructure the adult mental health services about three years ago, but that he wasn't aware of any real follow-up on those recommendations.
In other business, MHI Business Manager Tony Morris presented a list of Major Maintenance Projects for MHI. Some are under way at this time, and there are ten listed projects which should be completed by the year 2009, depending on legislative funding decisions.