State has a responsibility
The Iowa Department of Corrections reports that about 40 percent of its inmates have mental illnesses. The prison population in Iowa has more than tripled over the last two decades, overwhelming the mental health services provided by the state to inmates.
"We do have rather limited resources to try to manage and care for them," said Dr. Bruce Sieleni, a psychiatrist and mental health services director for the Department of Corrections. "We need a lot more emphasis on funding for the care of the mentally ill."
The death by suicide of a 21-year-old inmate at the Iowa State Penitentiary in Fort Madison on Sunday underscores the need for mental health services.
The state does have a 200-bed unit at the prison in Fort Madison, currently the largest mental heath facility in the state but still woefully inadequate to handle the mental health needs of the state's inmates.
In contrast, the four state mental health institutes now have a combined 158 beds for psychiatric patients, compared with thousands of psychiatric beds decades ago.
The reduction of the number mental health institute beds results primarily from advancement in development of drugs to treat mental illness, along with a transition of mental health institutes from chronic to acute care facilities, reducing stays from what was often the remainder of a person's life to an average of a few weeks.
However, another element of the reduction appears to be the result of placing more responsibility of mental health treatment onto the Department of Corrections
"It is just simply wrong that we have so many people in the correctional system who frankly used to be in the general mental health system," said Margaret Stout, director of the National Alliance for the Mentally Ill of Iowa.
A special unit operated by the Iowa Department of Corrections at the mental health institute in Cherokee would make sense. Other cooperative efforts with secured facilities, the Civil Commitment Unit for Sexual Offenders and the Youth Emergency Services center, have worked well at the MHI campus. It makes good use of unused state-owned space and available support services capabilities.