Sanity is madness put to good use. – George Santayana
Politicians Meddle with Iowa’s Mental Health System.
16Dec2009 Author: Mother Jones, RN 
I took this picture a couple of years ago during a trip to Iowa. This is the old Clarinda Asylum for the Insane. The name was changed for obvious reasons a long time ago to the Clarinda Treatment Complex. I grew up in Iowa, so let me tell you a few things about my home state. Among other things, Iowans grow corn, raise hogs, and sometimes elect people to the Iowa State House who need a little schooling about mental illness and the needs of the mentally ill.
Iowa currently has four state hospitals for the mentally ill. Now that number is being cut down to three. Iowa State Legislators, who have no clue about what they’re doing, ordered the head of the Department of Human Services, Charles Krogmeier, to shut down one of the state’s mental hospitals. The Clarinda facility and three other hospitals were put on the chopping block. Krogmeier didn’t want to shut down any of the hospitals. He said that the move wouldn’t save money or improve patient care, but the politicians gave him no choice. Mr. Krogmeier suggested the elimination of the Mount Pleasant Mental Health Institute.
Bravo, Iowa State Legislators. You and Governor Chet Culver are gutting Iowa’s mental health system by ignoring the big picture. State hospitals treat patients who don’t have insurance and cannot pay for private care, and those that no one else will take. You know what I mean. I’m talking about violent patients. They hurt themselves or others, and engage in inappropriate sexual behavior or start fires. Mental health patients without insurance, or those who exhibit dangerous behaviors, can wait many days in a hospital emergency room for a state hospital bed to open up. The consulting firm that Governor Culver hired suggested that the state close down the geropsych beds at Clarinda and the drug treatment center at the Mount Pleasant Mental Health Institute. They told Governor Culver that the geropsych patients could go into area nursing homes, and that the drug treatment patients could pay out of pocket, or find money elsewhere, for treatment in private facilities. Shows you what the “experts” know about the mental health system. Nursing homes won’t touch geropsych patients because of rules concerning chemical and physical restraints, and drug treatment patients wouldn’t be in state beds if they could pay for their treatment in the first place.
The Iowa State Legislature and Governor Culver need to take Mr. Krogmeier’s advice. He is advising the governor to open up a series of small 16 bed mental health centers throughout the state before closing a single hospital. This would facilitate revenue via Medicaid, and allow patients to be closer to home. Of course, opening centers takes time, and the clock is ticking. I hope the politicians can work things out, but judging by their track record, I don’t give it much hope. Shuffling patients to other hospitals and limiting beds isn’t going to solve the problem. It’s going to make things worse.
6 Responses to “Politicians Meddle with Iowa’s Mental Health System.”
Leave a reply
Disclaimer
There has been a lot of chatter in the blogosphere about medical bloggers and HIPAA regulations so let me make this very clear: I write composite stories about many different people that I've cared for over the years.
Luis
December 17th, 2009 at 9:01 am
Well, you got that exactly right: Gero patients won’t go to nursing homes or many SNFs. I have spent a little time working, at a very junior level, in a State Mental Hospital of Last Resort, and this is precisely the problem we had with many of our gero patients: other facilities wouldn’t touch ‘em, or, when we did get them there, they’d be shipped right back in a couple of weeks after they got violent.
Sigh.
Ken in Minnesota
December 19th, 2009 at 10:54 am
Well, you know that what Molly Ivins said about Texas legislators (something like, “If you don’t water them regularly, they shrivel up and die.”), probably applies to most legislators in Iowa and Minnesota, and…
RehabRN
December 22nd, 2009 at 11:12 am
MJ:
Too bad you’re not back in IA anymore. Sounds like they need a few psych nurses to go testify at the state house, so the far-removed legislators can get some idea of what’s going on.
They just close up everything, and wait for a major incident…and one always happens. In my state, we had a famous one when said patient was released when he was clearly a danger to others. He went home and killed his parents.
His siblings eventually fought for a change in the law that let him out. It’s just a shame their parents had to die to get him the resources he needed all along.
They just don’t get it unless you draw them pictures sometimes.
Steve/Nursedude
January 8th, 2010 at 12:41 am
MJ, what part of Iowa was home? I went to college at Wartburg College in Waverly.
Funny thing, all I could do in school was complain about how conservative Iowa is.(I grew up in Minnesota). Iowa is not the only state throwing the mentally ill under the bus-it’s just a bit surprising to me that a state that is progressive enough to allow gay marriages(Minnesota still has not) would fall for this shell game.
Mother Jones, RN
January 8th, 2010 at 9:03 am
Hi Steve. My hometown is Cedar Rapids, Iowa. I miss living in Iowa….except in Winter. Too cold. It’s sad, but every state is throwing the mentally ill under the bus. It’s all about the MONEY.
Gardengal
January 23rd, 2010 at 10:27 pm
I too am from Iowa, now residing in Wisconsin. I was there when they turned part of Cherokee Mental Health into a prison, cutting many mental health beds. One night in the ER, we had a 20 something female who needed a mental health committment immediately and after calling every single hospital and mental health facility in the state, we had to tell her family to take her back home because there were no beds available. Who knows what happened to her after that!!! Wisconsin has the same problem, too many people needing mental health care and not enough beds.