#thanksTerry – mental health care in Iowa continues to erode

This story in the Dickinson County News announces the closing of The Pride Group’s location in Okoboji, Iowa, along with one near the remaining state mental health facility in Cherokee, Iowa, and others. The Pride Group provides home based and residential care for people with mental illness. It is the only group doing so in rural northwest Iowa. The Okoboji facility’s history goes back to the early days of this century. It’s an old-school stone house first known as the County Home.

The Pride Group took over from Oak Haven in 2010, and signed a lease and agreement to provide services through 2020 in the facility. There’s no word yet on any mitigation of the loss to this area caused by The Pride Group pulling out early.

Spokespeople for The Pride Group cited changes in Medicaid and inability to recoup costs as reasons for reducing their capacity at a time when community-based care must increase.

Don’t forget, Gov. Branstad closed the two state residential facilities last year, and privatized Medicaid, leaving countless people scrambling to receive needed treatment for a variety of issues.

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When you close the institutions, a lot of good things happen: people live on a human scale in their own communities, with a lot more independence and dignity, for one.

But without the community based supports, the boundaries that keep people with mental illness and the people around them safe blur, and there’s no one to help until the police get involved.

Local police departments in Iowa are overwhelmed because of the lack of mental health beds. If an officer is called to the scene of a disturbance, and they identify a person as needing mental health care, it’s not that the officer isn’t fine with transporting the person to the hospital. It’s that once there, the officer must stay with the person until a facility has taken over custody.

The officer stays in the ER as security until a bed is located and the person is being transported there. It’s hardly ever available in the local hospital. The ER staff calls. And calls. All over the state. The officer waits. For hours. Sometimes a whole shift, then relief takes over. There isn’t much the ER can do for someone with suicidal thoughts, or who is having intrusive thoughts due to schizophrenia. The person needs a psychiatric evaluation.

In the small town there aren’t any psychiatrists. Here, they’d call someone in from 50 miles away, if they’re not on call somewhere else.

When they find a bed, it’s sometimes across the state, in a place the person has never heard of. Or a larger city they’ve never been to. You may think it doesn’t matter if they’re only going to be there while they’re inpatient anyway.

But how is their family supposed to visit when they’re 200 or more miles away?

They can’t talk to their own therapist, if they have one.

Their clergy person can’t visit (note: in the experience of people I know, most clergy do not visit the psychiatry floor anyway, but that’s an issue for another post).

If you’ve ever been in a strange town surrounded by strangers, remember how that feels. Then imagine how it feels if you’re so depressed you want to end it all, if you’re not in control of your thoughts. If your emotions are out of control. If your anxiety is through the roof.

Do you trust these strangers who tell you the medicine they’re giving you will help you feel better? They don’t have to consult with your doctor or team back home. They may not listen if you say you tried that med back home and it didn’t work right with your system.

On this World Bipolar Day, another light has gone out, one which was by no means fancy or even necessarily the most healing environment, but it did save lives, it did keep people safe and indoors who couldn’t manage to do that on their own.

#ThanksTerry for taking funds from those who most depend upon it and giving it to your wealthy friends.

I hope, as you leave to become ambassador to China, you treat Americans there better than you treated your Iowa consituents.

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New Media Journalist, writing plays under the pen name Ash Sanborn.

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