Kim Reynolds’ integration plan aims to improve mental health services in Iowa
Gov. Kim Reynolds has proposed consolidating them into seven unified regions that would separately manage behavioral health and substance use services.
As state officials and lawmakers begin working to shore up Iowa’s mental health and substance abuse care systems, new research released this week highlights just how dire the situation is in many Iowans.
Iowa ranks last in the United States for the number of psychiatric beds per resident, according to a new report released Wednesday by the Treatment Advocacy Center.
The report states that by 2023, the state will have 64 state-managed inpatient beds, or just 2 beds per 100,000 residents, ranking Iowa 51st on the list of 50 states and the District of Columbia.
According to the Treatment Advocacy Center, 50 beds per 100,000 people are needed to provide “minimally adequate treatment” for people with severe mental illness.
“Iowa fails to meet this minimum standard,” the center said.
It is estimated that more than 84,000 Iowans suffer from serious mental illness, including schizophrenia, severe bipolar disorder and major depressive disorder. According to the Treatment Advocacy Center, approximately 35,000 people receive treatment each year.
The number of public beds in Iowa has not changed since 2016, when the center last released a national report on state psychiatric bed totals.
However, the total number of psychiatric beds in Iowa did drop by nearly 80 percent between 2010 and 2016, from 149 to 64, according to the Center for Treatment Advocacy. In 2007, Iowa had 223 psychiatric beds.
The new report comes as Gov. Kim Reynolds has made improving access to mental health care one of her top priorities this legislative session.
“Improving access to mental health care has been one of my top priorities since taking office,” Reynolds said in a statement to the Register. “While we have made mental health a priority, There is still more work to be done.”
Reynolds continued: “That’s why we are focused on building a complete system of psychiatric care, focusing not only on high-quality state psychiatric hospitals that meet the most complex needs, but also on private psychiatric hospitals, crisis services and outpatient care. We must also emphasize Early intervention and ongoing behavioral health require coordination across the continuum and ensuring Iowans receive the right care in the right place at the right time.”
Report: Healthcare workforce shortage plays major role in inpatient availability
The Center for Treatment Advocacy’s new report only counts state-run psychiatric beds, but advocates say private facilities don’t have enough beds either.
Iowa has a total of 905 licensed psychiatric beds across the state, including 813 beds at community hospitals and 92 at one of the state’s two mental health facilities, according to the Iowa Department of Health and Human Services. bed.
Only about two-thirds of those beds, or 676, are actually staffed, further limiting patients’ access to inpatient care, state data shows.
While a lack of inpatient mental and behavioral health care has plagued the country long before COVID-19, the Treatment Advocacy Center says the pandemic’s impact on health care workers across the country has exacerbated the problem.
“The U.S. health care workforce is experiencing severe shortages, and the mental health care system is not immune, with many states currently having many beds unavailable for patients because there are not enough professionals to staff them,” the report states.
A whopping 94% of states reported that their state hospitals are facing staffing shortages, resulting in 15% of beds being closed due to a lack of medical staff to provide care, the report said.
Researchers found that the problem was largely caused by budget constraints that did not allow public hospitals to offer the same competitive wages that private institutions were able to offer their employees.
A report from the Treatment Advocacy Center states that the total number of public hospital beds nationwide will reach a “historic low” in 2023, with an average of 10.8 beds per 100,000 people.
Kim Reynolds’ proposed merger would be ‘game-changing’, some backers say
Supporters say a proposal by Reynolds and the state’s Health and Human Services agency to consolidate Iowa’s behavioral health and substance use regions could address a shortage of services where mental health needs are highest in Iowa.
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“Connection and integration of mental health and substance use disorder systems will be a game changer for Iowa,” said NAMI Iowa Executive Director Ryan Cane.
Iowa currently has 13 mental health regions and 19 substance use regions across the state, which were created to provide care to Iowans within the region. These areas are governed by local councils.
Reynolds proposed consolidating the 32 districts into seven unified districts that would separately manage behavioral health and substance use services. The Iowa Department of Health and Human Services will oversee the effort and contract with local administrative services organizations to manage the seven regions.
Reynolds noted during his 2024 State of the State address earlier this month that more than 25% of adults with serious mental health issues also face substance use disorders, but there is “little coordination” between mental health and substance abuse districts. .
“Through Behavioral Health System Alignment, we will align Iowa’s fragmented local service model for substance use and mental health care into a streamlined structure that supports improvements across the state for all Iowans,” Reynolds said in a statement. Access to care for Washingtonians.”
Reynolds and state officials have proposed increasing Medicaid payments for behavioral health care, including inpatient psychiatric care.
Reynolds said the adjustment would also require refocusing care in state mental health agencies on care for behaviorally complex youth and offenders, as well as increasing access to outpatient behavioral health services through certified community behavioral health clinics.
Providing services for children with mental health issues was a central point in Reynolds’ State of the Nation speech and subsequent statements on the issue.
She highlighted programs such as Ember Recovery Campus, a new YSS residential treatment program for Story County youth ages 12-18. Once it opens later this year, the facility will have 70 beds for crisis stabilization, emergency shelter and substance use disorder treatment.
“We make schools places of service,” Reynolds told The Iowa Press last week. “We’ve increased funding for behavioral health providers. We’re looking at the mental health space to make sure we’re actually efficient and effective. Again, we’re getting those funds on the ground and flowing to people.” “People need it and have access It. I’m proud to highlight the Ember Recovery campus.”
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Mental health advocates appear to agree that the move could address the current silos in behavioral health and substance abuse treatment in Iowa. Kane of NAMI, the Iowa chapter of the National Alliance on Mental Illness, said the organization’s advocacy focuses on increasing resources for those who suffer from both substance use disorders and mental health issues. This includes inpatient treatment programs and acute crisis stabilization.
“We believe this proposal has the potential to address areas of need across the continuum of care — from prevention to intensive treatment to recovery,” said NAMI Iowa’s Cane.
“While this proposal is still new, we support the goals set out by DHHS: ensuring Iowans have access to the same behavioral health services regardless of where they live in the state and eliminating administrative redundancy and duplication of services,” Kay En said.