CEDAR RAPIDS — Dr. Alan Whitters knows the mental health care system in Iowa is struggling.
There aren’t enough inpatient psychiatric beds, and so often patients are boarded in the hospital’s emergency department, meaning they’re staying in the ER for more than four hours at a time. That’s not an effective use of the patient’s or hospital’s time, he said.
“We stabilize our patients and they shouldn’t be discharged, but they have nowhere to go,” said Whitters, medical director of behavioral services at Mercy Medical Center.
He was talking with former U.S. Rep. Patrick Kennedy, D-Rhode Island, who was in Cedar Rapids on Wednesday for a mental health care roundtable and to promote presidential candidate Hillary Clinton’s mental health care plan at the Cedar Rapids Public Library downtown.
Kennedy led the discussion that included nearly 30 mental health advocates, providers, law enforcement and local officials.
“For those of you who this issue is very important, I am entirely with you,” Kennedy said. Kennedy, a mental health advocate and son of the late-Massachusetts Sen. Ted Kennedy, sponsored the 2008 Mental Health Parity Act, a bill requiring most health plans to have reimbursement rates for mental health services similar to physical illnesses.
He discussed a wide range of issues with attendees, the over use of jails at mental health facilities to the lack of psychiatric beds at hospitals.
A Treatment Advocacy Center report out earlier this summer ranked the state last for the number of state psychiatric beds per capita — 2 per 100,000 residents. More than two-thirds of Iowa counties don’t have a practicing psychiatrist, and there are only a handful of psychiatric residency slots at the University of Iowa Hospitals and Clinics.
“It’s my responsibility to run the county jail and that makes me the largest provider of mental health in the county,” Linn County Sheriff Brain Gardner said. “You don’t need me to tell you we aren’t designed to do that.”
Because of Linn County’s size, he has more resources than smaller counties, including doctors and nurses who are able to treat inmates, he added.
“Having said that, my folks are unfit to be dealing with this,” Gardner said.
Kennedy said the closure of two of the state’s mental health institutions by Gov. Terry Branstad in 2015 shifted tax dollars rather than saved tax dollars, pointing out those individuals are likely to end up in jail or the state’s hospitals’ emergency rooms.
“All those costs are dramatic and they add up,” he said.
Clinton’s plan calls for integrating mental and physical health care and increasing community-based treatment opportunities; promoting early diagnosis and intervention; enforcing current mental health parity laws; training law enforcement to deal with people with mental health issues; and investing in brain and behavioral research.
“I’m so excited — as someone who is an advocate for mental health — that there is such a crystal clear choice,” he said.