Policy Letter

Andrea S. Pratt
University of Saint Mary

April 5, 2015
The Honorable Governor
1007 East Grand Avenue
Des Moines, Iowa 50319

Dear Governor Terry Branstad,

As a health care professional and constituent, I urge you to not close or decrease mental health
facilities, mental health hospital beds, and access to mental health services throughout the state.
The juvenile home in Toledo was closed without warning in January of 2014. Now, the Clarinda
and Mount Pleasant facilities are closing.
The financial part was frustrating as the funding was approved in the budget for the juvenile
home, then it closed. Where did that funding go? Now, from an unidentified source, the funding
for the Clarinda and Mount Pleasant facilities will be going to the Cherokee and Independence
facilities. According to the proposed budget released by the Governors office, the funding does
increase for both facilities remaining open by approximately what will be saved by closing the
other two. What are we saving? According to an article posted by the Associated Press on the
Heartland connection site, there is no funding available in the proposed budget for the two
facilities that are closing as it has been removed.
I understand the need for reform and restructuring the mental health services in Iowa. This takes
money, realignment of services, and resources. According to Brothers (2014), since the redesign
has taken place effective July 1st, 2014, there has been a lot of positive comments with hopes of
more services entering the areas that have not had services or limited services. Brothers (2014),
also, lists the shortages remaining that will affect services now and in the future of a lack of
psychiatrists and new beds in the state as well as the country. Also, noted by Brothers (2014) is
the shortage or underfunding of mental health services through the years and remains so at this
time.
According to the Treatment Advocacy Center (2012), the availability of psychiatric beds in the
state of Iowa was 4.9/100,000. There was a strong statistical correlation between the number of
public psychiatric beds per 100,000 population and per capita state hospital expenditures by state
(r=0.622, p<0.001), (Treatment Advocacy Center, 2012). According to the Treatment
Advocacy Center (2012), the consequences of hospital bed closures providing an insufficient
number of public beds for the treatment of seriously ill psychiatric patients include an
increasing:

Number of mentally ill individuals in hospital emergency rooms waiting for psychiatric
beds;
Demand on police and sheriffs who, for all intents and purposes, become frontline
mental health workers;
Number of mentally ill individuals in jails and prisons; and
Number of acts of violence, including homicides, committed by mentally ill individuals
who are not being treated;

 Number of mentally ill homeless individuals.

So, the Treatment Advocacy Center (2012) states the following:
We are calling for a moratorium on further public hospital bed closures until a sufficient
number of psychiatric beds for acutely and/or chronically ill individuals is available either in
state hospitals or community facilities.
As a mother of a child with 100% mental disability, these changes are disturbing. Through the
years of seeking treatment, we have seen firsthand the lack of services, lack of funding, and lack
of beds for mental health. The big push was for everyone to be in a community based
environment. That is fine for those with the support to function. Our son was not able to do so.
He is, finally, having stability after two years of being shuffled from one company to another to
facilities to hospitals to jails and back again. He has had to wait for hours in an emergency room
while a psychiatric bed was found in the state. One time he waited for almost 24 hours, then was
released as the acute episode had passed. Our story is not isolated or unique to the road travelled
by those seeking mental health services for loved ones or themselves.
So, I am asking for you to reconsider the closing of further mental health beds, services, and
support in the community until adequate places are secured for the mentally ill. This includes
adequate funding, staffing, training, and availability of services for everyone in need. Iowa is
reflected as a state with less support than average in the country. Why? Please take into
consideration the information presented and how it affects everyone.
Sincerely,
Andrea S. Pratt
BSN, RN, MSN student at the University of Saint Mary
907 Arlington Drive
Marshalltown, IA 50158
641-753-4704

References

Associated Press (2015). Iowa Senate panel OKs bill on state mental health facilities. Retrieved
from www.heatlandconnection.com/news/story.aspx?id=1171746#.VSHpLPnF-T9
Brothers, J. (2014). A regionalized redesign of mental health services in Iowa. Retrieved from
https://nonprofitquarterly.org/policysocial-context/24940-a-regoinalized-redesign-of
mental -health-services-in-iowa.html
Iowa Department of Management (2015). Iowas program and budget fiscal years 2016-2017.
Retrieved from www.dom.state.ia.us/index_files/FY2016_BudgetinBrief.pdf
Treatment Advocacy Center (2012). No room at the inn, trends and consequences of closing
public psychiatric hospitals 2005-2010. Retrieved from
tacreports.org/storage/documents/no_room_at_the_inn-2012.pdf