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UI should aid displaced Linn County mental-health patients

BY DI EDITORIAL BOARD | OCTOBER 25, 2011 7:20 AM

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With recent changes in Linn County, the University of Iowa must try to extend its mental-health resources more than it does.

The Linn County Board of Supervisors' approval of the first round of Mental Health and Developmental Disabilities cuts will result in an influx of patients developmentally and mentally disabled patients in nearby Johnson County.

Mental-health services are invaluable, especially to those who don't have the financial means to ensure their own treatment. Iowa City and the university must make efforts to accommodate any displaced patients at prices they can afford.

This first round of cuts, approved by the county's Mental Health and Developmental Disabilities Advisory Board and totaling $2.3 million, mostly affects residents of Marion's Abbe Center for Community Care. The plan will necessitate the shift of nearly 100 residents from the care facility to smaller, local group homes such as the Abbe Center.

"There just isn't any more money, so Linn County is simply looking for other services that could cut down" said Stephen Trefz, the executive director of the Community Mental Health Center in Iowa City. "When people are moved out of a care facility to smaller units, the cost is shifted from the county dollar to the federal dollar."

Along with the cuts to mental-health facilities comes an altered state of supply and demand. While there will be fewer programs facilitating treatment, less funding for care provisions, and a subsequent decrease in efficiency and capability, the number of patients seeking care will most likely remain relatively constant. This trend will create a system of prioritization — in which wealth will become a deciding factor in who can be treated and who cannot. Budget cuts in the department will ultimately mean not enough — or not equal — treatment for everyone. Creating a system in which a lack of available funding places limitations on health treatment for those with less financial success isn't only a temporary solution to an issue, it's also un-American.

According to the Agency for Healthcare Research and Quality, 22 percent of American households include at least one child with special mental-health needs. Of this number, low-income and minority families account for higher rates of children mental health disabilities. In a study of Midwest cities, the agency notes that of those with mental-health needs, 98 percent receive, at some point, mental-health treatment.

It's important to realize, when examining this particular issue, that mental illnesses are biologically based disorders of the brain. According to the National Alliance on Mental Illness, mental-health illnesses "cannot be overcome through 'will power' and are not related to a person's 'character' or intelligence." To force the displaced residents of the affected facilities to find alternative care on their own would be an ignorant and callous contention.

"It's just unfortunate that the clients are the ones that must experience displacement or discontinuity of care," Trefz said.

Cuts to the Abbe Center would significantly lower not only the number of residents but also jeopardize the centralized care and quality of care for the residents, for those remaining and for those displaced. By sending residents of the facility to small group homes, the risk of malpractice and insufficient care is greatly increased, due in particular to isolation of cases and the reduced patient-caregiver ratio.

Lack of care today for the mentally and developmentally disabled could mean more time, effort, and money expenditure in the future. The lack of a centralized, county-funded facility for the management and rehabilitation of these patients could not only decrease the efficiency of the program, resulting in more long-term spending, but also, in turn, increase the severity of resident-specific mental and developmental ailments because of a lack of effective care. Ultimately, cutting spending on such a delicate scale will do more potential harm than good.

With such a substantial number of people in need of mental and developmental health care, it seems socially irresponsible and neglectful to implement budget reduction in Linn County. The question then comes down to a struggle between the ideals of a communal ethics and the concern of expenditure.

As an accredited medical-research institution, the University of Iowa can help minimize the detrimental effects of Linn County's unfortunate budget cuts. The UI can better facilitate unabridged, centralized care than almost any facility in the state.

Sacrifices have been made and will continue to be made. Until mental health care is prioritized to the extent deserved, the experts in the field will be looked toward to carry the burden of care. The UI has as many of experts as any institution in the state.


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