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UI officials to discuss Iowa's mental health care situation at Wednesday's Board of Regents meeting

BY STACEY MURRAY | MARCH 11, 2013 5:00 AM

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The University of Iowa Carver College of Medicine is working to fit the needs of the state’s insufficient mental-health care with progressive programs while the Iowa Legislature tries to pass funding for an overhaul of the state’s program.

“The system is underfunded, and more funding would allow for a more comprehensive program — that’s a good thing,” said Professor James Potash, the head of the UI Psychiatry Department.

Potash will present a report Wednesday to the state Board of Regents regarding the progress and direction of mental-health programs at the UI.

Iowa ranks 48th in the United States in its number of psychiatric hospital beds per capita, with 4.9 beds per 100,000 residents. In order to provide optimum care, officials estimate the state needs 50 beds per 100,000 residents.

Roughly 26.2 percent of adults in the U.S., 81.6 million people, suffer from a mental illness, according to the National Institute of Mental Health. According to the UIHC presentation prepared for the regents, there are an estimated 184,000 individuals with a serious mental illness in Iowa, roughly 6 percent of the population.

Along with this vast need, mental health in Iowa continues to face insufficient care.

Sixty-six counties in Iowa do not have a psychiatrist available. Johnson County leads the state with 67 psychiatrists followed by Polk County with 41, highlighting a gap in the state’s care abilities.

“There are more people seeking care here than there are providers able to give the care,” Potash said. “A big part of the reason for that is that there isn’t enough mental-health expertise in and around our state.”

According to the UIHC presentation, the admission rate for mental health care is extremely high. There are currently 586 kids on the waiting list for the child care clinic, and 412 adults waiting to be treated.

But government action might help Iowa residents seek assistance.

Potash said if the state Legislature passed Medicaid expansion, it would greatly benefit mental-health care. Currently, IowaCare, the health-care program provided by the state, doesn’t fund mental-health care.

Potash estimates the state would need to provide $80 million to $120 million to provide a state-of-the-art system. He said while there has been some progress, work still needs to continue.

With these needs growing, UI professors have taken on projects to better care for the current influx of patients.

Officials said they’ve contemplated adding a neurosciences institute. It would integrate psychiatry, neuroscience, and aspects of other departments that would allow the UI to create an interdisciplinary care program.

Patients with intellectual disabilities face a complex set of issues regarding mental health and would benefit from an interdisciplinary care such as behavior psychologists.

Alison Lynch, a UI clinical associate professor of psychiatry, works with programs to integrate family medicine and teach primary-care physicians to manage mental-health problems in places where psychiatrists aren’t available. 

“Many people have to travel to get mental-health care,” Lynch said. “That’s one of the reasons family care is appealing. They know about you and they take care of your health, so it can be a very holistic thing.”

Carolyn Turvey, a UI associate professor of psychiatry, has begun work with a program titled Transitional Care. This program cares for mental health and internal medicine, among other branches, to increase and emphasize care once patients have been discharged from the hospital.

This grant-based program provides social workers and nurses to help patients in the hospital.

“When people are discharged from the hospital, communication after can be poor,” Turvey said. “This grant provides resources and energy into transition into the community and help them if they can have remaining symptoms.”

While the UIHC continues to combat the growing need, Potash remains confident in the hospital’s ability to better care in the state.

“I think we are going to make progress by creating access on one hand but doing the better treatments on the other,” he said.


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