We are not beyond stigmatizing health problems
My sister-in-law, Susan, one of the strongest people I’ve ever met, couldn’t fight off a blood infection. She juggled not only my brother — a lifelong minister too often focused on lofty pursuits to be bogged down in the daily chores of living — but five children as well.
We buried Susan a few weekends ago and it was, as you might expect, an emotional ceremony.
At the same time Susan was in the hospital, another mother decided her life was no longer worth living. Beckie, who battled mental illness, first turned a rifle on her two adult sons before contacting a relative to say goodbye.
By the time law enforcement was alerted and arrived at the rural home, all three were dead.
The two men, who were brothers of my nephew’s wife, were buried that same weekend.
The juxtaposition of these two mothers and their lives remains startling. Both were struck down by diseases they could not overcome.
One family had every available medical resource at their disposal, while the other was largely left to fend for themselves.
As a society, I think we like to believe that we are beyond stigmatizing behavioral health issues. In small groups, however, we still point to subsequent tragedies with words like “crazy” and “nuts.”
We praise health care reforms that have lessened the burdens of pre-existing conditions, but mostly ignore our state’s lack of mental health professionals, treatment beds and waiting lists for care.
Over a three-year period, Iowa has transitioned to 15 mental health regions, each required to offer a baseline of mental health services. While the overhaul was done in part to address the previous county-based system’s inequities, it also is part of a national push to deinstitutionalize mental health delivery, providing a more community-based approach.
Unfortunately, and despite optimism regarding the new regions, community-based care is not yet a reality. About 40 percent of Iowans still live in areas underserved by mental health professionals. Even baseline, state-mandated services are at risk as Gov. Terry Branstad’s proposed budget strips about $46 million in promised funding.
These issues should come as little surprise to those attending recent legislative forums or other public meetings. Parents, many of whom lock themselves in their bedrooms as protection against violent teens, ask for help. Correctional officers have detailed their jobs a part law enforcement, part therapist. Having exhausted other local options, families discuss the challenges of taking elderly relatives with dementia into their homes.
Even before Gov. Branstad announced the defunding and closure of two of the state’s four mental health institutes, Iowans had too few beds for acute psychiatric treatment, dual-diagnosis and geriatric care. State officials point to existing community-based providers that lack the capacity or motivation to fill the gaps being created.
For a decade or more, Iowans have listened to platitudes about mental health services. Elected officials at all levels have promised to make such services a priority, pledged to drape a safety net over the system’s cracks.
Perhaps they just forgot to tell us about the holes in the net, big enough for a mother, two sons and countless others to fall through.
This column by Lynda Waddington originally published in The Gazette on Feb. 1, 2015. Photo credit: Cliff Jette/The Gazette