Iowa families often unsure where to turn for mental health care

Center Focus

Iowa families often unsure where to turn for mental health care


by Mary Nelle Trefz
Health Policy Associate

If a child falls on the playground and hurts her arm, her parents or caregivers probably know where to go for medical care and what will likely be done to diagnose and treat her injury. But if that child has a mental health issue? Often families and caregivers don’t know where to turn or what to expect. 

This gap has many causes, but an important one—and one many Iowans are surprised to learn—is that Iowa does not actually have a comprehensive children’s mental health system. Oversight and provision of mental health services for kids are scattered across multiple sectors and agencies. Some are in the Department of Human Services; others in the Department of Public Health; still others in the child welfare or juvenile court systems. 

Families are left to navigate a fragmented system, often not knowing how to find a provider or whether their insurance will cover the treatment. Services available to a child in one part of the state may not be available to another child somewhere else. 

Legislators created a workgroup in 2015 to tackle this crisis. Since then the Children’s Mental Health and Well-Being Workgroup has focused on components that would comprise a children’s mental health system, including prevention, early intervention and crisis response. The workgroup requested funding from the legislature to pilot innovative strategies through competitive grants.  

DHS in 2016 awarded grants to two agencies to plan and implement children’s mental health crisis services. Private foundations funded a third crisis planning grant. Independently, these initiatives all came up with similar recommendations: 

  1. A single phone number for parents, teachers or law enforcement to call when a child has mental health crisis.
  2. A pediatric mobile crisis team, including two mental health providers – one focused on the child and one on the family/adults
  3. A place that is not an emergency department for a family to go when a child is having a mental health crisis, with staff to help to stabilize the situation and connect the family with resources before they leave.  

The workgroup is using findings from these crisis planning grants to inform its next set of recommendations, and we expect to hear about those in coming weeks. 

Mental health activity this week at the Capitol 

  • HF 2176 passed out of subcommittee Thursday. This bill would require school employee training and protocols relating to suicide prevention and trauma-informed care. Subcommittee members heard powerful testimony from parents who lost children to suicide. One parent urged legislators to move the bill forward, saying, “We can’t wait any longer—there are children hurting right now, and schools don’t know how to help them.” The bill goes to the House Education Committee Monday, Feb. 12. 
  • The Health and Human Services Appropriations Subcommittee got good information this week on current efforts to improve access to mental health services. They heard a presentation Wednesday on workgroup recommendations for serving individuals with complex service needs. That came from Rick Shults, administrator of DHS’s division of Mental Health and Disability Services, and Kathy Stone, administrator of the Public Health Department’s division of Behavioral Health. 
  • On Thursday, subcommittee members heard from officials in the Department of Psychiatry at the University of Iowa on physician training related to mental health. The presentation highlighted some challenges Iowans face accessing mental health services, especially outside major metropolitan areas. There are only 225 psychiatrists in all of Iowa—fewer than 4 percent of all physicians—and two-thirds of them work in one of three counties: Johnson, Linn and Polk. When it comes to specialized mental-health services for children, the numbers are even worse—there are only 31 child psychiatrists in all of Iowa.  
02/09/2018 4:20 PM |Add a comment
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