We read all the time about how the landscape of mental and behavioral health care is not keeping up with the need in the United States. Compared to a few years ago, we now see a serious lack of psychiatric hospital beds, higher numbers of mental health diagnoses, and higher patient-to-provider ratios. These are further exasperated by a decreasing provider pool, and emergency departments and jail facilities that are forced to act as makeshift, extended-stay mental health institutions.
Iowa Department of Corrections Research Director Lettie Prell indicated in November 2016 that 57% of the Iowa prison population has at least one chronic mental health diagnosis (dementia, schizophrenia, bipolar disorder, etc.). This percentage has increased each year since the 2008 State of Iowa Systemic Study that was completed by Shive-Hattery employees (while employed with another firm).
At Shive-Hattery, we hear about these challenges first-hand as our healthcare and government clients struggle to find answers. Because caring for those with mental and behavioral health diagnoses impacts so many different sectors – healthcare, detention/corrections, judicial, and government agencies – we wanted to bring these parties together for an open, honest, interactive discussion about the issues at hand.
On Dec. 6, 2016, representatives from the following organizations and agencies gathered in West Des Moines, Iowa, for a roundtable to discuss ways to partner in addressing mental and behavioral health challenges:
Several local mental health advocates were also present. The roundtable’s goal was to discuss the current state of behavioral health in Iowa and beyond, as well as the most challenging issues that await us and what we see for the future of behavioral health. By bringing the healthcare and corrections communities together, we wanted to find common ground in terms of not only the questions we all face, but possible solutions.
- Broadlawns Medical Center
- Clinton County Justice Coordinating Commission
- Iowa Department of Corrections
- Iowa State Sheriffs’ and Deputies’ Association
- Iowa State University
- Mary Greeley Medical Center
- Mercy Medical Center – Des Moines
- Polk County Supervisors
- Shive-Hattery Architecture and Engineering
- UnityPoint Health – Des Moines
- University of Nebraska Omaha, School of Criminology and Criminal Justice
During the roundtable, it become clear: No matter your organization or your role, everyone is impacted by mental health issues. In fact, Former National Institute of Mental Health Director Thomas Insel indicates that mental health issues cost United States taxpayers at least $444 billion each year.
Although we certainly don’t have the answers, we realize that many of the country’s aging healthcare and government facilities aren’t designed for new mental health regimens, practices, and acuity levels. Adequate facilities and resources are key to answering questions like those discussed in the roundtable:
Shive-Hattery plans to publish a white paper that will present significant takeaways from the roundtable, hospital and government case studies detailing current mental/behavioral challenges and potential solutions, as well as the importance of healthcare and government entities working together to improve mental and behavioral health services across the country. We believe that the ultimate solution involves collaboration among all parties impacted by the current state of mental health and will involve healthcare and government entities working together to improve mental and behavioral health services across the country. As one roundtable participant indicated, "individuals with behavioral health disorders have a multi-system impact that requires a multi-system response."
- Is the current system working?
- What is the best environment in which to treat mental health?
- Community outreach/residential centers
- Crisis intervention centers
- Detention and correctional settings
- Are there proactive approaches and alternative treatments to keep mentally ill individuals out of detention settings?
- How can more providers be recruited to our communities?
- Are there national initiatives that can help?
- How can money be better spent to improve outcomes?
- What new care models can be implemented?
The roundtable discussion gave us a deeper understanding of the challenges we all face, how to facilitate future dialogue on the topic, and ideas for charting a path together toward an improved delivery system. We extend huge thanks to everyone who participated.