CLARINDA, Ia. –
State administrators are wrong when they say many patients at the state psychiatric hospital here could obtain similar services from private agencies in southern Iowa communities, mental-health professionals and patients alleged Saturday.
"I feel like my life depends on saving this place," declared James White of Clarinda, who has bipolar disorder and estimated he has been a patient at the facility 25 times over more than 20 years. He predicted that if the state closes the hospital, it will have to open more prison space for people whose lives go off track because their mental illnesses go untreated.
White drew raucous applause from more than 200 people who filled the facility's gym Saturday morning to give an earful to leaders of the Iowa Department of Human Services. The department plans to shutter the Clarinda and Mount Pleasant mental health institutes by June 30. Some inpatients would be shifted to northern Iowa, to the remaining state mental institutes at Independence and Cherokee. Others would be shifted to private agencies in southern Iowa, state leaders have said.
Ruth King of Clarinda, who described herself as mentally disabled, said it would be traumatic to be shipped away from southwest Iowa if she needs to be hospitalized. "I can't imagine traveling, maybe in handcuffs, that far and being in a crisis state of a mental illness," she said. She predicted patients would have to be drugged in order to make the hours-long trip.
Department of Human Services Director Charles Palmer told the crowd that new mental health treatment options are being considered as part of the statewide redesign of the overall system. He explained that new regional authorities, including the one that covers the Clarinda area, are considering opening short-term "crisis centers" or "step-down units." Those options offer effective, economical care in people's communities, he said. He also said that overall the state will have more inpatient psychiatric beds once services are consolidated at Independence and Cherokee.
Palmer said the Clarinda hospital now has 15 beds for adults with acute psychiatric illnesses, plus 20 beds for elderly psychiatric patients. It has 76 employees and an $8.5 million budget.
Local mental health administrator Mary Anne Gibson disputed Palmer's claim that southwest Iowa would soon have new private alternatives. Gibson is executive director of the Waubonsie Mental Health Center, which provides outpatient services. She said the new regional authority, formed under the state mental health redesign, is just getting started and is nowhere near opening a short-term crisis center.
Gibson told Palmer that even with improvements in outpatient psychiatric care, there still is a need for inpatient hospital beds to stabilize people with severe mental illnesses. Those beds should not be halfway across the state, she said. "I would urge you to consider how you would feel if your loved one with a medical problem had to be hospitalized 200 to 300 miles away," Gibson said.
Page County Sheriff Lyle Palmer complained that closing the Clarinda facility would force southwest Iowa sheriff's departments to transport more people to faraway mental hospitals for court-ordered evaluations. Rural sheriff's departments are already strapped, he said, and driving patients hundreds of miles away takes staff time that should be used to protect the public in their home counties. "We are not buses. We are not taxi services," he told Palmer.
Dr. Marin Broucek, a psychiatrist who works part time at the state hospital, said many patients in its geriatric unit are so difficult that they have failed in placements at 15 other facilities. She doubts many private facilities would welcome them if the state hospital closes.
Broucek was one of several speakers who countered Palmer's contention that demand for the hospital's services has dropped. The decline in use of the facility has been due to the state turning away prospective patients, the critics said. Broucek said many hospital emergency rooms are overrun with mental patients in crisis, because there are so few beds available in psychiatric units. "We need more mental health services, not fewer," she said.
Palmer, who held a similar meeting in Mount Pleasant last weekend, acknowledged how strongly Saturday's crowd disagreed with the closure plan that Gov. Terry Branstad has ordered. "I listened, and I heard," he said. He reiterated that patient and public safety would be the top priority as the changes are made.