DHS agenda for Clarinda MHI?

 Dear Editor:

Several reasons have been put forth for closing Clarinda Mental Health Institute. Foremost is the cost reflected by the staff/patient ratio. What the governor and (DHS Director) Mr. Palmer aren’t talking about is their responsibility for the current cost and staff/patient ratio; over the course of several years they have downsized  patient beds and programs, reduced catchment areas and budgets to reach a goal of closing Clarinda MHI. Now that they have put it in a vulnerable position, they believe their goal has been reached. Now that we have a good idea who is responsible for the current crisis, the next question is…what were they thinking?

One rationale for downsizing and closing institutions has been the move to community-based services and “best practices.” The actions they have  taken have been seriously flawed and have resulted in negative consequences.  

First, anyone familiar with the history of Clarinda MHI knows Clarinda was once famous throughout the world for the “Clarinda plan,” and that Clarinda MHI served a key role in establishing community mental health centers. MHI also provided outpatient treatment to hundreds of patients over many years. Clarinda’s staff are among the most professionally qualified staff in the state of Iowa and provide “best practices” treatment on a consistent basis. One does not need to lease a different building or build one that is unlikely to match the quality of the historical and updated MHI building to provide “best  practices” treatment. One glaring negative consequence of downsizing that DHS has instituted has been the influx of substance abusers and mentally ill into the prison  population. Prison is appropriate for hard-core felons, but not for mentally ill and substance abusers who would benefit from other less-restrictive forms of treatment. 

As MHIs are closed, Department of Human Services can be expected to farm out more services for needy  Iowans to out-of-state for-profit companies who deliver sub-standard services at a high cost. So … inappropriate placements, denial of  treatment, loss of jobs, sub-standard services, increased cost to taxpayers, increased local cost for transporting patients, and a huge  economic impact are among the negative consequences we can expect with the closing of southern MHIs. 

What is the right thing to do? The right thing to do is to restore funding and beds so the needs of persons with mental illness and/or  substance abuse problems can be met. A ladder or continuum of treatment that includes inpatient, residential, outpatient, detox and community response  teams are needed to provide the appropriate level of treatment based on level and type of illness presented. No one treatment modality is right for every person. Removal of any level of treatment will result in incorrect placements or treatments that are less effective. Our legislators can stop the MHI closures. It has been done by legislators in the past. I am quite sure the governor has some pet projects he wants funded.  

These items can be removed from the budget unless he agrees to compromise and do what is needed to make the MHIs viable. Legislators can also override a line-item veto with a two-thirds majority, which needs to be done if compromise cannot be reached. This will indeed be a true test as to whether our local legislators can get the job done.

Randy Young