'Overwhelming Loss:' Rural Iowans Brace For Mental Health Needs In The Wake Of The Derecho

When the derecho slammed into the state one month ago, many Iowans were already struggling with extreme stress. Accessing mental health care can be a major challenge in rural Iowa in the best of times. Some local leaders worry the devastation of the storm will push some even closer to crisis.

When the derecho hit on August 10, Juliana Kibbie Reisner was already grieving.

About a year ago, her mom got a terminal cancer diagnosis.

Reisner quit her job as a school counselor and moved back to her hometown of Palo, outside of Cedar Rapids, to take care of her mom.

She passed faster than anyone expected.

“I never thought I would be 50 years old and be the oldest generation in my family, you know?” Reisner said. “I have no grandparents. I have no parents. I wasn’t prepared for that. And you deal with it.”

Soon came the coronavirus pandemic, taking away so much from so many. And then a little over a month ago, the storm.

Like many Iowans, Reisner was caught off guard by the derecho, which has been compared to an in-land hurricane and packed winds estimated at 140 miles per hour.

She rode it out in her car. Her 13-year-old son was home alone, sheltering in the basement.

Ultimately Reisner and her two kids, the cats and the dog all made it out okay.

They have a roof over their heads, after moving out of their storm-damaged rental home and into an even smaller rental.

They’ve crammed everything they could salvage into the two bedroom home. Among the things that were lost were some of Reisner’s mother’s belongings, cherished items she was not ready to let go of.

The other night, Reisner said she broke down, when she heard a vase shatter.

“I picked up the glass and swept it up and I just, just cried. I just cried,” she said. “Sometimes it's overwhelming when you think of everything that you lose, you know?”

After working as a teacher and school counselor for two decades, Reisner says she knows the value of asking for help.

And she says she’s doing okay. But so many are not, especially in rural Iowa.

“The initial shock is over. But the long-term effects…which, I think in a lot of cases is going to prove to be more devastating,” said Steve Meyer, chair of the Benton County Emergency Management Commission. “Lot of worry about people's mental health.”

He said he’s particularly concerned aboutfarmers, many of whom have suffered in recent years from low commodity prices, negative farm income and a tariff war. Research published in The Journal of Rural Health has shown that between 1992 and 2010, suicide rates for farmers were higher than all occupations.

“They're dealing with multiple issues,” Meyer said. “A typical farm may have been there in one family for over 100 years. And they have worked for over 100 years to build that farm up. And in half an hour it's gone.”

According to the Centers for Disease Control and Prevention, Iowa’s suicide rates have significantly increased over the past two decades, at rates even higher than most of the rest of the country.

Stephen Beck sees the need for mental health care firsthand as the city administrator of Belle Plaine in Benton County.

“That’s our number one problem,” Beck said. “There's a lot of pain here and it leads to substance abuse and any other kind of abuse. And you can’t…I don't care how many Busch Lights you drink, you can't take that pain away.”

He says sometimes people come to him when they don’t know where else to go.

“People come into City Hall, and they say, ‘I'm suicidal’. They say…I've had three people come in here and tell me they were suicidal. And they know I'll listen to them and they know I will try to get them help,” Beck said.

When that happens, Beck says he calls his friend Shelby Chekal, who grew up in Belle Plaine and is now a crisis counselor with Foundation 2, a Cedar Rapids-based human services agency.

She works out of the Benton County Rural Access Center and responds to 911 calls alongside law enforcement officers, as well as whatever else comes up, like a call from Stephen Beck.

“He's always been very good at calling me to say, ‘hey, somebody is up here right now. Where are you? Can you get here right now?’” Chekal said.

So much of Chekal’s work is helping people when they are in crisis. She says it can be very difficult for rural Iowans to get help before they reach that point.

According to the Kaiser Family Foundation, roughly half of all Iowans live in a mental health care professional shortage area.

Pastor Kate West of the First Congregational United Church of Christ in Belle Plaine says she’s worried about residents who don’t open up about their needs, but may be struggling mightily in silence.

“Everyone does the ‘Iowa Nice’ thing, you know? We take care of ourselves,” West said, speaking generally about residents’ stubborn resilience after the storm.

“It factors in with farmers and their mental health. They will sit there and make sure their spouses and their kids are taken care of and the farm will be okay with buildings. And they'll just walk into a field and not come back,” West said.

When residents do ask for help and seek out treatment, Chekal says services in Benton County are very limited, with many patients forced to look outside of the county for care.

Yet she says many don’t have transportation to make the trip to Cedar Rapids to see a provider, or even a way to do a telehealth appointment.

“A lot of folks don't have smartphones. They don't have any phones at all. And so we spend a lot of time trying to track those people down,” she said. “We'll let them use our phones, we'll let them use our computers, just to get that initial appointment.”

It can be a difficult process, but Chekal and her colleagues are eager to help. She says she is seeing more Iowans reach out when they’re in crisis, and that gives her hope.

“People used to not reach out when they were suicidal. They would end up dying by suicide without a warning,” Chekal said. “And so the fact that these people are coming into a public building saying, ‘hey, I'm struggling here, and I need some help’, that's why I'm here, is to save those lives.”

If you or someone you know is in crisis, there is help available. Call the National Suicide Prevention Lifeline at 800-273-8255.

Help is also available from Your Life Iowa, by calling 855-581-8111, or by texting 855-895-8398.

Crisis counseling services specifically catering to those impacted by the covid-19 pandemic or the derecho are available at covidrecoveryiowa.org.