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Mental Health Advocates Applaud Progress But Raise Concerns About Proposed Children's System

children's mental health subcommitee
Katarina Sostaric/IPR
Nina Rickman tells lawmakers about challenges she faces in finding mental health services for her kids at the Iowa Capitol Wednesday, Feb. 27, 2019.

Lawmakers in the Iowa Senate advanced a plan Wednesday to start a children’s mental health system in the state.

Stakeholders said they support starting the system, but they have concerns about the need for sustainable funding, the bill’s lack of deadlines, and what some say is too narrow of a focus on children diagnosed with a severe emotional disturbance.

Republican Gov. Kim Reynolds submitted the proposal to lawmakers after receiving recommendations from an advisory board. It would start a children’s mental health system that aligns with the adult system, directing the state’s 14 mental health regions to provide similar types of services tailored to children.

It’s designed to serve Iowans under 18 who have been diagnosed with a severe emotional disturbance.

Orchard Place CEO Anne Starr is concerned about that.

“We can’t answer a crisis line and dispatch mobile crisis teams only if a family says, ‘We already have this severe emotional disturbance diagnosis,’” Starr said. “The point is, you’re trying to bring these kids in and get them connected to the appropriate services, and so they probably won’t have that diagnosis—not every child.”

The family’s income would also have to be under 500 percent of the federal poverty level for their children to qualify for services.

Tammy Nyden said it “buys into the stigma that mental health is an issue that has to do with poverty.” She said her son was on a waiting list for government-funded mental health services for nearly three years.

“The only reason he got services before that was my ex-husband lost his job and went on Medicaid,” Nyden said. “My household would have never qualified and he would’ve waited two more years to get any services.”

Nyden added there are also several kinds of services that are not included in the bill, even though they have been recommended by mental health work groups over the years.

According to county and county supervisor associations, developing a sustainable source of funding remains a fundamental issue. Property taxes and Medicaid pay for the adult mental health system, and the local governments and regional boards that administer services say they need more flexibility.

Mills County Supervisor Richard Crouch said he supports starting a children’s mental health system.

“It’s something that we’ve needed for a long time,” Crouch said. “But to start a program without funding doesn’t make much sense to me.”

He asked lawmakers to not add to county budgets this year.

Mary Neubauer said before she lost her son to suicide, trying to find a way through the mental health system was "truly a labyrinth." She told lawmakers youth depression, anxiety and suicide rates are rising across the country.

“Here in the Capitol, momentum is a precious thing,” Neubauer said. “I beg of you not to delay implementation of this legislation, and at the same time come up with funding solutions.”

She said a children’s mental health crisis hotline and deadlines for regions to develop these services are critical.

Despite a wide range of concerns with the proposal, people packed into the Statehouse meeting Wednesday applauded when three senators signed on to advance the bill. Lawmakers said they would consider changes.

Reynolds said earlier Wednesday said the bill is a first step to creating a children’s mental health structure where none exists.

“What I’ve seen is we’ve spent two decades talking about how much we need one, but we’ve yet to take the first step in creating the system,” Reynolds said. “And that’s what this does.”

She said the legislative process is an opportunity to address concerns.

Katarina Sostaric is IPR's State Government Reporter