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UIHC eating disorder program to end residential inpatient services

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As health care providers look to provide more resources for acute mental health needs, "difficult" cuts are made to services at the UIHC's Eating Disorder Program.

Content warning: This article includes information about eating disorders and treatment, as well as makes mention of self-harm.

July 20 was supposed to be a normal day. April Bannister had just moved into a new apartment in Iowa City. Her job with AmeriCorps had just begun two days prior. She decided to use her lunch break to go for a required therapy session.

Bannister has anorexia. According to the National Institute of Mental Health, it's an eating disorder characterized by a significant reduction in food intake leading to extremely low body weight and an intense fear of gaining weight. Survey data shows just over 30 percent of women with anorexia nervosa, its full name, seek treatment during their lifetime.

Bannister was in treatment. She had an outpatient team at the University of Iowa Hospitals and Clinic's Eating Disorder Program that included experts on nutrition and mental health and eating disorders themselves. While friends were beginning to ask her about her lower-than-normal weight, she said she felt normal when she entered her therapist's office.

"She has to weigh me and that was out of the ordinary," Bannister said. "I remember thinking my weight was going to be low and that would be trouble."

Deeming her low weight a health risk, she had Bannister committed for inpatient care at the UIHC. This was her seventh time, her second involuntary. On Tuesday, Bannister told IPR in a call that she was still in the inpatient program and had learned she'd be one of the last in the Eating Disorder Program to receive residential care.

The University of Iowa Hospitals and Clinics is ending its Eating Disorder Program’s residential care this fall. The program has provided intensive residential treatment for individuals 16 and older managing an eating disorder. It is one of the few places in the country with a medical psychiatry unit that addresses both mental and physical health concerns. But the hospital system said it’s redistributing funding to take on the growing numbers of Iowans with acute mental health care needs.

"It is always difficult to decide how to allocate limited resources, and the decision to make changes to the Eating Disorders Program was not made lightly," said Laura Shoemaker, a spokesperson for the UIHC in a written statement. "Overall, this decision will allow UI Health Care to serve the greatest number of Iowans with acute mental health care needs."

Inpatient care will remain available through the program's Eating Disorder Program’s partial hospitalization program or through being admitted as a patient to a behavioral care unit, Shoemaker added.

Over the summer, Gov. Kim Reynolds signed a bill aimed at addressing a shortage of mental health professionals which set up a loan repayment program for students who agree to work in an underserved are of Iowa after they get a degree in the mental health field. Another bill allowed a state board to issue provisional licenses to doctoral students in psychology, allowing them to practice during their internship with a licensed psychologist.

That still leaves fewer than 600 mental health beds for Iowa's 3 million people. The state did call for the creation of regional mental health crisis access centers, which would in theory take some of the load off of the state's system of mental health beds. But since the Legislature passed the bill in 2018, only two of those centers have opened.

UIHC said the Eating Disorder Program will continue providing intensive partial hospitalization, as well as outpatient services. People with eating disorders who require acute medical treatment will continue to receive inpatient services at the hospital.

"It’s terrifying quite honestly," Bannister said. "This program, while it has its issues, does save lives. It has saved my life on more than one occasion. It’s saved my life seven times: each time that I’ve been admitted."

As of Wednesday morning, the petition to "Save the Eating Disorder Program at University of Iowa" on change.org had garnered over 6,000 signatures. Bannister pointed to the comment section includes testimony from former patients and their close family and friends.

"My beloved niece almost died of anorexia. The U of I is the reason she survived. This program cannot be stopped," wrote Charlotte Farago.

"The UIHC saved my life. I would be dead if it weren't for the inpatient EDO unit. I am terrified for the future if a relapse were to occur," wrote Michaela Hoeger. "I've tried going out of state for treatment, but I'm always denied because of my insurance. The UIHC is my only option!"

The National Institute of Mental Health calls eating disorders "serious and often fatal illnesses." There are many symptoms, not of all which need to be present to be dangerous.

The National Eating Disorders Association offers support, resources and treatment options for yourself or a loved one struggling with an eating disorder. You can call or text 800-931-2237 or get more information from https://www.nationaleatingdisorders.org.

Editor's note: This story was updated at 10:10 a.m. on Sep. 9 to clarify that it is only the Eating Disorder Program's residential program that is ending.

Zachary Oren Smith is a reporter covering Eastern Iowa
Natalie Krebs is IPR's Health Reporter