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Packed Emergency Rooms Highlight Mental Health Care Needs in Iowa

U.S. Air Force Staff Sgt. Liliana Moreno

Days after her son Sergei died by suicide, Mary Neubauer and her husband Larry Loss, decided to publicly share their story.

“It was just heartbreaking for Larry and me, as his parents, to watch this vivacious funny loving outgoing kid just disintegrate in front of our eyes,” says Neubauer, “and no matter how much we helped, or how much we loved him, we just couldn’t stop it from happening.”

On this edition of River to River, Ben Kieffer talks with Neubauer about her family’s struggle to get Sergei the mental health care he needed.

“I realized that by the end of Sergei’s life, when he did take his own life, we were so frustrated because we had been living in that horrible situation and under that stress for months, if not years, and we hadn’t said anything,” she says, “and it just hit me that if none of us tell our stories, how do we ever expect other people to understand, to empathize, and to want to help?”

Sergei lived with anxiety and depression, as well as post-traumatic stress disorder due to abuse and trauma during his childhood, before he was adopted by Neubauer and Loss.

Neubauer says that while Sergei had a therapist, “It was obvious that Sergei needed long-term residential mental health care if he was to have a chance to develop those long term skills that he would need to deal with his depression, anxiety, PTSD; and there simply wasn’t any [long-term care] that we could find in Iowa.”

They finally found a facility in Arizona, then eventually California, that helped Sergei for a time.

“The fact that he was half the country away from us when he was going through treatment made it that much harder on our family in terms of trying to maintain the relationship and make sure that he knew we supported him and were thinking about him,” says Neubauer.

Due to Iowa’s lack of sub-acute psychiatric care, many Iowans with mental illness end up in the emergency room.

University of Iowa emergency room physician Dr. Hans House says that at any given moment, their ER has four to six patients waiting for in-patient service.

“One particular day […] we had 14 people [seeking treatment for mental illness] sitting in the ER for more than 24 hours; a few of them were waiting up to 50 hours for an in-patient bed,” he says.

More psychiatric hospitals would help lessen the caseload in Iowa’s emergency rooms, but if a recent public forum in Clive is any indication, residents may be resistant to a psychiatric facility in their town.

Dozens of Clive residents were at a recent meeting to speak against Mercy Medical Center’s plan to build a 100-bed inpatient psychiatric facility in their neighborhood. They shared concerns that mentally ill patients will assault children and make the neighborhood unsafe.

“It’s every bad stereotype about mental illness that’s ever been in popular culture, and in fact there are inpatient and outpatient psychiatric facilities located all over that there are absolutely no problems with,” says Peggy Huppert, executive director of National Alliance on Mental Illness Iowa.

“And if we’re going to expand services like we’re talking about with the law that was just passed, people all over the state of Iowa are going to be asked to have these facilities near them," Hupper continues. "I’m just hoping Iowans will embrace this, understand the need for it, and be willing to have it near them.”

If you or a loved one need support, the National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255.

Tips for talking with loved ones you suspect may be struggling with depression or suicidal thinking:

1. Start the conversation

“This is a subject that’s really taboo; it’s got a lot of stigma attached to it,” says licensed mental health counselor, Jason Knight. “Sometimes people are so concerned that they’re going to say the wrong thing, that they don’t say anything at all.”

Knight advises people to get beyond this concern and start the conversation with something along the lines of, “I’m concerned. I’m worried about you. Can we talk?”

2. Don’t try to cheer them up or deny their reality

“Be present with the person, listen, and express concern,” says Knight. “Ask how things are going, and acknowledge what they’re feeling.

3. Don’t be afraid to ask tough questions

While it may seem counterintuitive, Knight says that asking the person if they’ve considered killing themselves can lead to a productive conversation.

“It is absolutely OK to ask them if they’re feeling like killing themselves; you’re not giving them a suggestion by asking that question,” he says. “It’s important because then the next steps come into play. Then you want to know if they have a therapist. If there’s somebody else we can bring onto the scene if they need professional help.”

Ben Kieffer is the host of IPR's River to River