What can be said about the state of mental health in the Quad Cities? In many respects, it ainât very good. In concert with national trends, the suicide rate in the Quad Cities is escalating at an alarming rate. Meanwhile, there are cries around town that we do not have enough mental health services to serve the unmet needs of the community. Â
Recent conversation in public discourse centers on the idea that we donât have enough hospital beds to treat people in crisis. We even spent the better part of this last year deliberating green lighting an initiative to bring in a for-profit behavioral health company. This measure was shot down due to the $14 million dollar price tag, in addition to the promise from hospital systems in our region that they will increase access to inpatient psychiatric beds. Â
Often times, for-profit systems have a nasty habit of picking and choosing who they serve. Often times the most severe cases of mental illnesses are passed over in these systems because for profit systems generally limit the depth and scope of services they will provide for such cases (this is a cost savings measure). While this may be, there are doubts that our QC-based hospital systems will make good on their word to expand. Iowa Health Facilities Council Member Roberta Chambers commented, âall we have is speculation that this might be done in the future.â (see shot down). Having seen how those systems operate first hand, I agree with Roberta. Ask anyone trying to get services around here and youâll find that the system is already bogged down, and neither Illinois nor Iowa are ready to pump money into services that might actually provide our citizens with the care they need. Â Â
While there may be some merit to the idea that more hospital beds will make a dent in our mental health crisis, it is wildly short-sighted to think that bringing more hospital beds to town will make a significant impact. The problems are much bigger than that, and start all the way at the top. The people with the power (elected officials) to allocate resources to treat mental health issues generally do not carry much knowledge on the subject. Itâs understandably so. You have to spend a decent amount of time learning how these illnesses go to work on people before you can begin to get a handle on how to approach treating these illnesses. As a result, one page briefings provided by well-supported lobbyists by and large become the blueprint for success. This model stratifies how funds are distributed for care, and not nearly enough is earmarked for community preventative services. Â
This happens because of how money flows through the system. Our state officials have been trained over the years to look at rate of hospitalizations as the primary indicator of how well a provider is doing. Meaning, if you keep your clients and patients out of the hospital, you must be doing a good job. This metric tends to get a lot of attention since hospital visits are extremely pricy. Itâs not unheard of for a crisis unit visit to cost upwards of $10,000. But the thing is, people live in our communities everyday facing overwhelming depression anxiety, and other illnesses that cause hallucinations and delusional thought processes. Weâve got to change our collective focus to make sure people can get help before the crisis intervention services at the hospital, a last ditch service, becomes the first line of defense.
To make matters worse, money has been continually slashed from these budgets. Itâs been going on for years, but has recently gotten much worse. Â Branstad keeps cutting mental health budgets and closing facilities in the process. Rauner and Madigan wonât budge on their pissing match over Unions and the perceived value of neo-feudalism. As a result we are in month 10 of no Illinois State budget.
In light of the increasingly deep cuts, some (certainly not all) providers refuse to work with others throughout our region because they are worried collaborative efforts make them less useful to funders, resulting in cuts to the dollars they managed to get for their organization earmarked for serving the greater good. This political infighting makes it difficult for folks to access all of the services available in our region that, in combination, could keep them healthy enough to participate in life more fully.
Letâs bring it back to community based services. The state of Illinois allows an individual $5,139/year in individual therapy so long as they meet the guidelines of Mental Health Rule 132. The cost of one hour of individual therapy provided by a top tier licensed professional is $77.62 per hour. Further, the total allowable funds per person is determined by the Level of Care Utilization System (LOCUS), and it is noteworthy that a lot of folks do not meet the criteria for the maximum amount. For sake of argument, letâs say someone meets the maximum amount. They qualify for a little over 66 therapy sessions per year. Most folks receiving an hour of individual therapy, in addition to other community supports, fair much better than those who do not receive treatment and end up in the hospital. The cost to provide one person care (and one hour a week of therapy is better than most get) in the community for an entire year is far cheaper and beneficial than a short lived, high cost hospital visit.
So why donât more people get into high quality, lower cost treatment? The root cause goes back to the Stateâs failure to adequately fund community based services. However, this is made worse by just how difficult it is to access the system. While weâve made some strides in mandating insurance companies to provide coverage for behavioral health treatment (see the Mental Health Parity Act of 2008), it is still very difficult to access. The amount of people using the system greatly outweighs the available personnel to treat those issues. One in four people have mental health difficulties each year, and only about a third of those folks seek services. Start doing the math for our region and youâll get that we need more professionals to tackle the issue.
Even the best clinics in our area see wait times between 7-10 days. This is of course if you 1) have health insurance, 2) can find a provider that takes your insurance, 3) can access transportation to get you to the service and 4) are physically able to find your way to an appointment. If someone is struggling with a mental health issue, those four items are not always easy to sort out. Â
Beyond the bureaucratic red tape, the stigma attached to mental illnesses plays a very large role in keeping people form seeking services. When mental illnesses are stigmatized, people tend to think persons with mental illnesses are damaged, crazy, dangerous, and even violent people. Despite evidence that debunks these myths, we keep buying into these bullshit misrepresentations of mental illnesses. It doesnât help that the only time we ever talk about mental illnesses is when we have some kind of violent incident involving a person with mental illnesses. These stereotypes are perpetuated in the media (thank you CNN! -you miserable fucks-) and we as a population, remain ignorant to what it really means to have a mental illness. As a result, we create a reality where talking about mental health difficulties is taboo, and doing so will cause others to see you as damaged, crazy, dangerous, or violent.
Itâs time we throw that narrative right out. Mental illnesses are complex. While there are genetic factors that play a role in the manifestation of mental illnesses, the appearance of mental illnesses are due largely to the occurrence of traumatic events in a personâs life. This can be the loss of a loved one, witnessing violent events, being abused as a child, experiencing a debilitating physical illnesses, growing up in a home with a substance abuser, or even living with someone experiencing mental health difficulties. While these examples do not cover all possibilities, you begin to see that mental illnesses are not a decision. They can happen to anyone and everyone under the right set of circumstances. Additionally, many mental health issues go in cycles, meaning people have periods of time where they feel really good, and other times when face difficulties. Knowing this, we would all be wise to encourage our friends, family, and loved ones to speak up when things donât feel right.
There are a hell of a lot of problems with society and the system at large that dictate our ability to successfully treat mental illnesses. Despite all the barriers, many Quad Citians are successful in managing their mental health and are able to have families, be gainfully employed, and live life as a responsible upstanding citizen. We are beginning to discuss our mental health crisis publicly, and we are making a lot of progress in spreading awareness about our issues. BUTâŚwe need to get a whole lot better before we start patting ourselves on the back. Â
Hereâs what we as everyday ordinary citizens can do to improve the mental health of our community:
Read Up on Mental Illnesses.
People generally donât spend a lot of time learning mental illnesses. The more we know about these matters as individuals, the more we can get done as a collective region. Â Mental Health America is a great resource for getting up to speed on the basics of mental illnesses and how they can be treated. If reading is not your thing (hey youâve made it this far though!), check out mentalhealthchannel.tv. Itâs a great resource learning how these illnesses affect individuals and even covers a decent amount of ground on mental health policy. Try it!
Be a Mental Health Ally.
Being a mental health ally is simple in concept, and it takes commitment to actually become one. Being a mental health ally is about being supportive of those around you when they are not feeling their best. If you notice someone withdrawing, becoming distant, or disconnected from places, people, and things they enjoy, voice your concern in a non-confrontational and non-judgmental way. âLISTEN- intently and let the person youâre talking to open up as they are willing. Do not critique, do not give advice. Listen and let the person know you are there to help in any way you can. It is a difficult conversation to breach, but if you keep it non-judgmental and allow folks to open up, it creates support and increases the likelihood that a person will get help before a mental health crisis occurs.
Write, Call, and Meet with you Legislators
If you are worried about the state of mental health in the Quad Cities, voice your concerns to your elected officials. The only way we ever make progress on these matters is by passing legislation that corrects the systems that are failing us miserably. Our local legislators are really decent human beings. They will listen to us if we speak loudly and frequently enough. Encourage them to provide our community with more preventative services that will help persons with mental illnesses stay well enough to participate in life as fully as possible. If they keep cutting human services out of their budgets, donât vote for them.
These are incredibly complex issues and this article does not provide any sort of one size fits all approach to solving the state of mental health in the Quad Cities. Just a bit more insight and a couple of tips and tricks on how we might try to make a difference.
