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Mental Health Spending Cuts Indefensible

[Note: This material is copyright by The Daily Iowan, and is reproduced here as a matter of "fair use" for non-commercial, educational purposes only. Any other use may require the prior approval of The Daily Iowan.]

If passed, Senate File 169 - which designates appropriations according to county population - would allot Johnson County one of the largest slices of funds for mental-health services.

"We're not different counties here; we're one state," said Sen. Jack Hatch, D-Des Moines, who was on a legislative committee that studied mental-heath services. "We should acknowledge this is a statewide problem, that a citizen in Cherokee, Iowa, should get the same services as a citizen in Polk County."

In 2006, the National Institute for Mental Health gave Iowa an "F" for its rate of spending on mental-health services, according to the state Department of Mental Health Services. Meanwhile, 26 percent of Americans - or 58 million - suffer from a diagnosable mental-health issue.

In Iowa, counties have assisted roughly 45,000 patients who can't afford care, according to state mental-health officials. But if public spending is reduced, advocates for increasing mental-health spending fear it could harm Johnson County and the state.

"It's concerning that mental-health clients across the state won't get a basic level of service to meet their needs," said Elaine Sweet, the executive director of mental-health services in Johnson County.

The recent push for a tighter budget has forced some Iowa counties to dip into reserves to ensure everyone receives adequate care. Several larger counties will face harsh realities, such as Polk County, which will see a $6 million cut, and Linn County, with its $1 million deficit in fiscal 2006.

But in Johnson County, officials are optimistic that the cuts won't immediately affect clients.

"With federal cuts affecting Iowa counties, funding will depend on if the state cigarette tax passes," said Rep. Mary Mascher, D-Iowa City. "If the tax does not pass, we will have to make some very tough decisions that could possibly affect Johnson County and other areas of the state."

With $10,821,969 servicing an estimated 1,400 clients in fiscal 2006, the Johnson County mental-health budget has steadily risen over the last five years, compared with those of other counties, which have seen cuts and decreased services across the board because of a lack of funds.

"We are fortunate in Johnson County to have very responsive mental-health providers, who often donate their services and time, and a supportive Board of Supervisors," Sweet said.

The county provides low-income individuals with financial support for therapy, mental-health treatment, life-skills training, and employment opportunities, among other services.

Last year, the state Legislature allotted an estimated $143 million for mental-heath and disability services. Since 1997, lawmakers have capped the amount of tax money that can be used to supplement services.

"With a cap on the amount a county can levy from taxes, the percentage allocated to counties has been the same regardless of growth and inflation," Sweet said.

Health-care debates continuously rage across the country. The federal system is notoriously inefficient, and many state programs are no better. Numerous Americans - more than 40 million at last count - cannot afford health insurance, and many who can receive only basic coverage. Lost amid the gloomy headlines, victims of mental illnesses are often forgotten - both by the health-care system and average citizens. More than one-fourth of Americans suffer from diagnosable mental illnesses, but their struggles do not draw much attention. Soon, it may get worse for thousands of Iowans afflicted with mental illnesses.

Since 1997, the state has capped the amount of tax money counties can raise for mental-health programs. The state Legislature initially promised it would make up the difference. But in 2002, the assistance for mental-health care provided to the counties was slashed, leaving many of them with budget shortfalls. (Iowa law requires counties to pick up the tab for mental-health care for individuals who cannot afford it.)

No-cost care has been provided at the expense of Iowa counties to roughly 45,000 Iowans unable to afford care. The state is again planning to cut state spending for mental-health premiums, a move we find indefensible. The Iowa Department of Mental Health Services has already given the state an "F" for spending on mental-health services.

We don't, however, find it wise to simply throw money around statewide in efforts to solve the problem. It is only specific counties that require more funding - as a whole, the counties boast a significant reserve. It would be foolish to give more money to areas that don't need it. Additionally, programs to redistribute funds between the counties are not wise.

The Legislature is also tackling a bill that would equalize mental-health services across the state. This is a more proper step - it is only right that every Iowan can expect the same care. We should not, however, achieve equal care by only supporting a minimum standard. Victims of mental-health diseases require more than meager attention; even minor disorders can significantly impair an individual's ability to live. More severe ailments are incomprehensibly terrible and, more often than not, can't ever be fully overcome.

Iowa City residents don't have to go far to see the debilitating effects mental illnesses can have. Many of the homeless individuals in the city appear to struggle with mental afflictions - but little action is taken to alleviate their plight. If counties are forced to slash services, matters will worsen.

The terrors of mental illnesses are often known only to their victims. Every possible means should be used to help them in their struggles. No amount of money will cure cases of severe depression or schizophrenia. But higher levels of care can help ensure those suffering from these disorders will live a less painful life. © Copyright 2007 Daily Iowan