Mental Health in Jasper County: Still in Crisis

More than a year after mental health was determined to be the number one health concern in Jasper County a myriad of challenges still exist but efforts are underway to improve mental health care access.

Julie Bishop Gibson is the grant coordinator for a three-year $100,000 grant which aims to increase access to mental health care and improve coordination among Jasper County providers. Skiff Medical Center and House of Mercy applied for the Catholic Health Initiatives grant following a panel discussion at city hall in November 2015 hosted by the Newton Daily News and Newton Police Department. A subsequent Community Health Needs Assessment in 2016 identified a growing concern with mental health care.

As Gibson enters the second year of the grant she points to some successes — calls are up to the Central Iowa Crisis Line, she’s developed a brochure of mental health and substance abuse resources and collaboration among a strong network of local providers is already in place.

Jody Eaton, CEO of Central Iowa Community Services which serves a 10-county region, says Jasper County is ahead of the game for a rural county.

“What makes Jasper County stand out is not only the number of agencies and providers that we have locally but the array of community-based services provided and the tremendous growth we have seen in the numbers served in outpatient therapy and community-based programs,” Eaton said.

Another area where Jasper County stands out, Eaton said, is the willingness of the Jasper County Sheriff’s Office to incorporate jail-based mental health services including therapy services, psychiatric services and intensive case management.

Significant Need

Jasper County Sheriff John Halferty said the jail and law enforcement officers continue to feel the pinch when it comes to mental health.

“It is still true today (that we are in crisis) we still see a significant need in bed space for inpatient,” Halferty said.

Halferty said a recent order for a committal resulted in his staff spending more than 48 hours straight at Skiff because it was determined the individual needed assistance but there was no bed available.

“The person has been very violent in the past, it took several deputies to make contact with the individual and encourage the person to get into the vehicle to get into Skiff and start the evaluation process,” Halferty said.

He said it’s not uncommon for the committal process to take a 48-hour hold.

“That requires us to stay with the person constantly. It also takes a room at the emergency room and staff at the emergency room because they have their obligation to treat the patient as well.”

When the public forum met in 2015, Halferty said about one in four of the inmates at the Jasper County Jail needed some sort of mental health resource. Those numbers are now higher, Halferty said, and creates many challenges for jail staff. Among those are finding enough segregated cells, spending more time communicating with inmates and often the inability to take them to the courthouse for hearings and instead relying on a circuit TV system.

“Without a doubt, we have had individuals and we currently have individuals who are in jail because either no (mental health) resources or facilities were available,” Halferty said. “What happens many times is the individual is in a condition where they won’t accept resources and they end up committing a criminal act, misdemeanor crimes, and they end up in jail unable to bond out.”

Sonja Ranck, chief clinical officer at Skiff, said the hospital is proud to support Gibson’s grant work on the complex topic of mental health.

“Statewide the same issues remain, with the significant lack of available beds for patients with mental health needs. When there is a delay in finding a bed, patients can experience long ED stays,” Ranck said.

She said the average stay including wait time for a bed is 24-hours, but in some cases patients must wait multiple days.

“Skiff continues to meet frequently with local experts, as well as network through the Iowa Hospital Association, to further the cause of better service and resources for some of our most vulnerable patients,” Ranck said.

Setting Goals

Gibson said she was interested in the mental health grant coordinator position because she’s experienced the frustration firsthand.

“I have an extended family member who has had some challenges with behavioral health,” Gibson said. “I’m not an expert and I’m not a practitioner but I’m a good collaborator and convener of the conversation.”

Gibson’s goals, along with local stakeholders in the mental health coalition, include improving coordination among community organizations to provide coordinated mental health services and increasing the quality and quantity of outpatient mental health/substance abuse services.

“We’re looking to coordinate mental health efforts — looking for ways providers can work together more, figure out gaps and where to meet them,” Gibson said. “As the coordinator, I’m the convener of the conversation … connecting people with one another … and the asker of good questions around why and why not,” Gibson said.

The coalition meetings have gathered providers, law enforcement and others to tackle some tough conversations, Gibson said.

“I say we’re sort of standing at the bottom of a mountain looking up and wondering how we’re going to climb it and someone keeps dumping more rock at the top of it in the form of fewer dollars and system changes,” Gibson said.

One of her objectives is to improve mental health crisis response by getting services to people early before they have a crisis.

“In some instances using the crisis line for help instead of calling 911 might result in better care than a trip to Skiff. The ER isn’t the path it once was ... there are very few beds available,” Gibson said.

Eaton said many regions are now focusing on additional development of crisis services for the region to help alleviate the statewide issue of lack of inpatient beds for individuals with complex needs. In June 2014 there were 30 crisis stabilization beds statewide and there are now 86, she said.

Gibson said the coalition is looking at how many crisis appointments are available locally and whether there needs to be more.

“What people need is an interaction with a medical professional that can help ease their symptoms and work toward stability,” Gibson said.

Meanwhile, a stigma-reduction campaign may also be a development from the coalition.

“It’s still something people tend to be embarrassed about. We’re not embarrassed when our hearts don’t work ... when our thinking or brain chemistry isn’t functioning there can be shame,” Gibson said. “Right now our providers are working full speed but it’s still hard to find those doors. If it could be normalized we wouldn’t carry so much fear.”

Gibson is hoping to hear from Jasper County residents about mental health care concerns. She’s scheduled coffee shop hours at Uncle Nancy’s from 10 to 11:30 a.m. Thursday, 4:30 to 6 p.m. June 13 and 9 a.m. to 10:30 a.m. June 24. She can also be reached at jgibson@mercydesmoines.org or 641-260-7124.

Contact Abigail Pelzer at 641-792-3121 ext. 6530 or apelzer@newtondailynews.com