Righting a sinking mental health ship

It's too big, folks.

The mental health situation is too big to condense into a column for you. Earlier this year, our family of papers did an entire series on mental health in northwest Iowa, and the beast is rearing its head again.

There's some potential for a game of musical chairs among the mental health regions in this corner of the state. I've sat through three meetings on what Dickinson County's options are, now that O'Brien County is officially leaving the Northwest Iowa Care Connections mental health region come July. I'll tell you the options are confounding, confusing and convoluted, but they boil down to three basics: join the Sioux Rivers region to the west with O'Brien, join the County Social Services region to the east or stay where we are. Clay County has the added option of joining the Rolling Hills region to the south, and any of those decisions compounds the options available to our neighboring counties.

It's become clear to me, having written about the financial challenges of the regions earlier this year, and having attended a number very in-depth meetings on the subject this week that switching regions is only a band-aid solution. All the regions have similar issues, if not the same issues. Mental health taxes are capped at both the regional and state levels, yet I've heard county supervisors and regional CEOs say those taxes won't meet current mental health demands — both in regard to the needs of the local populace and the number of services the state requires regions to provide. Clay County Supervisor and Northwest Iowa Care Connections Board Member Barry Anderson compared it to jumping from one sinking ship to another, while he and others discussed the issue last week at a special meeting of the Dickinson County Board of Supervisors.

It's a fine visual to be sure, and while the ships are sinking, Iowa's county jails are becoming the state's largest mental health facility — a point reiterated by Dickinson County Sheriff Greg Baloun during that very meeting. Now, Baloun doesn't often mince words, and last week's meeting was no acceptation. He's clearly tired of the system spinning its wheels, and he … we'll say strongly urged the board to do something about it. He and some others are recommending the county join Sioux Rivers to the west, as many of the clients transported by the sheriff's office currently go that way for treatment.
But like I said, everyone knows this isn't the long-term solution. Sioux Rivers expects they'll have to raise their mental health tax by around $8 soon to around $30 per capita — close to double what Northwest Iowa Care Connections currently taxes. On the other hand, Care Connections is projecting a need to double its mental health tax — reaching the region's current maximum of $30.30 per capita. And Care Connections also anticipates it may have to pay out $7 and some change from the region's reserves to stay afloat until 2022 or so.

So, I agree with Anderson. We're all sinking, just at different rates. A number of voices in the room said nothing is going to be solved unless the legislature steps up to the plate and changes something — ideally put more funding into Iowa's mental health system. Baloun strongly voiced his opinion that informational meetings weren't solving the problem last week, and he told the board of supervisors they need to do something.

Personally, I agree something needs to be done, and I'm fine with becoming part of a new mental health region if that's deemed the best option for the moment, but that won't bring about new legislation or an increase in funding for the regions. Remember, what the board and the regions are hoping for in part is greater funding from the state legislature — either through changing their maximum mental health tax or funding the system through a different tax.

The problem lies in that we often want both services and low taxes. Folks, I'm sorry, but government services are funded through taxation.

Now, here's a possible solution getting kicked around out there. Some 63 percent of Iowa voters approved the creation of the National Resource and Outdoor Recreation Trust Fund back in 2010. There's a law on the books that says the next three-eights of a cent in state sales tax increase has to be earmarked to fill that trust. So far, we've had no increases at the state level, so the fund sits dry. Our state legislators have told me in the past that it's more likely the state would approve a whole cent sales tax increase rather than a fractional one. That would leave five-eights of a penny to go where ever — and some legislators feel mental health would be a great place for that fractional penny.

But like I've said before, there's no reason the state should increase the sales tax if we don't tell them we're willing to pay it. We can't expect our legislators to vote with our dinning-room-table-conversations in mind if we don't clue them in on what we're saying. So, if you're tired of seeing your county government try to find the least leaky ship in the fleet, tell your legislator to increase your sales tax and put five-eights of a cent toward mental health. If you're tired of mental health providers closing their doors and cutting back services because they can't afford to help, tell your legislator to increase your sales tax and put five-eights of a cent toward mental health. If you're tired of seeing your friends, family and neighbors dressed in an orange jumpsuit and ankle chains because they don't have the support to keep their substance addiction at bay or cope with their mental condition, tell your legislator to increase your sales tax and put five-eights of a cent toward mental health.

I realize that a fraction of a penny might not be enough to bilge out the overflow in the hull of our mental health regions, but it's certainly a step in the right direction, and it just might be enough to right the ship long enough to get our bearings and plot a course out of the storm.