The head of the Iowa Department of Human Services says he’s “not sure” there’s a need for more in-patient psychiatric bed space in Iowa for adults suffering from acute mental illnesses. Advocates for the mentally ill have raised concerns after the state-run Mental Health Institutes in Clarinda and Mount Pleasant were closed June 30th. Chuck Palmer briefed the Iowa Council on Human Services late Wednesday morning.

Palmer said “The vast majority of people with mental illness will never have to be in in-patient treatment…and shouldn’t if we do a decent job.” Palmer is touting a “redesign” of the state’s public and private mental health care delivery system that was begun in 2011. Palmer says the goal is to have a wider range of services availble, closer to the patient’s home. “If you were to ask me today: ‘Palmer, do we need more psychiatric beds?’ I’d say: ‘I’m not sure.'”

He told  the council “I know we are developing more alternatives.” Palmer says there should be more attention paid to “specialized care” immediately after a mental illness is first diagnosed, and more “Where’s my greatest return on investment?” Palmer asked. “It’s to put in place those things that help defer higher cost services or, frankly, inpatient psychiatric services.”

He says today in Iowa there are more than 700 spaces for adult inpatient psychiatric care in 27 private hospitals and the two remaining state-run Mental Health. As of August 1st, Palmer and his staff have a new electronic system to track openings. Palmer says it will help hospitals track down an empty bed for a patient suffering from an acute mental illness, although some hospitals are having technical issues with the system today.

The Mental Health Institute in Mount Pleasant provided inpatient services to patients with the dual diagnosis of substance abuse and a mental illness, while the M-H-I in Clarinda provided care for frail elderly patients who had a mental illness. Three of those patients have died after being transferred to private facilities. Palmer extended his condolences to the families, but he told the council he’s not sure the state should be in the business of providing geriatric care to mentally ill patients.

Members of the Council on Human Services praised Palmer’s work and said it was too bad all the news about the mental health redesign has been negative and few have focused on the “really positive” big picture.

(Radio Iowa)