As the Executive Director of Foundation 2, a large agency in Eastern Iowa whose expertise is in crisis response, suicide intervention and prevention, I continue to see the increasing need for a variety of levels of care to meet both the short- and long-term needs of adults and youth accessing our mental health system.

As an agency, our crisis services continue to rise. Crisis phone calls are increasing and the content is more intense. We’re dispatching counselors at a higher rate than ever before for our mobile crisis services and the number of youth we serve at our emergency youth shelter with mental health issues are growing. Across our community, state, and nation, we’re seeing an increase in the number of suicides in a variety of age groups. And while I’m so thankful our qualified staff is available to provide crucial, short term support to people when they need it most, I’m also recognizing how inadequate our system really is.

Last Friday, I went with one of our mobile crisis counselors out on a call. This is a rare occurrence for me. As an administrator, I usually find myself at my desk — not interacting one-on-one with clients, yet every so often I believe it is important to be reminded what our staff “in the trenches” do. It helps me understand the challenges that come with direct care work providing crisis intervention and suicide prevention to our community. While I was on the mobile crisis call with staff I saw significant evidence of what I thought to be true: Our mental health system continues to be insufficient to meet the ongoing needs of adults and youth.

Both children and adults are struggling to get the level of service they need, when they need it. Physicians and psychiatrists are forced to make tough decisions about when to discharge patients from hospitals because the short- and long-term needs for their patients can’t adequately be met. Wait lists for outpatient psychiatrists are weeks or months long, and the number of psychiatric beds for youth and adults are decreasing due to repeated funding cuts from the state and federal government; all while the mental health needs of adults and children continue to grow. As a community, and as a state, it feels like we’re doing it wrong.

I’ve seen this cycle before and I understand the conundrum: Do we need more inpatient facilities or do we need to keep people in their homes with intensive services? The answer? Both. Mental health issues are broad and can present themselves in a variety of ways and intensities. Having a range of services that can appropriately meet the wide spectrum of mental health needs of people in our community and state is a must. However — because that is not how the system is currently set up, all of us in the mental health field are forced to make tough decisions that, even in the best circumstances, that don’t fully meet the current or future needs of the client.

All systems change over time and the mental health system is no different, but as legislators and funders make decisions, it is important to keep in mind that there is a cost — both financially and medically — to not having a variety of services in place to meet the changing mental health needs of Iowans. It is my hope that as bills are offered in the Iowa Legislature, and tough cuts are made, appropriate options for those living with mental health challenges can be available at a reasonable cost to both the individual and the provider.

Taking care of the mental health needs of Iowans is the responsibility of us all, and how we handle these issues has far-reaching effects in our communities — either positive or negative. We need to make sure that we are giving the dedicated professionals who give their lives to helping those in need — of all genders, races, backgrounds, economic status — the tools they need to care for our family, friends, and neighbors in a way that makes life better for us all. Appropriate and excellent care for someone with a mental illness is just as critical as accessing care for someone who has diabetes or cancer. If as a community we don’t view helping someone access insulin as optional, accessing treatment for mental health should be no different. Lack of access to the appropriate level of care can mean life or death and many times, it does.

• Emily Blomme is the Executive Director of Foundation 2 ( If you are in crisis, please call our Foundation 2 Crisis Line 24 hrs. a day, 7 days a week at (800) 332-4224.

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