What you need to know about
Iowa’s Children’s Mental Health Care Crisis
There are approximately 80,000 youth in Iowa with Severe Emotional Disorder
(SED), in other words, children who have mental illness, which causes disability in the
school, home, and / or community environments.1
 These are not socially maladjusted children
 They are not bad kids. They are not the result of bad parenting, weakness of will, or
character flaws.
 These children are ill. They have a brain disorder – some were born with it, and for
some it resulted from brain injury or trauma. And just like children with kidney or
heart disorders, they urgently need medical care.
Why Early Intervention Matters
 50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24,
 but the average delay between onset of symptoms and intervention is 8-10
years.2
 Alarmingly, in any given year, only 20% of American children and adolescents
with mental illnesses are identified and receive services, leaving the other 80%
behind.3 (This roughly translates to 64,000 kids in Iowa who are not
receiving needed services.)
 Early intervention is key because the child’s brain is rapidly developing and
continues to do so until the early 20’s.4
 Research shows that early identification and treatment of mental illness
prevents the loss of critical development that cannot be recovered, it helps youth
avoid years of unnecessary suffering and greatly reduces long-term disability.5
But in Iowa children with SED are made to wait:
 Waiting over two years to receive Medicaid Waivers that provide essential
community-based services necessary to keep them out of institutions.6 (Even
though such services are mandated by the Federal Supreme Court Olmstead
Decision.7)
 Waiting 3-6 months to get an appointment with a psychiatrist because Iowa does
not have enough providers.8
 Waiting hours, sometimes days, in the emergency room while doctors try to
locate available beds – beds that are often hours away from the child’s home.9
 Waiting for Iowa insurance companies to comply with federal mandates for
mental health parity – that is to cover mental health in the same way that it
covers physical health.10
What is Iowa waiting for? We know that:
 Approximately 50% of students age 14 and older with a mental illness drop out
of high school.11
 70% of youth in state and local juvenile justice systems have a mental illness.12


Suicide is the 3rd leading cause of death in youth ages 10-24.13
90% of those who die by suicide have an underlying mental illness.14
Can Iowa Afford to help these kids?
 These children are being told that Iowa does not have the money to provide them
life-saving services, despite a budget surplus of over half a million dollars.
 Yet Iowa will find the money to pay for the inevitable unemployment, homelessness,
and incarceration that will plague them as adults if they are untreated as children.
 Studies show that treatment works, wrap-around services provided in youth result
in lower prison and homelessness rates and higher employment rates.15
 Iowa cannot afford not to treat children with SED.
It is time for leadership on this issue – an issue so central to Iowa’s future wellbeing.
How long will we make Iowa’s children wait?
According to the US Census Bureau in 2013 the population of Iowa was 3,090,416 and in 2011 23.6% of the Iowa
Population was under 18 years of age. (http://www.iowadatacenter.org/quickfacts#section-6) “ Approximately 11-13
percent of children and youth have a serious emotional disturbance (SED) that causes substantial impairment in how
they function at home, at school, or in the community, and for 5 percent a serious emotional disturbance causes
extreme impairment in their functioning (Surgeon General’s Conference on Children’s Mental Health; Merikangas,
He, et al, 2010).”
2 National Institute of Mental Health Release of landmark and collaborative study conducted by Harvard University, the
University of Michigan and the NIMH Intramural Research Program (release dated June 6, 2005 and accessed at
www.nimh.nih.gov).
3 U.S. Public Health Service, Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action
Agenda. Washington, DC: Department of Health and Human Services, 2000.
4 NIH, “The Teen Brain: Still Under Construction, http://www.nimh.nih.gov/health/publications/the-teen-brain-stillunder-construction/index.shtml
5 New Freedom Commission on Måental Health, Achieving the Promise: Transforming Mental Health Care in America. Final
Report. DHHS Pub. No. SMA-0303832. Rockville, MD: 2003.
6 See data on Medicaid Waiting lists at
https://dhs.iowa.gov/sites/default/files/10.3.14%20Monthly%20Slot%20and%20Waiting%20list%20%28public%29.p
df
7 For more information on the Olmstead decition see: http://www.ada.gov/olmstead/olmstead_about.htm
8 Iowa ranks 46 in the nation for the supply of psychiatrists. The AMOS Mental Health and Disabilities Workforce
Workgroup Report, December 2014.
9Brandy Zadrozny, “How America’ Hospitals are Failing Mentally Ill Kids.” The Daily Beast, 3-19-2014:
http://www.thedailybeast.com/articles/2014/03/19/how-american-hopsitals-are-failing-mentally-ill-kids.html; and
Tony Leys, “Mentally Ill Kids Need State’s Help, families say”, Des Moines Register,
http://www.desmoinesregister.com/story/news/local/government/2014/12/03/mental-health-kids/19853157/
10 For more information on the Mental Health Parity and Addiction Equity Act of 2008 see:
http://www.dol.gov/ebsa/newsroom/fsmhpaea.html
11 U.S. Department of Education, Twenty-third annual report to Congress on the implementation of the Individuals with
Disabilities Education Act, Washington, D.C., 2001.
12 Teplin, L. Archives of General Psychiatry, Vol. 59, December 2002.
13 Shaffer, D., & Craft, L. “Methods of Adolescent Suicide Prevention.” Journal of Clinical Psychiatry, 60 (Suppl. 2), 70-74,
1999.
14 Shaffer, D., & Craft, L. “Methods of Adolescent Suicide Prevention.” Journal of Clinical Psychiatry, 60 (Suppl. 2), 70-74,
1999.
15 “When children with untreated mental disorders become adults, they use more health care services and incur higher
health care costs than other adults. Left untreated, childhood disorders are likely to persist and lead to a downward spiral
of school failure, limited or non-existent employment opportunities and poverty in adulthood. No other illnesses harm so
many children so seriously.” Child and Adolescent Action Center: Facts on Children’s mental Health in America, NAMI
http://www.nami.org/Template.cfm?Section=federal_and_state_policy_legislation&template=/ContentManagement/Cont
entDisplay.cfm&ContentID=43804
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