IOWA CITY, Iowa (KCRG) – The number of psychiatrists in the state is decreasing due to retirements – and statistics show that two-thirds of Iowa providers work in Johnson, Linn or Polk counties, hours away from rural residents struggling with their mental health.
It’s a dire situation for some Iowa farmers, with financial pressure compounding into worsening mental health, according to farmer and Iowa Corn Growers Association President Mark Mueller.
“If you know of a farmer that is acting like he’s under distress, he is,” said Mueller.
He said members of each of the association’s multiple committees know a colleague who has died by suicide.
“Things are getting dark on the farm,” said Mueller. “We have a mindset of we’re going to go it alone and we’re going to conquer the elements. We’re going to conquer the markets. We’re going to get by. But frankly, we need to ask for help and we don’t always do it.“
He encouraged anyone who is struggling with their mental health to reach out for help – saying Iowa Corn can get those in need connected with resources.
This tough situation – combined with the fact that 73 of the 99 counties didn’t have psychiatrists as of fall 2022 according to the University of Iowa – is pushing the state to make changes.
University of Iowa expanding psychiatry services with state collaboration
In recent years, the legislature has increased funding for the University of Iowa to expand its psychiatry residency program.
Dr. Jodi Tate, the vice chair of education for the Department of Psychiatry, said the state provided funding for the first expansion in 2019 – taking the program from seven to nine residents.
The university developed a specific public rural psychiatry track in 2020 to push to get psychiatrists in underserved communities. A 2022 bill expanded the residency even more and required a rural rotation at one of five state facilities.
Dr. Tate called the expansion a phased approach – explaining that setting up the residencies requires careful planning and approval with national accrediting bodies. She said this process has been worth it.
“We still have a lot of work to do and getting residents to the sites,“ she said. ”There’s a lot of barriers with housing and the presence of psychiatrists that can supervise and, but we’re getting there.”
She said developing these residency programs make it likely that the state will retain more psychiatrists.
“Residents that train in Iowa are more likely to stay in Iowa compared to other specialties,” she said.
One of those residents is the current Public Psychiatry Fellow, Dr. Magdalena Maginot. Dr. Tate said during Dr. Maginot’s time in the new fellowship program, she decided to stay in Iowa because she “loved her experience” working at the Mental Health Institute in Independence.
Data from the department shows the number of residents at rural sites has increased from three to 23 and from two to 10 locations since 2020.
Dr. Tate said the focus is on collaboration in order to offer care to more people with programs like telehealth services. Two programs with Washington and Van Buren county hospitals have been “really successful” in serving those rural communities.
Another step forward happened at the State Training School in Eldora, where there was not previously a board-certified child psychiatrist. Dr. Tate said the university worked with Iowa’s Department of Health and Human Services to organize a telehealth service with a child psychiatrist and UIHC resident.
Dr. Tate said the next step the university and state are working on is to offer continuing education for providers at facilities statewide, rather than the providers needing to travel to Iowa City.
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