- Associated Press - Sunday, September 11, 2016

CHEROKEE, Iowa (AP) - More than a year after two of Iowa’s four mental health institutes shut down, the institute in Cherokee is operating similarly to how it had been in recent years.

Apprehension had run through Cherokee in 2009, when state officials explored closing one or more of the state’s four mental health institutes. The loss of the Northwest Iowa campus would have delivered a $24 million hit to the local economy. So the facility, which has treated patients for 114 years, has now survived two possible cuts in seven years.

The Sioux City Journal (https://bit.ly/2cGXhvA ) reports that the state in July 2015 shuttered mental health institutes in Mount Pleasant and Clarinda. The closures, however, have not resulted in more patients being treated in Cherokee or the other remaining institute in Independence.

Cherokee still has 36 beds — 24 for adults and 12 for children — and remains full most days, Mental Health Institute Superintendent Cory Turner said.

“Typically, we are an entity that is full all the time,” said Turner, who began leading the institute last summer.

In 2015, 552 people were served with an average length of stay for adults at 34 days and nine days for children. That compares to 539 in 2014, with the stay slightly shorter for adults compared to the year before.

The number of Cherokee MHI employees also has remained constant, Turner said.

“The closures at the other MHIs haven’t really affected us, from a patient perspective or from even a staffing perspective. We haven’t lost positions or funding, that hasn’t been an issue for us. And from a patient perspective, we are seeing the same amount of patients, as far as an admission rate,” Turner said.

The high mark for Cherokee institute employment came in the 1970s, with 475 workers; the highest number of patients served was in 1949, with about 1,300.

Following a plan by Gov. Terry Branstad to move to community-based mental health care services and away from larger institutions, the closures at Mount Pleasant and Clarinda were made because of difficulty in recruiting clinical staff, a declining number of people served and high costs to serve them.

Iowa Department of Human Services spokeswoman Amy McCoy said private providers can provide some services at one-fourth the cost of what’s delivered by the state institutes.

“The numbers in the mental health institutes have continued to go down, as more people are served in the community. The private hospitals are able to offer the same types of services that the MHIs offer,” McCoy said.

Once the Clarinda and Mount Pleasant facilities closed, three patients were transferred to Cherokee. McCoy said the two remaining institutes are providing good service and Cherokee hasn’t been swamped with more clients.

Cherokee stayed off the state chopping block by having national accreditation, meeting rigorous standards in providing modern care and operating the state’s only facility for CUSO, or civil commitment unit for sex offenders. With that move, Cherokee had survived a possible axing that worried some locals officials, since the MHI is a vital cog in the community of 5,253 people. There are nearly 170 employees at the sprawling campus on the west end of the Cherokee County seat, making it the fourth-largest employer in the county.

The Cherokee facility takes children and adults who are in need of acute psychiatric services. They have to meet at least two criteria to be admitted, among them indicating suicidal intentions, the desire to harm themselves or others, a need to have psychotropic medications monitored and a need for 24-hour professional observation.

McCoy and Turner said a key point is that regardless of what is happening elsewhere on how services are delivered, once people are in Cherokee they receive top care. Workers make sure people are getting the right medications, ways to address certain behaviors such as anger management and help with skills building to work successfully back in the world.

“Recovery is possible,” McCoy said. “They can live successfully out in the community.

Treatment methods for mental illness have advanced over the years, and the practice of major restraint and seclusion in private rooms is nearly nonexistent.

McCoy and Turner said there are no plans for the state to close the Cherokee institute.

“If we are providing that good level of care, we don’t have anything to worry about, maybe that is the best way to put it. The support from the community is just astonishing… It is a big employer for the community, and I think (people) understand the need for the level of service here on the western half of the state,” Turner said.

The first patients arrived in 1902 at the late-19th-century Renaissance Revival stone buildings covering 800 acres in Cherokee. More than 1,000 people came by railroad from the other institutes for treatment.

At one point, those who received services helped provide labor to grow vegetables and crops. The institute evolved away from the work-camp concept and, as services changed, some buildings have closed and the active grounds now cover about 200 acres. Beyond the mental health institute, the state also runs the Youth Emergency Services (YES) facility for youth detention on the Cherokee grounds.

Cherokee City Administrator Sam Kooiker said all the services are important to Cherokee. Kooiker noted the town came together about 1900 at the time the possibility of an institute was pitched, helping it come to fruition.

Kooiker said area legislators, more recently, have defended the necessity of keeping the facility in Cherokee.

“Over nearly 115 years, MHI has been one of the cornerstones of our community…They are a stable employer and they are important to our community,” he said.


Information from: Sioux City Journal, https://www.siouxcityjournal.com

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