1842

Passage of Iowa “Poor Law” leads to a system of county homes. Counties assumed the responsibility for the public costs of services to people with mental illness and intellectual disability who didn’t have family support. Society was recognizing that some people needed help and something was put into place.

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1861-1902

Around the same time of Iowa’s Poor Law, there was a movement to not just provide confinement in poor farms or prisons. The movement fought for the establishment of hospitals to provide treatment for “the insane”. Mt Pleasant was built in 1861, Independence in 1873, Clarinda in 1888 and Cherokee in 1902. If a person was too ill to reside at a county home or their county did not have a home, that person would be sent to an MHI.

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1940’s

While mental health treatment continued to evolve, by the 1940’s, all 99 of Iowa’s counties had a county home. Most of those were upgraded versions of the previous “poor farms”. Most county homes were located outside town limits. It was believed that there was less stress in the countryside and residents would benefit  from “therapeutic breezes”. The county homes were thought to be acceptable outplacement opportunities for MHI patients.

It was around this time that hospitals began to open psychiatric units.

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1950’s

First generation of anti-psychotic medications were introduced, making it possible for MHI patients to improve enough to be discharged. Outpatient clinics and community mental health centers begin to appear.

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1960’s and 1970’s

“One Flew Over the Cuckoo’s Nest” published and made into  a movie. Geraldo Rivera’s national expose publized, shedding light on deplorable conditions of large institutions. Large scale de-institutionalization occurs for MHI’s and State Hospitals, significantly decreasing their populations.

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1980’s

Home and Community-Based Services were introduced. Instead of a person in need of services going to a facility or hospital, they could be served in their own home.

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Late 1980’s-mid 1990’s

Second generation anti-psychotic medications offer breakthroughs in treatment for many people with mental illness. With better medications, people were able to function more independently in the community.

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Americans with Disabilities Act of 1990 prohibits discrimination based on ability level.

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1999

Olmstead vs. LC  supreme court decision found that under ADA, individuals are entitled to receive services in the least restrictive environment consistent with their needs.

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Mental Health Services continued to evolve in Iowa with more focus on helping individuals live with more independence in the community.

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2014

Iowa Mental Health Redesign was implemented. Instead of mental health funding coming from counties, counties joined to form regions. Each region  is responsible for having needed services for residents within that region.

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A light has been shown mental health in Iowa and word is spreading. The stigma of mental health problems needs  to end.  We need to band together in our communities to make sure those that need help have access to mental health services.

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Many of Iowa’s counties have established coalitions to address mental health needs in our communities.

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