There would be no large, family birthday celebration for Jing Htun’s 7-year-old son, thanks to COVID-19 social distancing restrictions. But she made sure there would be cake. Htun picked one up from the Hy-Vee bakery on Euclid Avenue on the morning of March 23, her son’s birthday. The cake was nothing elaborate, she said, just enough to put a smile on his face. She made her way to the checkout line.
Some Iowa hospitals ramping up their efforts to treat COVID-19 victims will not survive the pandemic without an infusion of cash, the head of the professional association for those hospitals said.
With farmers facing increasing stress and depression, Midwestern states and national farm groups are making more efforts to better provide services to alleviate the high rate of suicide among the agriculture industry. Yet in rural areas, this care is more of a challenge. Rural hospitals — often the primary source of health care services in these areas — are closing or merging. Since 2010, 23 hospitals have closed across the Midwest — a loss of nearly 1,000 beds, according to the North Carolina Rural Health Research Program.
An Institute for Nonprofit News investigation by 12 news outlets across seven states found that rural Midwest hospitals have reduced services or merging with larger health systems in an effort to deal with financial and regulatory pressures. Only two of those Midwestern hospitals were in Illinois, but accessing mental health services in rural communities remains difficult. Some groups have decided to address the situation themselves.
A collaborative project including the Institute for Nonprofit News and INN members IowaWatch, KCUR, Bridge Magazine, Wisconsin Watch, Side Effects Public Media and The Conversation; as well as Iowa Public Radio, Minnesota Public Radio, Wisconsin Public Radio, The Gazette (Cedar Rapids, IA), Iowa Falls Times Citizen and N’west Iowa REVIEW. The project was made possible by support from INN, with additional support from the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems. For more stories visit hospitals.iowawatch.org
For example, the organization GROW sets up meetings over Zoom, a video conferencing app, to help those in rural areas experiencing mental health issues.And more than a dozen farm bureau managers in Illinois have taken mental health first aid classes that help people recognize signs of distress. Harry Brockus — the chief executive officer of Carle Hoopeston and Carle Richland in Central Illinois, a collection of hospitals that serves 41 mostly rural counties — said there is a physician shortage across the country and recruitment to rural areas is an even bigger challenge.
“We do not offer the amenities that physicians are looking for,” he said, “such as shopping, schools and different entertainment venues.”
Other challenges in rural areas, such as transportation, housing and access to healthy food, can make rural healthcare costs inefficient and unaffordable, Brockus said.
This has left rural America in a bind when it comes to care for mental health.
A seven-state news investigation revealed plenty of problems facing rural patients but also a variety of creative attempts to solve them. The head of the National Rural Health Association puts it this way: “Everyone realizes we’re at a crisis point.”
Hospital leaders say a policy fix is needed to ensure the future of rural hospitals in Iowa and across the country that are succumbing to financial pressures and closing their doors. Until that fix comes, though, Iowa’s network of rural community hospitals is making tough choices and smart partnerships to get by, a series of interviews by Iowa news organizations collaborating with IowaWatch revealed. Some have dropped OB-GYN services. Smaller hospitals have turned to larger ones to form partnerships, which can
result in the elimination of services to be more cost-efficient but forces
patients to drive out of town for health care. Other efforts to maintain local
hospital care include shifting to more outpatient care, the interviews show.
This podcast of an original IowaWatch Connection radio report lets those in the Midwest U.S. trying to attract the necessary resources to meet mental health care demand in flood-stricken regions tell you about the problem. It includes one health care center that is trying to address the health care worker shortage head-on with a full-time recruiter.
Psychologist Lauren Welter says she faces an ethical issue with no easy answer on a regular basis: Should she take on more clients and provide less care to those she already sees, or turn away potential clients who have no alternatives?
FLOODED SENSES: MEETING MENTAL HEALTH CARE DEMAND IN DISASTER-STICKEN IOWA. Iowa does not have enough psychiatrists, psychologists, therapists or other mental health care providers to handle an increasing need to care for farmers dealing with relentless flooding this year, several mental health experts IowaWatch interviewed warned.
A stigma exists in agricultural communities when it comes to seeking mental healthcare. Moreover, Kyle Godwin, who recently researched patterns in farmer suicide for his University of Iowa School of Public Health master’s thesis, said his research data might suggest that doing anything to improve farmer mental health care will be difficult unless something is done to end this stigma. Paradoxically, Godwin’s research showed that in regions of Iowa that had a higher saturation of mental healthcare professionals, there were more farmer suicides, not less. “Of course, naturally, you want to think that the places with mental health centers are going to have lower suicide rates, and studies have found that with the general population, that a higher proportion of healthcare providers and mental healthcare providers have generally related to lower suicide rates,” Godwin, who grew up on an Iowa farm, said in an IowaWatch interview. “But then I think we have to remember that for when we’re talking about farmers… just in rural areas, in general, I should say, you know, stigma may play a more prominent role.”
Many mental healthcare providers IowaWatch spoke with pointed to stigma as a major roadblock when trying to treat farmers.
Here are seven healthy tips for eating fish in Iowa, from the Iowa departments of public health and natural resources.
Since the August 2017 accident, Tate Manahl has endured more than 30 surgeries to repair severe injuries to his legs and internal organs. FairWarning has identified 133 cases of young children being injured by backovers of riding mowers since 2004.