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Doing the 'Brain Health' Dishes

In her Condition of the State message, the Governor of my home state noted that Iowa has invested significant resources since a 2013 redesign of mental health services. This statement struck me as odd, given that her associate and predecessor ordered the closing of two state mental health institutions in 2015. With that large of a service loss, it’s easy to believe that one in five adults are living with an unmet mental health need.

Gov. Reynolds also promised to continue to do more this year with the creation of a mental health system for children, stating;

Creating a mental health system is complex and it won’t be solved overnight. But no parent, child, friend or neighbor should suffer in silence when it comes to mental health.

It’s prudent to be cautiously optimistic of these sorts of promises. In the words that greet visitors at a New Monastic Christian Community: “Everyone wants a revolution, but no one wants to do the dishes.”

Movements begin — and often end — with talk of reform and revolution. But genuine improvement begins during discussions while doing the dishes.

Like everyone in The Mighty community, I want to do the dishes because I am a parent, brother and son who also happens to be a university president. I have been immersed in mental health concerns for most of my adult life walking with friends, family members and students who are learning to manage their brain health conditions.

Some years ago, I led a campus movement to recast the term “mental health” to the less stigmatized “brain health.” This revised nomenclature softens the imbedded societal shame associated with conditions of our brain.

Most likely, someone you love is coping with dementia, ADD/ADHD, schizophrenia, bipolar disorder, PTSD, OCD, depression, anxiety, alcoholism, narcolepsy, Parkinson’s, opioid addiction, dyslexia, dysgraphia, dyscalculia or Alzheimer’s. All conditions of our human brain. You are not alone.

While I welcome a brain health revolution in this country, I am, first, interested in offering thoughtful suggestions for our governor and the public servants of our state. That being said, these suggestions should serve other states and their leaders, just as well as Iowa.

Begin with early identification: Every school needs embedded educational psychologists who understand the difference between ADD and ADHD, for example. Children with ADD look to be awake, but their brains are sleeping. Children with dyscalculia are often perceived as intellectually inferior. Without an informed intervention, in later adolescence, these treatable maladies can metastasize into more aggressive conditions like depression and anxiety. Our governor has proposed $3 million to help teachers identify mental illness in the classroom. Assuming $60,000 in salary and benefits, this appropriation could fund 50 specialists in a state with 367 public school districts. Let’s begin a pilot program in 10 districts, using a total of five specialists each, documenting what we learn over a period of three years. The smarter we are, the more effective we’ll become in serving our children and wisely spending taxpayer resources.

Identify treatment resources: Treatment for some brain conditions is already in place. For example, specialists trained in the Herman Method can re-teach children with dyslexia how to read. Children with depression require psychiatric interventions. Given that two-thirds of Iowa’s counties do not have access to a psychiatrist, each high school should be equipped with a tele-psychiatry portal. This portal, paired with physician assistants with specialties in psychiatry, creates a cost-effective multiplier effect. We can multiply the resources to serve children.

Equip independent colleges, universities and community colleges: About 60 to 70 percent of all Iowa high school students pursue some form of post-secondary education. These bridge years from adolescence to young adulthood are a precarious time. As is the case with grade transcripts, the legislature should loosen privacy laws and enable students to provide us with documented brain health transcripts. Today, many college students arrive to campus with a brain health condition, some still undiagnosed. Even more frightening is the amount of college students who actively consider death by suicide. The sooner we are aware of brain health challenges, the quicker we can provide a support plan.

Work to end the stigma: I attended The Des Moines Register-sponsored mental health forum last fall, which featured Governor Reynolds and two challengers. The most powerful moment in that forum was when she shared her struggle with alcoholism. It takes uncommon courage for political leaders to lay themselves bare. Our governor’s willingness to share her brain health disease was, thus far, her most important act of public leadership. Her bully pulpit will now help thousands of Iowans.

I hope our state and federal leaders will begin a revolution. But first, the rest of us need to begin helping with the dishes.

Please take the time to comment below with specific ways you believe your legislators can address these types of brain health issues. Or, if you’ve come across a program, legislative agenda, or organization in your home state that is successfully addressing brain health, please share information and links.

Follow this journey on Dr. Bullock’s website.

Getty image via Deagreez

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