Doing the Brain Health Dishes

Originally published January 27, 2019 in the Cedar Rapids Gazette & the Waverly Newspapers

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In her Condition of the State message, Gov. Kim Reynolds noted that Iowa has invested significant resources since a 2013 redesign of mental health services and will continue to do more this year with the creation of a mental health system for children.

“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,” she said.

I am hopeful about Governor Reynolds’ commitment to improving mental health services, and I am encouraged by her emphasis on early detection for our children. Yet, I am also cautious because, 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. 

I want to do the dishes because I am a parent, brother and son who also happens to be a university president in this state.  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.  They can:

1. 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. The 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.

2. 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. 

3. 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, 50 percent of college students arrive to campus with a brain health condition, 25 percent of which are undiagnosed.  Even more frightening, 7 percent of all college students actively consider death by suicide.  To put that into perspective, approximately 1,000 students on our campus have a brain health condition, and 140 actively consider suicide.  The sooner we are aware of brain health challenges, the quicker we can provide a support plan.

4. 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 Governor Reynolds’ public declaration begins a revolution.  But first, the rest of us need to begin helping with the dishes.