Our Only In-Person Qualified Provider of Psychiatric Medications Has Left: Here’s What It Means for You

On Tuesday the 8th of December, many Grinnell students received a letter announcing that Megan Berryhill (ARNP), the only full-time psychiatric healthcare provider in Grinnell, has resigned her position at Grinnell Regional Mental Health Center. Ms. Berryhill works as a psychiatric nurse practitioner, a position functionally comparable to a psychiatrist. Her last day will be December 22nd, two weeks from now.

This news presents yet another barrier for students who are trying with increasing difficulty to access care for their mental health. Many students rely on Ms. Berryhill for medication management and are now unsure of where to go. For any student looking to access psychiatric care, the following choices are available:

  1. Make use of tele-psych services through Grinnell Regional–meaning you would see a psychiatrist via video chat
  2. See Ms. Berryhill once she establishes her new practice in an undecided location
  3. Travel to other providers in Des Moines, Iowa City, or elsewhere

Unfortunately, Grinnell Regional only offers tele-psych part time. Like all community psychiatric resources, this service is needed by the entire town of Grinnell. While a handful of tele-psych appointments have been set aside for students, demand cannot be met through time-share access to one part-time professional. When we called Grinnell Regional on Wednesday, December 9th, we were told that there is only one designated student appointment slot available between now and the end of the semester. This scarcity is particularly concerning as Ms. Berryhill is still seeing students during this time.

Of course, many students looking for an in-person provider find Megan Berryhill to be an excellent resource. Ms. Berryhill will continue to practice in central Iowa, but she has not determined whether she will practice in or near Grinnell. This presents a problem: the College will not provide driver services beyond the town. In order to see any provider outside Grinnell, students must arrange for their own transportation. At a minimum, students with cars will experience the added financial barrier of paying for gas, in addition to paying for appointments and medication. At a maximum, students without access to a car will have to hire a driver.

So really, your options look something more like this:

  1. Tele-psych, if you can get an appointment
  2. See Ms. Berryhill, when her practice eventually opens. This is genuinely a great option for many, but it hinges on access to transportation
  3. Travel to other providers in Des Moines or Iowa City if you can find an affordable ride and can spare time away from campus jobs and classes
  4. Try to get a family doctor to prescribe medications. Before attempting, you should know that family doctors do not benefit from the same extensive training given to psychiatrists and ARNPs. Many of these doctors feel uncomfortable prescribing certain psychiatric medications for this reason. Many others are simply not qualified.
  5. Go without needed psychiatric care. This option is often paired with option six:
  6. Do what many Grinnellians see as a necessary action: Self-medicate with drugs, alcohol, or other substances.

Students have been calling on Grinnell College to help us access options that are safe and reasonable. But so far we have seen insufficient action taken. For years, Grinnell has refused to expand SHACS driver services to drive students to Newton, Iowa City or Des Moines. Grinnell also lacks any publicized reimbursement program for students who cannot otherwise afford mental healthcare. And since Dr. Laura Van Cleve left Grinnell early this year, the College has not replaced her.

The increasingly drastic lack of available mental healthcare disproportionately affects students who are already struggling. Ms. Berryhill’s resignation adds one more element of uncertainty to what is already an unacceptable situation. SHACS used to provide Dr. Van Cleve’s services for free every Tuesday afternoon. Now, those who can’t pay for psychiatry are left to go without. Survivors of sexual violence do not have adequate options for trauma-specialized therapy. Additionally, SHACS staff is all-white, and students have reported difficulties in finding a SHACS therapist who is culturally competent to work with survivors, students of color, and LGBTQ students.

This situation hurts our friends and members of our community. This situation hurts students who can’t afford to bus or drive an hour away in order to see a provider. It hurts students who can’t afford the co-pay to see anyone outside of SHACS, as well as students who would be forced to pay for their care out-of-pocket. This situation hurts student survivors, students of color, and LGBTQ students who find that their only options for therapy are providers who treat them disrespectfully. This situation hurts students in crisis who are flailing desperately for resources but can’t find what they need. It’s not just fear, stigma, and money in the way; sometimes it’s an hour drive down I-80.

As part of our advocacy for survivors of sexual violence, Dissenting Voices has joined the many students urging the College to invest more effectively in mental health services. In September of this year, Dissenting Voices published our Aims and Goals, where we asked for a trauma-specialized therapist and increased diversity among staff at SHACS. We also asked for expanded telemedicine options in the interim. This has not happened. On November 20th, DV leadership met with administrators to ask that, in absence of these changes, Grinnell expand its SHACS driver services to transport students to out-of-town mental health resources. This has not happened either.

Once again, we implore the college to commit to necessary interim measures as well as long-term change. The issue we face is a systemic one. It requires a proactive, multi-pronged approach. In the short term, students are suffering for lack of basic care. The College needs to address this situation by instituting an official, need-based reimbursement program and expanding SHACS van services to provide out-of-town transportation. In the long term, the College must show real dedication to exploring how we can continually incentivize culturally competent and appropriately qualified providers of all types to come to and stay in Grinnell. We have an opportunity to improve the lives of not just Grinnell College students, but also members of the wider Grinnell community who need access to mental health care. This is not just a problem faced by a couple students here and there; mental illness is a universal condition and students, staff, and faculty alike all have reason to care about the treatment available.

Mental healthcare is an issue of student safety. It is a human right. It’s also an issue of equal educational access. When students have access to healthcare we need, we are better able to participate equally and fully in Grinnell’s intellectual and social life.  If you believe that mental health care is extremely important, show it. Tell the powers that be that you care, that mental health matters to you. Don’t just stand by as our community faces increasingly intolerable conditions.

So here’s what you can do to push for change:

1.) Please forward this article to alumni, friends, relatives- anyone who has reason to care about the quality of life at Grinnell and who might have a thing or two to say about this problem.

2.) We encourage you to make your voices heard! Please email [kington], [voos], [latham], [butleran], and [rolonjoe] with your concerns and opinions. Let them know that our community needs immediate action and long-term planning for equitable mental health resources.

3.) Students and alums: if you are interested in receiving updates about the fight for equitable mental health coverage, email dissentingvoices9@gmail.com to be added to our listserv.

** Please note that there may be some similarity between this article and a Dissenting Voices WordPress post on the same topic. The similarity is because these authors are responsible for both pieces.

4 Comments

  1. Actually you might want to do some more research. I have a psychiatrist that I see in town. He works for Midwest counseling and comes in town once a week. I agree that we need more people but saying that we have no psychiatric care providers in town is inaccurate.

    • Hi Zafeiro,

      Thanks for bringing this to our attention on facebook and in the comments here. For context (and in defense of our research): this psychiatrist is not mentioned in SHACS referral literature. It is also not mentioned in the 3rd party referral lists we consulted, or on the SHACS website under the list of in-town providers. Nor has this option been recommended by any of the providers we have spoken to (including SHACS counselors and Ms. Berryhill).

      I’m not sure why this is. One explanation is that this provider may not be taking new patients. After reading your comment, though, I left a voicemail for Midwest Counselling asking about it. Hopefully we will know more once we hear back.

  2. GC Dissenting Voices

    December 11, 2015 at 5:59 PM

    Hi Zafeiro,

    Thanks for bringing this to our attention on facebook and in the comments here. For context (and in defense of our research): this psychiatrist is not mentioned in SHACS referral literature. It is also not mentioned in the 3rd party referral lists we consulted, or on the SHACS website under the list of in-town providers. Nor has this option been recommended by any of the providers we have spoken to (including SHACS counselors and Ms. Berryhill).

    I’m not sure why this is. One explanation is that this provider may not be taking new patients. After reading your comment, though, I left a voicemail for Midwest Counselling asking about it. Hopefully we will know more once we hear back.

    -Devyn

  3. Here is an article that gives context to our local issues: http://www.thegazette.com/subject/news/iowa-faces-shortage-in-psychiatrists-and-resolving-the-problem-wont-be-easy-20150308 . Note that as of last March, 68 of our 99 counties did not have a psychiatrist. I think that number may be higher now. This is a statewide issue that we are effected by and sustainable solutions will need to be addressed at multiple levels.

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