Girls happily reading their books - at Orchard Place Des Moines

Finding Hope for Seriously Mentally ill Children


Orchard Place Anne Star featured in the Des Moines Register regarding helping Iowa's kids receive mental health care.

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Anne Starr was on her way to the state Capitol to lobby legislators on behalf of the Iowa's mentally ill youth when I called her earlier this month.

She had marijuana on her mind.

No, not for personal use, or even medical use. Starr is CEO of Orchard Place, a Des Moines organization that provides mental-health services to children.

She was thinking about marijuana in terms of lobbying. She recalled the 2014 session, when scores of people came forward to testify before the legislature about chronic pain, epilepsy and other ailments that cannabis oil is supposed to help alleviate.

Starr was, in a sense, a little jealous.

"You had these parents who very passionately spoke about their children with epilepsy," she said. "They can come forward. There isn't any stigma or shame that's attached to that."

But for her clients — youth struggling with sometimes profound mental illnesses — there absolutely is.

The youth "don't want their peers to know, because they don't want to be one of those 'crazy kids,' " Starr said. "And parents often feel as if someone is going to judge them, that they've terribly screwed up their kid."

So the Fort Dodge native must fight for legislation and funding without one of lobbyists' most powerful tools: stories of deep personal impact.

That hasn't stopped Starr, who enters her second year leading Orchard Place, one of the top providers of mental-health services to Iowa youth.

Orchard Place began as an orphanage in 1886, but eventually evolved into the psychiatric institute it is today in 1965 — 50 years ago this year.

The organization served nearly 10,000 children in 2014 alone. It works with some of the most troubled children in the state, often with emotional and behavioral challenges that make it difficult for them to function in school or daily family life.

Orchard Place does everything from help connect families and children with counseling services to acting as a residential program for more than 100 children with the most severe needs.

Cases include children diagnosed with severe mental disorders such as depression, attachment disorders, self-harming and suicidal ideation and psychosis.

Starr knows words like "suicidal ideation" and "psychosis" lose a lot of people.

"A lot of people still just don't understand mental health," she said. "It's difficult because it isn't just one thing. It's many things that affect individuals very differently."

Mental health issues in youth may be misunderstood, but, unfortunately, they are all too common.

The National Alliance on Mental Illness estimates more than 1 in 5 children will have a serious emotional disturbance between the ages of 12 and 17.

My colleague Tony Leys, the Register's health reporter, has written extensively on the growing tide of children with severe diagnoses and the absence of care, both inpatient and outpatient, particularly in rural communities.

And so every year, people like Starr climb the steps of Capitol Hill and ask our elected officials to do more, because there is more need.

Last year, Orchard Place expanded its services to include an Integrated Health Program. The program helps children struggling with mental health issues stay in school and active in the community. Counselors work with families to develop goals for the kids to focus on long-term well-being.

The new program served nearly 1,400 children. Because there's always more to be done. So up the Hill Starr goes.

This year, Starr is fighting for continued funding for in-home therapy. In many situations, Starr said, the best place to treat an illness is in the home — making home that safe space where struggling children can collect themselves and work their way toward a more peaceful future.

"We've seen great results in that," Starr said.

She hopes Gov. Terry Branstad and the Iowa Legislature will make more Iowa children eligible for Medicaid benefits for mental health.

She's pushing for improvements to the system of mental-health care for youth regardless of how they come into the system.

Some kids are referred by the courts, others through the Iowa Department of Human Services, and so on. She wants better communication between the branches of government doing the work to help struggling kids to achieve better results.

Starr wants to make mental-health services available to kids at schools regardless of whether they have private insurance.

It's a big, ambitious list. And Starr is a realistic person. She won't get them all this session.

But that doesn't stop her from hoping. Hope is the big currency in her line of work.

And despite the sadness that comes with mental illness and emotional disturbances, she sees plenty of hope every day.

"You always have to remind yourself that this is only part of these kids' journey," Starr said. "You see these young people, and they don't know how they're going to get through this. Yet it can be miraculous. They work really hard at it. They work really, really hard to get better."

So Starr sees that, and it's easy to climb those stairs at the Capitol and try to tell their stories, to give voice to the voiceless and help the struggling on their way to better lives.