There has been a lack of mental health services in Marshalltown for a while, and providers are struggling to meet the increasing demand.

YSS of Marshall County Director David Hicks said while the demand for mental health services increased due to the COVID-19 pandemic, it was a problem prior to it.

“There were still a lot of unmet needs before then,” he said. “We’ve probably never had ‘enough’ therapists in our 40 years in Marshalltown.”

Hicks attributes the increase to people being more accepting of seeking out mental health help.

“They’ve suffered in silence long enough and want relief,” he said.

Center Associates Executive Director Paul Daniel said the need for mental help in Marshalltown is great. He believes the stigma of seeking mental help is slowly breaking down, and people are utilizing it not just in times of crisis.

“Slowly we are saying ‘This is OK,'” he said. “They know brain health is just as important as heart health, lung health. Because we are decreasing that stigma, it has welcomed people to seek out services. We just need to figure out how to work and maneuver.”

Daniel said businesses are also more comfortable talking about mental health, and seeking help for employees. For example, he is providing services to businesses in town who recognize some of their staff have experienced trauma or are going through hardships.

“The trajectory of mental health is increasing, it’s rising,” Daniel said. “What we’re trying to do is bend that down a little bit – which is our hope – by getting the word out that it is OK.”

School district

The Marshalltown Community School District has seen an increase in the amount of students who need mental health care, according to Director of Special Services Matt Cretsinger.

“I attribute some of it to the pandemic and the results of it,” he said. “The pandemic was hard on everybody.”

A huge part of the increase, according to Cretsinger, is people have realized the effects of a lack of socialization, and are seeking balance. Throw in some recent events in Marshalltown history, and there is another reason for the increase.

“The tornado, derecho, the pandemic – all of those things created stress. All those things add up and create a trauma effect,” he said. “Trauma effect is a thing in which students might be inattentive or depressed. It is the underlying factor in which stress built up and things became more prevalent.”

Cretsinger said all children also experience life at home. If the parent is stressed, worried about employment or bills, it will have an impact.

“It’s amazing what kids perceive, how they hear and carry stressors for us,” he said.

During the last school year, Center Associates was partnered with the school district to provide mental health services to students. However, the center pulled services from elementary schools for the upcoming year to help meet the increasing demand in the community. They will continue to provide services at Miller Middle School, Marshalltown High School and Marshalltown Learning Academy.

“I think we have been fortunate to have Center Associates as a remarkable partner,” Cretsinger said. “We have other great partners, such as YSS, Wild Spirit Counseling, Grace C. Mae Advocate Center. We are possibly adding a new provider. We are looking to bring another one on to fill up the space.”

Daniel said the elementary school withdrawal is temporary — at least until they get enough clinicians.

“We want to take care of our people here first,” he said. “Until we have the right staff, it’s more of a pause.”

From September 2022 through April, Daniel said four Center Associates professionals made 467 visits to Marshalltown elementary schools and treated 100 students. On top of patients at the Center Associates facility, he said the past year led to staff burnout.

The mental health provider does still offer the option for younger patients to go directly to their building for treatment. There were some advantages for the professionals to go to the schools as it allowed them to observe behavior directly, rather than receiving notes from teachers or parents. That is one thing Daniel said they will not have by bringing patients to the facility.

Trying to address the problem

One hurdle mental health facilities face when trying to meet the demand is lack of staff. Daniel said they have been having trouble finding clinicians.

“Our average wait is six to eight weeks, which is a concern,” he said. “If we had five or six more clinicians willing to see patients, that would help. Would we still have a wait time? Yes, because the need is still going up.”

At YSS, Hicks hopes to add one more therapist. However, he would like to be assured that the therapist meets enough people to pay for the added cost.

“We need to have the right balance of clinicians and clients being seen,” he said. “We have to pay our staff whether the client comes to their appointment or not. We are a non-profit, but will still have to operate like any business would. We have to pay for the light bill, too.”

YSS is also looking at different groups that could be offered in the schools, and are assessing strategies. For example, he said one collaboration they are working on is yoga.

Another action Center Associates has taken is starting an urgent care to provide triage care. According to Daniel, it will give patients who have waited a long time a chance to get treatment. They have also ventured into telehealth, which is not as effective, but will address issues. He said many times people who are given the option to use telehealth would rather come in.

“We play ball at the Y with your dad. We shop at the same grocery store,” Daniel said. “People want face-to-face, a connection. They want to feel like you belong here, that you’re understanding.”

As providers struggle to meet the needs, patience is requested.

“We are grateful for when we can help, but understand that we have limits like everyone else,” Hicks said. “We don’t have all of the answers either. There are a lot of ways you can help yourself — seek meaningful connections with others, focus on the present, let go of toxic relationships, exercise, eat regular and healthy meals, focus on what you are grateful for, stay positive, get away from social media and always be good to yourself.”

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Contact Lana Bradstream

at 641-753-6611 ext. 210 or

lbradstream@timesrepublican.com.