One voice for a children’s mental health system

Chaney Yeast Director of Government Relations and Medical-Legal Project, Blank Children’s Hospital

This post shares Chaney's journey as a fellow in the first cohort and was first published in September 2019. Chaney continues to work on this issue as part of the second cohort of fellows.

The Journey

The fellowship was a good match for Chaney, who already was advocating for children’s health issues for Blank Children’s Hospital. The harder part was narrowing her focus for the project. She eventually landed on an issue that had the potential for bipartisan support: children’s mental health.

Even within that issue, Chaney had to decide whether to focus on issues, such as improving the array of mental health services or supporting better crisis intervention. The workshop with Topos Partnership gave her a chance to try to articulate what she was passionate about. “The Topos workshop was a way to narrow down what I felt I could bring to the table in a way other advocates could not,” says Chaney.

This Topos workshop launched a long journey for Chaney, in partnership with MidIowa Health Foundation (MIHF), lead mentor Rick Kozin, and other fellows, who supported her in finding one concise, engaging message that would unify the charge as the key strategy to bringing about a children’s mental health system in Iowa.

The Issue

In the 2018 legislative session, Chaney pushed the governor’s office and the Legislature to implement trauma-informed practices and build up services for children’s mental health. But as the legislative session was winding down and support for mental health shifted in unexpected ways, Chaney saw a flurry of activity from mental health advocates, pediatricians, parents, and service providers who were pushing for specific changes or funding. “There were probably 10-15 different messages on children’s mental health, and I think we confused legislators and made it feel overwhelming, because they didn’t know where to start, because the experts were giving them so many different paths to take,” Chaney says.

The different messages illustrated one of the biggest issues in Iowa: There was no children’s mental health system. Parents, schools, primary care providers, and law enforcement even today scramble to help when a child shows signs of poor mental health. State and federal funding restrictions make it difficult for families to access the treatment and support services.

Chaney re-centered her efforts on building that coordinated, collaborative effort. In the interim period leading up to the next session, she worked to identify a broad message that everyone could get behind, while still being able to talk about their individual issues or needs, to drive the effort toward a children’s mental health system. The message broadly spoke to the “shared responsibility” to fix the patchwork of children’s mental health services, the importance of developing brain architecture to future mental health, and the impact adversity has on the developing brain.

This message became invaluable as Erin Drinnin, community impact officer of health at United Way of Central Iowa, and Kim Scorza, CEO and president of Seasons Center, brought together organizations across the state who wanted to make sure Gov. Kim Reynolds considered the Children’s Mental Health Board’s recommendations when she proposed two bills. That coalition formed with Chaney’s support when she saw a desire from two other groups to have the children’s mental health voice heard apart from the broader conversation of mental health service needs for all Iowans. The coalition began to use Chaney’s messaging to make its case.

While funding is one of the biggest needs to improve mental health services for kids, the coalition recognized that they needed to first support Gov. Reynolds’ policy bills that would establish the structure for a children’s mental health system.

Successes

The meticulous process of developing broader statements on the importance of children’s mental health to the future prosperity of the state and creating a pyramid visual that explained where various services fit into a system paid off as Chaney watched other mental health advocates refer to the pyramid when testifying to legislators.

“Chaney did a good job of gently illustrating where there was dissonance among message in the previous session and what the advantages were of rowing together,” says Denise Swartz of MIHF. “Other people did convene some of those tables, but Chaney being at those tables and delivering that message again and again really drove that willingness to all come together.”

In May 2019, Gov. Reynolds signed into law the governance structure for a children’s mental health system that includes making sure kid needs are represented in making decisions and outlines the services regions must offer.

In addition to strong messaging, this achievement also stemmed, in part, from cultivating relationships with the governor’s office and becoming a trusted resource on the issues of childhood trauma and mental health. “I felt like we established that trusting relationship with the governor’s office, so we could provide additional input for the children’s mental health bills,” says Chaney.

“I think Chaney has been a phenomenal role model to the other fellows when it comes to positive stressors and identifying where there is intersection and where she can bring others along in being part of something,” says MIHF President Suzanne.

“It’s that confidence in leadership but also a tone that she uses that is approachable at all levels,” Denise says. “Whether she’s connecting with grassroots organizations or the governor’s office, she models that authentic leadership.”

Lessons Learned

“I think what I thought initially versus what I think now is very different,” says Chaney about the fellowship experience. “It made me slow down and really strategize how to create common messaging that all advocates all over the state could get behind regarding children’s mental health, and in hindsight, that type of slow, detailed, really thinking out what the message would be and how it would be used has been one of the greatest wins we’ve had.”

Chaney was eager to have messages ready by the first session of her fellowship, but after several painstakingly long sessions with Topos, she realized it would take longer to get to a point that unified many advocates. In the process, she saw how valuable that collaboration was: “I always knew collaboration was important, but in the sense of how do we get everyone working in the same direction, how do we make sure we have a common loud voice rather than these smaller voices running off on our own, that is a huge takeaway.”

This process is one she plans to replicate in her future work.

Benefits of the Fellowship

Building a deeper relationship in working with fellows Mary Nelle and Lisa fueled her work on children’s mental health. With their individual strengths, they worked together to arrive at this common message.

She also found creative ways to spend a larger budget than she was used to, such as purchasing billboards around the Capitol during legislative session to educate stakeholders on how mental health begins at birth. The funds also allowed her to build capacity for future work at Blank Children’s Hospital by allowing colleagues to attend national trainings on trauma-informed care.

“The fellowship gave me an opportunity to be creative and take risks with some uncertainty whether or not a particular strategy would be successful,” says Chaney.

The Future

Now that the children’s mental health policy bill passed, Chaney is working with stakeholders on how to gain funding to fully implement the system. They have pulled in a few states to understand how they fund their children’s mental health system. Iowa’s system is more complicated, and she expects she will not find one model that can be replicated, but that she’ll have to spend time finding that common platform that unifies everyone.

She is working with Topos on developing two to three talking points around funding that can be distributed to mental health advocates across the state to continue to speak with one voice.

The fellowship has also strengthened her relationships within her organization and with local, state, and national partners that can help fuel future work.

“In the business of public policy, strategic relationships are a valuable currency,” says Chaney. “Suzanne, Denise, and Rick have made me a rich woman! My ultimate goal is to use that currency to build a better future for children and families in Iowa.”