CONTACT: BECKY SOGLIN
Iowa City IA 52242
(319) 335-6660; fax (319) 335-8034
Release: Sept. 22, 2000
UI makes strides in IMPACT program to treat schizophrenia and related
IOWA CITY, Iowa -- A University of Iowa Health Care outreach program that
helps people with serious mental illnesses is successfully helping those individuals
stay on their medication -- and stay out of the hospital. The program, which
also helps train more health care providers to provide psychiatric outreach
services, is becoming a model for mental health care outreach across the state.
IMPACT -- Integrated Multi-Program Assertive Community Treatment program
-- brings a team of health care professionals to the homes of people in Johnson
County with schizophrenia, bipolar affective disorder (manic depression) or
schizoaffective disorder. Outcomes for the past four years show that patient
involvement cuts hospital stays from 37 days annually to seven days after
the first year in the program, then to four days after the second year and
three days after the third year.
"We help people who have a history of repeat hospitalizations while
receiving care via traditional mental health services," said Nancy Williams,
M.D., UI assistant professor (clinical) of psychiatry and IMPACT clinical
director. "The program saves dollars by reducing hospitalizations, but
more importantly it improves people's lives."
Based on a model from the University of Wisconsin, the Iowa City program
was started in 1996 by Gerard Clancy, M.D., UI associate professor (clinical)
of psychiatry, and Betsy Hradek, a UI psychiatric nurse.
IMPACT physicians and nurses make regular home visits that encourage patients
not to stop taking medications, a downfall that can lead to re-hospitalization.
But there is more to IMPACT than just taking medications. Home visits by IMPACT
counselors, social workers and occupational therapists serve a wide variety
of functions to help people live independently. During these visits, patients
can get help with basic living skills such as cleaning and grocery shopping,
problem-solve daily stressors, or get assistance with finding a job.
IMPACT aims to provide leadership for spread of the model in Iowa, Williams
said. In 1998, similar programs were started with UI involvement in Cedar
Rapids and Des Moines. However, one barrier to getting the model adopted elsewhere
in the state is finding trained clinicians. Currently, IMPACT involves students
from the UI School of Social Work, the UI College of Education, and the UI
Colleges of Medicine, Nursing and Pharmacy during their internships and elective
"A major problem with providing this type of care to people with serious
and persistent mental illness is the lack of trained clinicians familiar with
the model," Williams said. "By training more students, we hope to
provide better services for the state. Involving students also helps bring
new ideas to the program."
Ryan Carnahan of Mitchellville, Iowa, is studying for a PharmD. degree at
the UI and recently completed a clerkship with IMPACT. Carnahan said he learned
a great deal by working with the IMPACT staff and especially by working directly
with the patients and answering their questions about medication.
Perhaps most important, he got to know the patients as people, playing basketball
and baseball with them and enjoying pizza parties.
"I'm thankful to have had the opportunity for that kind of experience,"
said Carnahan, who is now an intern at Hartig Drug in Iowa City and plans
to graduate next May. "It's something you can't get in a lot of places.
It gives you a good perspective on how these illnesses affect people's lives
and breaks down the stigma that surrounds mental illnesses."
Although Carnahan's IMPACT internship ended in August, he still keeps in
touch with many of the patients and is organizing a group rock-climbing event.
Schizophrenia is one of the topics that will be addressed during this fall's
UI Mini Medical School on "New Hope in Understanding and Treating Mental
Illness." Williams will discuss schizophrenia, and Clancy will discuss
clinical depression at 7 p.m., Tuesday, Sept. 26 in the Medical Alumni Auditorium
of the UI Hospitals and Clinics.
Pre-registration is required to attend the program. Call toll-free (800)
691-2323 or, in Iowa City, 384-9988. To register online, visit the web site
University of Iowa Health Care describes the partnership between
the UI College of Medicine and the UI Hospitals and Clinics and the patient
care, medical education and research programs and services they provide.