Five years after Sergei’s suicide, the mental health services he needed most are still not available in Iowa

Some of us in the front row gasped at the documentary’s opening image: A handsome, sandy-haired teenager, eyes closed, tightly hugging his brightly grinning mom at the top of the State Capitol, the city skyline in the distance.

We gasped, tears already starting, because five years ago this month, that young man, Sergei Neubauer, died by suicide. He was a smart, sweet, caring 18-year-old who went out of his way to help others, even as he worked to hide his own trauma. The pain of his loss is still achingly fresh.

The documentary, “Facing Suicide in Iowa,” by Iowa PBS, tells Sergei’s story and that of another bright and promising Iowa teenager, Cameron Carico, who lost his life to suicide in 2012. The program and a panel discussion, held Sept. 6 after the premiere, made it clear that while there has been real and significant progress in Iowa, there is still a long way to go.

The 30-minute Iowa documentary will air at 8 p.m. Sept. 12 and 6:30 p.m. Sept. 13. It is a companion to a 90-minute national documentary, “Facing Suicide” that will air at 8 p.m. Sept. 13 on Iowa PBS.

Sergei’s parents, our close friends Mary Neubauer and Larry Loss, have dedicated a large share of their lives since their son’s death to working to improve the state’s mental health services. At the time Sergei died, there were few mental-health resources for anyone, let alone children like Sergei, and parents like Neubauer and Loss were left to try to find help on their own.

In hindsight, Neubauer said during the panel discussion, working for change “was our way of just standing in the darkness and screaming, ‘Do you see this? Do you see this?’ — and wanting lawmakers and policymakers and just everyone in society to see this and be willing to do something about it.”

I encourage everyone, especially Iowa parents, voters, state officeholders and candidates, to watch the “Facing Suicide” program. But here are a few things you should know:

• Iowa’s suicide rate is far above the national average, and is getting worse.
• The 2021 Iowa Youth Survey showed that 24% of 11^th graders reported having suicidal thoughts in the past year. The percentage for sixth-graders was 17% — still shockingly high. About half of the kids who had considered suicide had actually made a plan to take their own lives and about a quarter had made an attempt.
• “We’re seeing an uptick in all of the precursors for suicidal ideation and … a prevalence in our state — binge drinking rates of depression and access to crisis mental health services. And all of those indicators are having a steep trajectory in our state,” Iowa Department of Health and Human Services Director Kelly Garcia said during the documentary.

Iowa has made some progress in developing access to services over the past five years, overhauling its regional system and creating a framework for children’s mental health. Iowans have new crisis intervention services, including a national suicide and crisis hotline that is reached by dialing 988.

New mobile crisis units are working with law enforcement to address mental health crises in the field, helping to prevent incidents from escalating into arrests or worse. Iowa has two new mental health hospitals, adding beds for crisis care.  The governor has directed federal assistance toward school-based mental health programs, including training teachers to recognize warning signs. The COVID-19 pandemic has increased the use of telehealth for mental health counseling.

These developments were hard-won and took a huge amount of work by advocates like Mary and Larry, Brian and Dawn Carico, and many others. They are important and will save Iowans’ lives. I don’t want to minimize them.

Advocate: We have a children’s mental health system built out of toothpicks

But crisis intervention is just a start. In the documentary, Jennifer Ulie-Wells of the advocacy group Please Pass the Love, was brutally honest in her assessment of Iowa’s system and some of its leadership:

“So when I’m up at the Capitol, and I’m talking to legislators, and they say to me, ‘Jen, mental health is not really a thing. It’s just bad parenting,’ it’s very, very frustrating, because that’s not  accurate. It’s not evidence based, it’s not science based. And it totally dismisses an entire experience that we know millions of people are going through. And when you have that mentality, that means that you’re also not being an advocate for the constituents that you represent.”

(Some of us watching the documentary at Iowa PBS gasped again at this point. Some, perhaps, in shock. For me, it was anger at the level of ignorance it would take for a legislator to make such a remark about bad parenting.)

Ulie-Wells added: “Which is why in the state of Iowa, we have a children’s mental health system built out of toothpicks. So when you look at a mental health system that’s built out of toothpicks, and then you have a catastrophe like COVID that comes blowing through, of course, your system is going to blow down.”

One of the most severe needs in Iowa is simply more providers, particularly those with expertise in treating children. Programs like loan forgiveness for providers, more psychiatric residencies at University of Iowa, and tiered reimbursements for hospitals that treat the most serious illnesses can be effective, but they need resources.

Which is probably why, five years after Sergei Neubauer’s death, Iowa still lacks a long-term, subacute residential treatment center for teenagers and young adults. It’s not hospitalization but it’s time in a safe place to learn coping skills and put them into practice for a period of months. Mary Neubauer said they had to go out of state to find those services for Sergei – too far away, so the entire family suffered from the distance.

“And it’s my dream that someday we’ll get there because that’s what our son so desperately needed and that we couldn’t find for him here,” Mary Neubauer said.

I hope Iowa policymakers think seriously about making mental health access a priority in the state’s budget and policy. I hope voters make it their mission to elect people who will work for change. Those who want to help can start by contacting the advocacy group NAMI Iowa, [email protected] or (515) 254-0417.

And if you’re in crisis or know someone who is, please call the Iowa 988 hotline.

Watching the documentary isn’t fun, even if you haven’t lost someone to suicide. It certainly wasn’t fun for Mary and Larry to retell their story. But it’s important. And it makes a difference. Iowa’s children deserve better than a house of toothpicks.

“Is it painful or are events like this painful? Yes,” Mary Neubauer said. “But I continue to speak out and to try to push for change out of, quite frankly, deep-seated fear, because I know how many other families are in the situation now that we were in with Sergei. And unless we make changes, they’re going to have the same terrible outcome that we did, so let’s all keep talking about it, let’s all keep pushing for change, because that’s the only way that things are going to get better.”