A Practical, Compassionate Fix

To a Harmful Gap in Children's Mental Healthcare

Photo courtesy of Nina Richtman

Over the past several years, parents, providers, and educators have sounded the alarm about gaps in access to intensive mental health services for youth with complex needs. When appropriate treatment beds, residential programs, or crisis supports are unavailable, families are left navigating impossible choices. What happens when a parent does everything right—seeks evaluations, pursues therapy, works with schools and doctors—yet still cannot secure the level of care their child requires to remain safe?

In an October 2024 Gaps post, I had the privilege of interviewing Des Moines-area parent and advocate Nina Richtman about the painfully impossible choice she had to make for her complex needs kids, both of whom she adopted from foster care: relinquishing custody in order to get them the intensive services they desperately needed when none was otherwise available.

Furthermore, I learned, that parents in these cases requesting a CINA can be and are placed on the Iowa Child Abuse Registry. Not because they harmed their child, but because they made a painful, last resort option in a dysfunctional children’s mental healthcare system.

Reforming this part of the CINA (Child In Need of Assistance) law has been proposed for the third year in a row, with one big difference: the proposed change is on its own rather than part of a bigger foster care reform bill, so it’s made it farther in the legislative process than in the previous two years.

Last week, Nina wrote a powerful Facebook post she gave me permission to share here.

Iowa friends-

The bill (HF 2256) I have been championing has made it through the House HHS committee and hopefully will be up for a full House vote soon. For anyone interested in helping, please email your Iowa House representative and ask them to vote YES on this bill. Below is sample email language you can use, and you can find your House representative here: https://www.legis.iowa.gov/legislators/find.

WHAT TO SEND (feel free to tailor it and share your personal connection to mental health care in Iowa):

Subject: Please Support HF 2256 to Protect Families Seeking Mental Health Care

Dear Representative XXX,

I am writing as an Iowa resident and advocate for families navigating the children’s mental health system. Many parents across the state have faced situations where, despite exhausting every available resource to secure treatment for a child with complex mental health needs, they are left with no safe options because the appropriate level of care simply doesn’t exist.

In some cases, these families have had to relinquish custody and have been placed on the Iowa Child Abuse Registry—not because they harmed their child, but because they could not find an open treatment bed or access the intensive services their child urgently needed. This outcome is both unfair and deeply harmful, especially for parents who work in fields like education, healthcare, or social services where being placed on the registry can jeopardize their careers.

HF 2256 provides an important and narrowly tailored clarification:

When parents have genuinely exhausted all treatment options and a child’s untreated mental health condition threatens the safety of the household, the child may be considered a Child in Need of Assistance (CINA) without penalizing the parent.

This change does not alter the CINA process or diminish child protections. Instead, it ensures that well‑intentioned parents are not labeled as abusive for seeking help in an overwhelmed mental health system. It protects families from unnecessary punishment, keeps parents engaged in their child’s care, and ensures young people with significant needs can access additional support through the juvenile court system.

This bill is a practical, compassionate fix to a documented gap in our system, and it will make an immediate difference for families who are already under extraordinary stress.

I hope you will consider supporting HF 2256 and standing with Iowa families who are doing everything they can to keep their children safe.

As HF 2256 moves closer to a full House vote, the voices of Iowa families and advocates can make a meaningful difference. This bill does not seek to overhaul the system overnight—but it does offer an immediate, compassionate correction to a gap that has placed already-struggling parents in untenable positions. By clarifying protections for families who are actively seeking help, Iowa has the opportunity to affirm that pursuing mental health care is an act of responsibility, not neglect. Now is the time to speak up, reach out to your representative, and stand alongside the families working every day to keep their children—and their homes—safe.