Broadlawns psychiatrist leads rare expansion of mental-health services
Janice Landy knows how it feels to be kept in the background.
The veteran psychiatrist helps patients with the kind of mental-health problems many other people don’t like to think about. She’s regularly worked in faded, tucked-away areas of hospitals, where patients with ailments such as bipolar disorder, schizophrenia or addictions often are sent.
Many hospitals have built shiny, prominent wings for patients with cancer, heart problems or childhood diseases. Donors flock to those projects, which aren't burdened by the stigma plaguing mental illness.
But Landy, who is one of The Des Moines Register's People to Watch in 2017, is leading mental-health care into the forefront at Polk County’s public hospital. At a time when many other hospitals are trimming or eliminating such programs, Broadlawns Medical Center has doubled its mental-health staff and is adding inpatient psychiatric beds. The hospital is helping launch a training program for new psychiatrists, and it soon will move its outpatient mental-health services into a sparkling, $25 million addition on the hospital’s east side.
Landy, who is Broadlawns’ psychiatric section chief, normally displays a calm, steady manner. But she teared up on a recent morning as she walked through the construction site, showing visitors how inviting the new clinic will be.
“When you’re really, literally being used to being in the basement, to see such state-of-the-art facilities that have been designed specifically for us, it's just remarkable,” she said.
The new clinic promises to be an unusually positive place for troubled patients to seek help, she said.
“I hope it gives them the message that they count.”
'Everybody has a lot of different facets to them.'
Landy, 54, grew up in Cedar Falls and worked in New Mexico, Illinois and Minnesota before coming back to Iowa. She has worked at Broadlawns since 2011 and became its lead psychiatrist in 2012. This latest career chapter let her resume practicing medicine at the hospital where she found her calling.
The first time she came to Broadlawns was nearly 30 years ago, when she was a University of Iowa medical student. She’d entered medical school because teachers had told her it would be a perfect place for a studious young woman like her. She’d buckled down and made it most of the way through her coursework and clinical assignments without actually being sure she wanted to be a physician. But that changed when she arrived at Broadlawns to spend a few months in a psychiatric rotation.
Psychiatry isn’t usually seen as the most glamorous medical specialty, but Landy embraced it.
“I loved the patients, I loved what I was doing,” she recalled.
All these years later, she still feels privileged to listen to mentally ill patients recount their life stories.
“They are often not easy stories to hear. But they’re rich, they’re interesting,” she said. “Even people who have lived really tortured lives — that’s not who they are, that’s not all they are. Everybody has a lot of different facets to them.”
She has to accept the fact that many patients aren’t happy to see her, at least at first.
Patient Taylor Burkhead made no bones about it in recalling his initial encounters with Landy in Broadlawns’ inpatient mental-health unit.
“I didn’t really like her, to be honest with you, because I was there by court order, and I didn’t want to be there,” he said. “When I first met her, I didn’t really think I needed help.”
Burkhead, 22, of Des Moines, had been arrested for trespassing at his former high school. He said he went there to seek help for family problems, but he made school leaders nervous. After several days in jail, he was sent to Broadlawns for a mental evaluation.
Landy eventually diagnosed the young man with bipolar disorder, and has treated him ever since, including during two subsequent hospitalizations. She helps him understand his mental disorder and how to stay on top of it. He recently graduated from community college, and he has an apartment and a car. He also has a job — transporting patients and materials around Broadlawns. Without psychiatric help, he likely would have gotten in more legal trouble, he said.
Burkhead said he gained respect for Landy and the other staff members, who offer a calm and knowledgeable presence in stressful situations. “There’s a lot of patients who aren’t happy to be there. They’re not always nice,” he said. “But the doctors still come in every day and try to help people.”
Expansion of mental-health care services
Under Landy’s leadership, Broadlawns’ psychiatry section has more than doubled its number of full-time psychiatrists, nurse practitioners and physician assistants. The taxpayer-owned hospital extensively remodeled its inpatient mental-health unit a few years ago and is planning to expand it from 30 to 44 beds next summer.
Inpatient psychiatric units are routinely filled, forcing many patients to be shipped to other hospitals around the state. Every day in Iowa, sheriff’s deputies drive hundreds of miles to deliver mentally ill residents to court-ordered treatment. The expansion of Broadlawns’ inpatient unit means fewer central Iowans will have to endure such transfers.
The improvements are rare good news for Iowans with mental illness.
“I think it’s great that Broadlawns is stepping up — and Dr. Landy is a big part of it,” said Peggy Huppert, executive director of the Iowa chapter of the National Alliance on Mental Illness. “They’re definitely bucking the trend.”
Huppert, whose group represents Iowans with mental illness, added that the long-run effects of the new psychiatric residency program could be “huge.” The state faces a crippling shortage of such specialists, forcing many patients to wait months for psychiatric appointments.
The joint Broadlawns/UnityPoint residency program, which eventually will produce four psychiatrists per year, is being founded with $2.5 million in state grants. A similar program is being started by Mercy Medical Center, which received a $1.5 million state grant. The only other psychiatric residency program in the state is at the University of Iowa. Many of its graduates stay in the Iowa City area or move out of state.
Landy is quick to share credit for her department's success. She notes that when she returned in 2011, Broadlawns was rebounding from tough financial times, which threatened its existence about 15 years ago. The public hospital has thrived under the Affordable Care Act, also known Obamacare. The federal law expanded the Medicaid program to cover 150,000 more poor Iowa adults, including many with chronic mental illnesses. Medicaid pays relatively low rates to hospitals, but it’s vastly preferable to no insurance, which is what many Broadlawns patients used to have.
“It doesn’t cover the whole cost of care, obviously, but it helps,” said Jody Jenner, the hospital’s chief executive officer.
Jenner said Broadlawns leaders see mental-health care as one of the community’s biggest needs. They have invested heavily in the facilities and staff.
Jenner said Broadlawns reached a “critical mass” of psychiatrists and other mental-health professionals after suffering through lean years without nearly enough. In those days, any new psychiatrist would be burdened with having to shoulder a huge workload, with little backup or time off. It’s easier for Broadlawns to recruit now, he said, because prospective staff members see that they’ll have support of numerous colleagues.
Jenner said Landy has been a key part of the department’s renewal, showing steadiness, wisdom and empathy toward patients.
“She just has tremendous insight into how behavioral health should be delivered,” he said.
EDUCATION: Bachelor's in biology and psychology, University of Northern Iowa, 1985. Medical degree, University of Iowa, 1990.
CAREER: Behavioral health section chief, Broadlawns Medical Center, 2011 to present. Broadlawns staff psychiatrist, 2011-2012. Clinical faculty, University of Minnesota, 2002-2011. Staff psychiatrist, including nearly five years as division head, Regions Hospital, St. Paul, Minn., 2000-2011. Staff psychiatrist, BroMenn Medical Group, Normal, Ill., 1998-2000. Psychiatric resident, then psychiatrist, University of New Mexico Medical Center, 1990-1998.
FAMILY: Husband, Jack, and three children, ages 16 to 22.
15 People to Watch in 2017: About the Series
These are central Iowans in business, arts, nonprofits, civic activism and unelected government positions who are expected to make a difference in their fields of endeavor in 2017. Readers were invited to submit nominations. Selections were made by Des Moines Register editors and reporters. Look for profiles daily through early January.
With this story at DesMoinesRegister.com/PeopletoWatch, see profiles of:
- Molly Hanson, executive director of Iowa Rivers Revival
- Tia Rodemeyer and Means Chan, co-founders of the Des Moines Girl Gang
- Gabriel Glynn, Iowa tech entrepreneur
- Kathleen Law, attorney at Nyemaster Goode
- Izaah Knox, associate executive director at Urban Dreams, manager of Wellmark’s Beacon internship program
- Anne Roth, Finance director and deputy campaign manager for U.S. Sen. Chuck Grassley's 2016 re-election campaign; account executive focusing on issues advocacy for DCI Group
- Dina Keahna, head coach of Meskwaki Settlement boys' basketball
- Rami Eltibi, an interventional cardiologist in Dubuque
- Megan McKay, owner of Peace Tree Brewing