DES MOINES - The Iowa House and Senate moved legislation last week that has the state taking a greater role in taking care of the mentally ill.

But whether it's the House plan that offers property tax relief or the Senate plan that creates eight mental health regions in the state or some sort of hybrid, there still will be the problem of getting mental health services to rural communities.

"The primary concern for rural Iowa is really related to recruiting psychiatrists to practice in rural parts of the state," said Dr. Bhasker Dave, superintendent of the state-run Mental Health Institute of Independence. "It becomes an access issue for the people who live there."

Iowa ranks 47th in the U.S. in the number of psychiatrists per capita and 46th per capita in the number of psychologists, according to the most recent figures available from the U.S. Department of Health and Human Services.

According to Roger Tracy, assistant dean at the University of Iowa's Carver College of Medicine, as of December 2010, more than a quarter of the available psychiatrist jobs in the state - these are positions that are budgeted for - are unfilled, and this is the lowest percentage since 2006.