The maddening confusion about mental health continues

The maddening confusion about mental health continues

- in Fitzsimon File

Governor Mike Easley may not want to talk about it, much less spend money addressing it, but the state’s mental health crisis continues. The “Q” section and the front page of Sunday’s Raleigh News and Observer made that clear again with disturbing news accounts detailing the problems and accompanying columns by state officials, leading legislators, and mental health providers that ranged from maddening to surprisingly thoughtful.

The thoughtful perspectives came from outside the Easley Administration. That’s not a shock since Easley’s budget spends only $3.5 million in new funding for a system that needs hundreds of millions of dollars in new investments over the next few years to provide services for thousands of families caught up in the confusing web of acronyms, privatization schemes, and here today gone tomorrow service providers.

To be fair, Easley has also weighed in with a harebrained proposal to build a $170 million state office building on the Dorathea Dix land and didn’t see fit to consult or even inform the Wake County legislative delegation or a commission working  for a couple of years on what do with the land.

Sunday’s News and Observer detailed the revolving door admissions and discharges at the state’s mental hospitals that has prompted a federal investigation and convinced some grieving families that their loved ones suicides were partially the result of the hospitals rush to discharge them back to communities that had no services to help.

Mental Health Director Michael Moseley told the N&O that what happens after patients are discharged is not the hospitals fault, that the problem is a lack of services at the local level.  The article makes a convincing case that the hospitals’ admission and discharge policies are questionable at best, but even if Moseley was right, his comments about the lack of community services are outrageous.

He runs the department that is supposed to make sure people get the services they need in hospitals and in their communities. If people’s lives are at risk, Moseley ought to be banging on the tables at the General Assembly and in the Governor’s budget office, not playing a shell game of blame.

The opinion columns that were printed with the story included one from Moseley’s boss, Health and Human Services Secretary Carmen Hooker, whose message is remarkably to stay the current disastrous course. 

Senate President Pro Tem Marc Basnight sounds a much different tune, urging lawmakers to pass parity legislation to require insurance companies to cover mental illness the same way they cover physical ailments. Basnight also recognizes the need for more investment in mental health services and proposes an increase in the tax on alcohol to pay for it.

Rep. Verla Insko, who chairs the House Mental Health Committee, wants more funding for substance abuse programs, more housing for the mentally ill and more accountability for service providers.

Dr. E. Drew Bridges, the former head of the N.C. Psychiatric Association, asks the question that policymakers may be afraid to ask. Is privatization itself the problem? The 2001 mental health reform legislation created Local Management Entities to administer the delivery of services, not to provide them.  Bridges points out that the market is not designed to provide expensive services to people who are unable to pay for them.

Even the News and Observer itself is adding to the chaos. The paper deserves credit for Sunday’s coverage, but a recent editorial and a column by the paper’s senior political reporter both went out of their way to praise Easley’s budget proposals, neither mentioning the lack of funding for mental health.

Three and a half million dollars and an office building won’t do it. Neither will bland reassurances or efforts to shift blame from Administration officials.  Basnight, Insko and other legislators have their work cut out for them in the next few years, trying to save a mental health system that is not only broken, but that is run by an Administration that is either unable or unwilling to fix it.