A long way to go in mental health reform

A long way to go in mental health reform

- in Fitzsimon File

Good news, bad news, and frustrating news this week about the state’s struggling mental health reform efforts. Good news has been rare in recent years in the state’s efforts to shift treatment of many people with mental illness from institutions to local communities.

The problems have been well documented and most have meant that people with a mental illness, developmental disability, or substance abuse problem have not been able to access the services they need, directly affecting the safety and quality of life for thousands of people and putting enormous stress on families across the state.

The Legislative Mental Health Oversight Committee met Tuesday for the first time since the General Assembly adjourned and heard reports on various aspects of the reform efforts.

Lawmakers heard that money appropriated last year for housing for people with mental illness and other disabilities is paying off, with construction of 425 housing units underway in 33 counties. There was also encouraging news about improvements in crisis care for the mentally ill, another focus of lawmakers this past session. 

But those won’t be the headlines from the meeting. Several legislators from Wake County raised serious questions about a report from state officials about the transition of patients to the new mental health hospital in Butner from Dorothea Dix and John Umstead hospitals, which are scheduled to close. 

Rep. Deborah Ross pointed out that the report from the Department of Health and Human Services did not address all the issues that the law requires before any hospital can be closed, a point that several of her colleagues agreed with.

Committee Co-Chair Senator Martin Nesbitt summed up the sense of the committee by pointing out that the state shouldn’t close any hospital if there was a shortfall of beds available for patients who need them, leaving the question of closing the hospitals as scheduled at best unresolved, at least from the Committee’s point of view.

The meeting comes as the media continue to expose the problems that mental health reform is causing for families in the state. The Asheville Citizen-Times reported Tuesday that in the last nine months, the state has issued 15 policy implementation updates about mental health services and 80 bulletins about policy changes. 

The morass of changing rules and regulations means patients suffer and the Citizen-Times tells the story of one of them, a man with bipolar disorder, discharged from a mental hospital and now without medication, who found out recently that it will be three months before he can see a local service provider.

Advocates for the mentally ill say his story is not atypical and a Focal Point Documentary airing this week on WRAL-TV makes that clear. Called “The State of Minds,” the program tells the stories of people who lost services as part of the privatization that came with mental health reform.  (You can see a preview of the documentary on wral.com)

It includes comments from public officials, like Carmen Hooker Odom, the former Secretary of Health and Human Services, who is still defensive about reform efforts.

One theme running through the documentary and news stories is the lack of trust in the Department that has developed among patients, families and advocates in the mental health community. They have lost faith in state officials’ ability and even willingness to help them.

Restoring that faith is the first priority of the new HHS Secretary Dempsey Benton, who addressed the legislative committee Tuesday. Benton is known as top-flight administrator and there’s plenty for him to fix. The federal government has suspended payments to one state mental hospital because of problems with patient care and is threatening sanctions against another one.

But Benton has to do more than just make sure things run smoothly. He needs to find a way to convince people that the Department cares about them and wants to make sure they get the services they need. Then he needs to deliver on that promise, and soon, because the suffering continues.

About the author

Chris Fitzsimon, Founder and Executive Director of N.C. Policy Watch, writes the Fitzsimon File, delivers a radio commentary broadcast on WRAL-FM and hosts "News and Views," a weekly radio news magazine that airs on multiple stations across North Carolina.
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