Fitzsimon File

Admitting the problem

If it is true that the first step in solving a problem is admitting you have one, then maybe things are finally beginning to turn around for the state's troubled mental health system.

Senator Martin Nesbitt, the chair of the legislative commission that oversees the system, told lawmakers Tuesday morning that the General Assembly made a serious mistake this year by deeply slashing funding for mental health.

Nesbitt pointed specifically to the last minute $40 million cut to Local Management Entities (LMEs), the agencies that manage services for the mentally ill, developmentally disabled, and people with addictions.

He said the cuts have forced LMEs "to decide who they won't help." Lawmakers heard how bad the state is doing from people who should know, top officials with the Department of Health and Human Services.

Assistant Secretary Michael Watson, who used to run an LME himself, said that despite a careful planning process to implement the cuts, people across the state are losing important services and many more are being turned away, as most programs are capped because there is no money to pay for new patients.

That is not news to advocates or family members of people with a mental illness or developmental disability. A coalition of groups last month called for lawmakers to return to Raleigh for a special session to address the growing crisis in mental health, as the cuts made this summer are now being felt by families across the state.

Tuesday's meeting comes after yet another News & Observer story about the system's problems, this time a report on patients with a mental illness languishing in emergency rooms, sometimes handcuffed, sedated, or even tasered to keep them quiet.

The N&O referred to an internal DHHS report which described the problem that prompted one advocate to say that if similar things were happening to animals, the public would be outraged.

Watson told the oversight committee Tuesday that the budget cuts are being felt in jails, ERs and state mental hospitals, confirming the general outline of the N&O story. 

One primary goal of the 2001 mental health reform efforts was to treat more people in their communities and reduce admissions to state hospitals. That has yet to happen.

The new Central Regional Hospital in Butner now has an overflow wing and it is still not enough.  It is not hard to figure out why.  LME Director Rhett Melton said that the budget cuts to his agency came to 26 percent this year while demand for services has increased beyond projections.

Health and Human Services Secretary Lanier Cansler told the committee that enrollment in Medicaid is 9,000 higher than forecast.

And all this slamming a system that was underfunded and struggling before the economic crisis began.

State officials and many lawmakers have soft-pedaled the extent of the crisis in mental health for years. Former Governor Mike Easley didn't seem to notice there were any problems until the media uncovered abuse and neglect throughout the system.  There have been periodic reports of serious problems amid sputtering progress ever since.

Then the came the worst budget shortfall in the state's history and last minute cuts on top of other deep reductions to mental health and development disability services, a total of $155 million slashed.

Nesbitt called the budget cuts a "bad deed' that lawmakers need to fix. That's some version of good news, that a prominent lawmaker is willing to candidly talk about how wrong the General Assembly was to cut mental health programs so deeply.

Now that everyone finally admits there's a problem, it is time to start solving it. People with a mental illness or a developmental disability have waited and suffered long enough.

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