Daily News

Privatizing treatment left gaps in the system, an expert says, and people without Medicaid can end up with no place to go

Lynn Bonner, Staff Writer State and local officials didn’t do enough to help the neediest of patients when they reorganized the mental health system, according to an expert’s report.

Sweeping changes in the last six years have converted the mental health system by making private companies largely responsible for community mental health treatment, taking that role from local government agencies. Instead of treating patients, local government offices were to monitor companies and ensure that patients were getting what they needed from private providers.

According to a consultant’s report, local mental health offices are not able to guide patients to needed treatment or adequately monitor private companies.

"There has been insufficient joint effort at resolving consumer access problems," says the report by Alice Lin, a consultant to the state mental health division.

Eighty-five percent of patients, those whose care is paid by Medicaid, can find companies to treat them, Lin said in an interview Wednesday. But the 15 percent who are poor but don’t qualify for the federal money or have hard-to-treat disabilities continue to slip through the cracks of the new system, just as they did the old.

Lin, who helped write the 2001 bill that changed the mental health system, said the changes were meant to help the tough patients, homeless people who use illegal drugs, for example. The state and local offices have not cooperated well enough to resolve the problems of patients unable to find care. Most states have a hard time with the same problems, Lin said, but "I wanted to feel proud of our system. I feel we can do better."

Lin said some good things have happened since 2001. North Carolina legislators pay more attention to mental health than do their counterparts in other states; the state has a special fund for mental health services; and consumers and their families are asked for advice on what counties need.

"I think it was a very balanced report," said Mike Moseley, director of the state office that oversees mental health services.

Lin focused on seven local mental health offices, including the Durham County office and one that oversees Orange, Person and Chatham counties. She also talked to state government officials and private companies.

Local mental health directors said remaking the system took effort, but they did not ignore patients’ needs. "That’s what we keep in the forefront of our mind," said Judy Truitt, head of the Orange/Person/Chatham office. (more…)

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