Fitzsimon File

After several delays caused by staffing shortages, design problems, and safety concerns, the state's new mental hospital in Butner opened this week, at least partially. Two hundred patients were transferred from the John Umstead Hospital to the new Central Regional Hospital that when fully operational will also serve the patients currently at Dorothea Dix in Raleigh.

There has been no specific date set for the transfer of Dix patients, but Health and Human Services Secretary Dempsey Benton said in an interview this week that he expected it to happen in four to six weeks.

Problems with the new hospital have dominated news about the state's troubled mental health system in the last few months, rivaled only by the controversy surrounding the community support program that provides life skills for patients with a disability or mental illness.

A News & Observer series earlier in the year estimated that the waste, fraud and mismanagement of the program added up to $400 million, an amount disputed by advocates and state officials, but one that dominated much of the debate about mental health in the General Assembly session that ended Friday.

Benton seems to have a handle on the community support program and initial reports about the new hospital have been positive, though there's a long way to go, especially in hiring permanent staff and raising pay to reduce turnover at all three state hospitals.

Legislative leaders worked closely with Benton this session on revising some of the structural problems with the poorly designed and disastrously implemented 2001 mental health reform efforts, with much of the discussion about the 25 Local Management Entities (LMEs) created to oversee services provided by private companies.

Benton tried unsuccessfully to convince lawmakers to consolidate the LMEs into 9 larger ones to reduce management and administrative costs. Many legislators have close ties to the LME in their area and fiercely oppose both consolidation and giving state officials more authority over them.

Lost in all the talk about community support and the new hospital is a huge, dangerous hole that remains in the mental health safety net. Many LMEs are simply not doing a very good job taking care of people who leave a mental hospital, making sure they have access to services and a support network in their home county.

Benton says that statewide less than half the patients who leave mental hospitals receive the attention transitioning back into their community that LMEs are required to give them. In some areas less than one in three does.

A report from a Health and Human Services working group released earlier this year found that 1,200 people were discharged from hospitals to homeless shelters in 2007 and it appears that not much has improved.

State lawmakers balked at giving Benton more authority to step in when the LMEs ignore patients leaving hospitals, but he didn't get very far. An LME can shirk its responsibility for six months before the state can step in and even then it is not clear what state officials can do.

Six months is a long time and less than half the patients getting help navigating the maze of regulations and acronyms when leaving state institutions is simply not acceptable. Too many people with mental illness are still winding up in homeless shelters and too few people in the General Assembly and the media are paying attention. 

 Email This Post  Print This Post

This entry was posted on Wednesday, July 23rd, 2008 at 1:36 pm and is filed under Fitzsimon File. You can follow any responses to this entry through the RSS 2.0 feed.