In NC, people with mental illness turned away from psychiatric hospitals, end up in ERs

From The News-Observer in N.C.:

RALEIGH, N.C. -- People with mental illness are still languishing in North Carolina's hospital emergency rooms for days, unable to get psychiatric treatment.

A study released August 6 by the Wake County chapter of the National Alliance on Mental Illness found that, on average, patients who need admission to state psychiatric hospitals waited 2.6 days.

Of the more than 3,000 people on a waiting list in the first six months of this year, at least 212 people had to wait more than a week, according to NAMI's analysis of state data.

Another 900, nearly a third of all those seeking admission, went home after nearly two days without getting a bed.

"Emergency departments and crisis centers are not a therapeutic environment for paranoia, out-of-control thoughts, emotions and personal nightmares," said Gerry Akland, the president of Wake NAMI, an advocacy group. "As a society, we would not condone this treatment for our pets. It is time for the state of North Carolina to solve this problem."

As part of a 2001 reform effort, the state Department of Health and Human Services halved the number of beds in state psychiatric hospitals in favor of a plan to treat patients through private treatment providers.

But despite hundreds of millions in taxpayer money spent, there have never been enough private psychiatric beds available to meet the swelling need for treatment of chronically ill patients, who often lack private health insurance. Deep cuts to the state's mental health budget during the recession have also caused the reduction of state hospital beds, making matters worse.

An internal state study last year of conditions in nine emergency rooms found that waiting patients with mental illness were often handcuffed and sometimes shocked with stun guns by police or hospital security.

State officials tout the $29 million spent toward the addition of about 100 new psychiatric treatment beds in community hospitals scattered around the state.

"We are all concerned about North Carolina's ability to provide appropriate care for residents of the state who need mental health services, most especially for individuals who are in crisis," said Lanier Cansler, the state's DHHS secretary. "We are making progress, but the progress is restrained by the limited availability of funding, particularly in these difficult economic times."

But Akland said the state's own data on wait times for patients show that current efforts are nowhere near enough to meet the demand of people needing treatment. He expressed concern for what will happen if the state follows through with the closure of Dorothea Dix Hospital in Raleigh.

Opened in 1856, Dix is the oldest of the state's four government-run psychiatric hospitals. Its planned closure was blocked by a lawsuit in 2008, but that injunction was lifted by a judge last year.

The state budget approved by legislators in June did not include any money to keep Dix open for the next year and instead invested another $9 million in the effort to shift patients to private treatment beds.

However, no closure date for Dix has been announced. The hospital recently had its accreditation renewed by a national quality assurance commission.

"The critical need for beds in our state psychiatric hospitals continues to spiral out of control, and thousands of North Carolinians are suffering," Akland said. "It is time for our state legislature and our governor to do more than plug holes in a broken mental health system that has been repeatedly underfunded."