Clean up mess

Published 12:00 am Monday, January 14, 2008

By Staff
once and for all
(This editorial originally appeared in The Times-News of Hendersonville.)
Meet the new gang that couldn’t shoot straight: the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services.
In 2001, the Legislature ordered an ill-planned reform of mental health services. The idea was admirable. Get people out of large state facilities and into smaller community-based treatment programs where they would get more individualized care closer to home. But rural areas in particular lacked the necessary facilities and care providers; people in crisis ended up flooding hospital emergency rooms, homeless shelters and jails.
The division that oversees the system ought to be leading efforts to fix the reform. So far, all it has managed to do is make matters worse.
The latest example is the division’s failure to adequately oversee the construction of a new mental hospital to replace two older facilities and its failure to ensure that all four state psychiatric hospitals meet federal safety and administrative standards.
Dempsey Benton, the new secretary of the Department of Health and Human Services, has delayed closing Dorothea Dix Hospital in Raleigh and John Umstead Hospital in Butner for 60 days. Patient transfers were supposed to start in February and be completed by March 1. Benton said the delay will give the state time to fix construction problems at the $120 million Central Regional Hospital, which is to replace Dix and Umstead.
It seems Mike Moseley, the director of the Division of Mental Health, and his staff haven’t been paying close attention to construction at the hospital. A recent internal review found 30 types of hazards in the facility, some of which could allow patients to hang themselves. It is good that Benton wants to make the hospital safe for patients, but we have to wonder where Moseley and his staff have been?
Benton also said the delay will give the state time to correct problems at the state’s four psychiatric hospitals and its 10 other mental health facilities. All four hospitals have been under pressure to improve patient safety and administration.
That’s a particular concern for mountain residents because of problems at Broughton Hospital in Morganton, the state’s largest mental hospital and the one that serves the mountains. Just last month, Benton removed the hospital’s director. The move came after the hospital lost its ability to collect Medicaid and Medicare reimbursements in the wake of a federal investigation into the death of a patient. The hospital is now fighting to keep its accreditation from being revoked.
Things have gotten so bad that Benton has ordered that the staff of the four psychiatric hospitals report directly to him rather than to the Division of Mental Health.
When you have to bypass a link in the chain of command, it’s time to seriously question the suitability of that link.
It has been six years since reform was first mandated. The mental health care system has been bumping from crisis to crisis ever since. The people least able to cope with change have been presented with a shifting set of rules, services and providers.
As the Times-News has reported numerous times, if it weren’t for Henderson County commissioners stepping up to the plate, mental health care here would be in horrible shape. The county came up with the money that kept the Sixth Avenue Clubhouse from closing, was a leader in getting the state to set reasonable reimbursement rates for local providers and led efforts to find new providers after New Vistas-Mountain Laurel, the mountains’ primary care provider, went bankrupt. Without a grant that the county was instrumental in obtaining, Pardee Hospital would have closed its medical detox unit on Dec. 1.
But Henderson County can’t continue doing what the state should be doing. Nor should it have to.
Benton says Gov. Mike Easley has ordered him to craft a plan to fix the mental health system. It’s past time.