03/06/08 — Officials eye mental health proposals

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Officials eye mental health proposals

By News-Argus Staff
Published in News on March 6, 2008 1:46 PM

After Gov. Mike Easley announced several initiatives Tuesday designed to shake up the mental health reforms begun in 2001, some local officials, including Eastpointe Director Ken Jones, voiced concern about the direction of the proposals -- namely those concerning the state's relationship with the local management entities.

However, other proposals, specifically those dealing with crisis care, are already gaining traction.

During his press conference, Easley called for the state General Assembly to appropriate about $40 million this year for the expansion of mobile crisis teams and to help provide more psychiatric beds in community hospitals.

The reason is because the shift to community-based mental health care has not eased the burden on the state's mental health hospitals as planned.

If anything, that burden has increased as patients in crisis, particularly on nights and weekends, show up at local emergency rooms and are then taken to the state institutions.

The goal of the mobile crisis teams is to intercept those people before they need that emergency care.

"That would benefit us, certainly," said Wayne Memorial director of public relations Amy Cain. "There certainly would be a benefit in mobile crisis teams in that they would help people in ways other than them being in the emergency departments.

"We're going to take care of them regardless of what they need, but our emergency department can't handle a large number of mental health patients showing up. We have to take care of the patients with physical needs."

Currently there are no crisis teams working in the Eastpointe catchment area of Wayne, Sampson, Lenoir and Duplin counties, although Jones said a contract is in place for a provider to soon begin serving Sampson -- the county he identified as having the highest need.

And, he added, as the resources become available, those teams will then spread to the other three counties. In the meantime, Eastpointe will continue to support on-call services.

"That will be a big help for us in that it should keep a significant number of consumers from being admitted here," Cherry Hospital Director Dr. Jack St. Clair said.

The problem is that Cherry, like the state's other institutions, consistently operates at capacity.

"We exceed our capacity regularly here because we have become the safety net, in great, part for the community," he said.

In the 65 days since the beginning of the year, Cherry has been at or over capacity for 49 of them.

To help alleviate the problem, the hospital does have diversion contracts with three private psychiatric hospitals in Wilmington, Raleigh and Jacksonville and is working on several others.

But having an expanded capacity for short-term acute patients at either those or at other local community hospitals like Wayne Memorial also would be beneficial, St. Clair said.

However, that also presents a whole new host of challenges.

On average, Wayne Memorial has 18 to 24 patients on its psychiatric floor -- near capacity. Ms. Cain also said that its outpatient provider -- Stoney Creek Behavioral Health -- consistently operates at or near full capacity.

"There's really not a whole lot of flexibility there," she said. "We're certainly in no position to double our amount of patients. We just don't have the space, and we don't have the staff."

The key, St. Clair said, will be for the state to possibly provide funding and other incentives for the local hospitals to make those adjustments.

"I certainly would support that," he said.

And he added that overall, he was supportive of the governor's direction Tuesday.

"I think it's good for us to look at all of our options and to consider what additional resources need to be put in place to offset the high admission rates in our psychiatric hospitals, because what I'm ending up with here are conditions that are not safe for patients or staff," he said.