Research Shows NC Still Needs More State Hospital Beds

On December 12, 2015 the newspaper, the major newspapers in North Caroline, Winston-Salem Journal p, The Durham Morning Herald, and the Raleigh News and Observer, all published as article,Researchers measure NC psychiatric bed shortage.” In this article, hard data confirmed what has been known for a number of years, the North Carolina, in spite of its unique and laudatory efforts, almost head and shoulders above most states in the US, still needs many more psychiatric beds. North Carolina is unique and to be regarded positively in its almost singular effort to spend hundreds of millions of dollars upgradings its entire state hospital physical plants over the last several years. Almost no other state in the Union is doing this in this time of tight state fiscal budgets, and the lingering slow recovery of the now nearly 10 years banking and housing bubble scandal-induced Great Recession. NC has closed one old hospital, the former John Umsted state hospital in the “institutional” town of Butner NC, just 20 miles or so NE of Durham and replaced it and the now closed famous Dorothea Dix Hospital of Raleigh named after the 19th century’s more famous mental health reformer, Dorothea Dix, with a new nearly 400 bed state hospital , Central Regional Hospital. NC has also nearly finished completing replacing the old “Cherry State Hospital,” in Goldsboro serving the eastern third of the state with another completely new facility.

As an historical and “tourist guide” type aside, the town of Butner is tiny and sprang up in the rattlesnake-infested pine forests north of Durham in WWII when Camp Butner was built by the Army as a major military training center and was the site of a 4000 bed Army hospital for wounded veterans from the ongoing War in Europe. It was the second largest such hospital during WWII on the East Coast. After the war, in 1947, the year I was born it was sold to NC for $1 on the condition it be utilized as a state hospital for the mentally ill. On a persona note, my own training psychoanalyst, who came to NC to help state psychiatry at UNC Medical School, was named its first psychiatric superintendent. Butner is currently also the 30 year site for the famous or infamous “Federal Correctional Facity” where some of the worst federal psychiatrically insane criminals have been housed and evaluated such as Ted Kazsinski, The “Unibombers,” Mark Chapman, John Hinkley and many others.

The research published in the national journal Psychiatric Services, used information and data from 2011 till 2012. Other state-based data from NC’s own DHHS from July 2014 to March 2015 show “average wait ties for the new Central Hospital, the largest, of more than 3 days for admissions, keeping in mind that all admissions are emergent and come via involuntary commitment.

The goes on to note pointedly that the state like so many other has cut state-wide the number of state psychiatric hospital beds since 2000, from 1,755 beds in 2001 to about 850 in 2012. At the same the original state reform plan promulgated and legislate in 1999-2000 promised/pledged/stated that 16 community based smaller inpatient/crisis stabilization/less than acute inpatient facilities would be built all over the state. To date on four such units have been built, and three of them are housed in community hospitals, one in Raleigh’s Wake Medical Center, one in Cannon Memorial Hospital in western Linville of 10 beds, (home of Linville gorge and Falls), and one in Waynesville’s Haywood Regional Hospital of 12 or 16 beds. Raleigh’s unit was not built by the state but by Wake County a few years ago after ‘getting tired’ of the state’s inactionn, and Capital city had to have a unit to serve its population with the closure of Dix Hospital in Raleigh. So part of the problem, ans is the case in almost ALL other states undergoing “bed crises” in state hospital circles, is the absolute failure to provide adequate new community based treatment entities and placements. North Carolina recently was adjudged to be in violation of a 2012 agreement to make efforts to place some 1000 state hospital patients in community residences, placements, group homes, and has only been able to place 400, so the Feds are coming to town for enforcement…

But it is NOT all bad news. On December 15, 2015 the U.S. Substance Abuse and Mental Health Servide Administration (SAMHSA) awarded a grant to the NC Dept. of Health and Human Services (DHHS) to plan for the establishment of a network over the state of “Certified Community Behaviorl Health Services,” the very bodies named in the original 1999-2000 mental health reform legislation but never implemented by the state legislature. This grant will provide $978,401 as part of similar funding for 23 other states to accomplish the same thing. Hopefully this grant will speed things along and real tangible quality localized service sites for the chronically mentally will materialize and start to fulfill the promises of now 16 years ago.

 

 

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Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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