NC Mental Health in the news

MENTAL HEALTH:State Department of Health and Human Services Secretary Dempsey Benton outlined plans Wednesday to address troubles in the state's mental health system. Benton members of a legislative committee on mental health that he plans to ensure basic psychiatric care throughout the state, buy space for the mentally ill in community hospitals, report all institutional deaths to a medical examiner and weed out unqualified private companies. Some of the proposals would reverse changes from a 2001 reform plan that allowed companies to take the responsibility for providing mental-health treatment from local governments. The News & Observer recently reported that under the reforms, the state wasted at least $400 million on a service called community support and spent too little on treatment of serious mental illness.

The report also revealed nearly 200 cases since December 2000 in which employees of state mental institutions abused patients and 82 cases in which patients died under questionable circumstances. Some of the questionable deaths were not investigated after they were wrongly reported as resulting from natural causes. Benton announced a policy requiring that all deaths at state mental institutions, regardless of suspected cause, be reported immediately by telephone to a medical examiner. The medical examiner will determine whether additional inquiry is needed and whether an autopsy should be performed -- effectively removing state hospital staffers from the decision-making process. State law already requires that medical examiners be notified of all deaths for potential autopsy if they are the result of violence, suicide or unknown causes.

Benton also proposed to have "basic psychiatric services" in each region, answering criticism about spotty local services. Local mental-health offices often have psychiatrists on staff who also work for private providers. But Benton said the local offices should have psychiatrists who work only for the public system, "telepsychiatry" equipment to allow doctors to assess patients who are miles away, and social workers. The state needs to sign contracts with local hospitals for 180 beds for mentally ill patients so it can keep more people closer to their homes and out of state institutions, Benton said. A central goal of the 2001 reforms was to send fewer people to state mental hospitals. However, short-term admissions to the facilities has increased since the reforms. Benton did not put a price on most of the proposals, but he estimated an annual cost of $65 million to $70 million. (Lynn Bonner and Michael Biesecker, THE NEWS & OBSERVER, 3/27/08).

BROUGHTON INSPECTION:Broughton Hospital got a surprise visit from federal inspectors this week seeking to do a complete review of the facility and its operations, according to state officials. The move could mean the hospital could see its Medicaid and Medicare funding reinstated. Broughton has gone without Medicaid and Medicare funding since August, when the federal government halted payments amid concerns over a patient death and a patient injury. Mark Van Sciver, spokesman for the N.C. Department of Health and Human Services, said funding could be reinstated within a few weeks if the Morganton hospital, one of the state's four psychiatric hospitals, passes the inspection. The cuts have cost Broughton about $1 million a month. Broughton serves about 4,000 patients each year from the state's 37 westernmost counties and has about 1,200 employees and a $77 million budget. (Marcie Young, THE CHARLOTTE OBSERVER, 3/26/08).