Reform the Reform: How mental health reform went wrong and what lies ahead

John Locke Foundation

July 18, 2007

Key Facts:
1. North Carolina’s 2001 mental health reform was ambitious and well intentioned but flawed.
2. Many proven ideas did not make the final version of reform and lawmakers immediately raided the mental health trust fund to cover a General Fund fiscal crisis in 2001.
3. Later changes targeting specific problems have left the entire system worse off.
4. Money is spent poorly by local management entities (LMEs) with little oversight, leaving essential services with too little money.
5. More money is not the solution. Pennsylvania spends more than three times as much per person as North Carolina with similar results.
6. North Carolina’s involuntary commitment law does provide better safety for patients and the community than does Virginia’s.
7. There is no single state to emulate, but many states have gotten specific policies right.

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