Monday, September 29, 2008

Editorial on Dix Move

The transfer of Dix hospital patients to a new mental health facility in Butner seems rushed. Standards must be met

And the move goes on. By Oct. 8, 170 patients from Dorothea Dix Hospital, the 152-year-old mental health facility in Raleigh, will be moved to Central Regional, a new facility in Butner. Dix will remain open with 60 beds, a crisis step funded by the state and Wake County, whose residents in need of mental health care have long used Dix.

Given the troubled -- and that's putting it mildly -- state of North Carolina's mental health system, the move from Dix seems a curious risk, at least right now.

A News & Observer series earlier this year demonstrated widespread chaos, wasted money, problems with staffing and shortcomings in care for many patients needing help. Closing Dix and having a consolidated facility in Butner were originally part of a plan to make mental health care better by de-institutionalizing some patients and shifting responsibility for some services from the state to the county level, and from public agencies to private companies. It didn't work. Some counties lacked needed facilities and personnel, and some companies providing "community services" appeared to be charging a lot for very little.

Enter Dempsey Benton, the now-secretary of the Department of Health and Human Services, as part of a promise by Governor Easley to fix things. Benton's a proven administrator (a former Raleigh city manager). Closing Dix remained in the game plan. But in recent months, there have been complaints about the new hospital in Butner, and even officials acknowledge there are staffing problems, technical difficulties, space shortages for doctors. Also, the facility hasn't passed muster with a couple of accrediting agencies.

Yet Benton insists the time for closing Dix -- which has also stirred a legislative debate about what to do with the choice property on which it sits -- is right.

Presumably the secretary believes the problems with the new hospital, or most of them, will be ironed out in the next couple of weeks. We must all hope so. There must be a sense of urgency about ensuring that more than minimum requirements are met, that this becomes a world-class facility.

If Benton can deliver that, he will have put at least some parts of the mental health system in order. If he suspects that the move was precipitous, he must absolutely reverse himself, until the public can be assured that Central Regional is doing the job for patients.

Yes, there's the point. In all the political hullabaloo (ramped up by the campaign for governor between Republican Pat McCrory and Democrat Beverly Perdue) about how to fix a horribly broken system, and the legislative debate, and the public outcry, it must be remembered that ensuring a competent, compassionate and sturdy mental health care system is about people. It's about the patient with a severe psychiatric disorder who must be hospitalized a lot, or the patient with a problem that can be treated in the community. It's about elderly people, young people, even children. It's about all those who care about these people.

Closing Dix is a risk. Benton needs to be ready should his optimism not prove accurate.

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