Wednesday, September 24, 2008

Editorial: Patients At Risk

http://www.newsobserver.com/opinion/editorials/story/1228676.html

When your doctor advises you to lay off the doughnuts and potato chips, you of course are free to keep on scarfing down the fried, fatty stuff. But you're just asking to be whacked by the harmful consequences. In other words: ignore doctors' warnings at your peril.

In Raleigh, the Easley administration is fielding the advice of doctors that a scheduled decommissioning of Dorothea Dix Hospital could have unpleasant side effects among the mentally ill patients who are on track to be relocated to the new Central Regional Hospital in Butner.

The Dix phase-out has been controversial ever since it was planned as part of a larger effort at mental health reform that would bring more services into communities where patients lived. That reform effort has proved troubled in concept and execution. Meanwhile, the Butner hospital was opened only with difficulty because of design flaws that had to be fixed and ongoing staff shortages.

In a letter Friday to administrators at the Department of Health and Human Services, a group of Dix doctors and psychologists who were said to be speaking for all of their colleagues cited still-unresolved problems at Central Regional that they said would make the facility hazardous for patients and staff alike.

For instance, they said that some children would have to be housed at the old Umstead hospital nearby. Umstead is also being phased out, and sometimes is not staffed with doctors and medical nurses who would be needed in the event of a medical emergency.

The Dix group also pointed to what it said were inadequacies in the planned forensic unit at Central. That maximum security unit would house mental patients either awaiting trial on criminal charges or those found not guilty of violent crimes by reason of insanity. Technicians have not yet been appropriately trained, according to the letter, and the unit's design would not keep patients out of the nursing station.

The transfer of patients from Dix already has been delayed. But whatever urgency administrators now are feeling, their higher responsibility is to protect their patients and staff by holding off on this move until it plainly can be accomplished with no additional risk to anyone.

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