Wednesday, September 24, 2008

Onslow Memorial In Bind Over MH Patients

Hospital CEO says state decision is sending more patients its way
September 23, 2008 - 12:37AM


Since the state closed the local mental health crisis center two months ago, the Emergency Department at Onslow Memorial Hospital has been flooded with potentially dangerous mental health patients, said OMH President Ed Piper.

The hospital sent letters asking Gov. Mike Easley and state representatives from Onslow County for help in resolving the issue, but so far those officials have not responded, Piper said.
When the N.C. Department of Health and Human Services determined that Onslow / Carteret Behavioral Healthcare Services at 215-B Memorial Drive was operating without a valid license, the state ordered the facility to stop providing certain mental health services July 18.

"Within hours, by default, our Emergency Department assumed the awesome challenge of accommodating this population of patients with mental illness, developmental disabilities and substance abuse and addiction while trying to provide emergency care services to a large patient volume of over 120 patients a day," Piper wrote in a Sept. 17 letter.

When local authorities take someone into custody who needs to be involuntarily committed, they have no choice now but to take them to OMH. The person is brought into the waiting room where patients with physical injuries are waiting to be seen, sat down in a chair, and his or her handcuffs are removed, hospital staff said.

"Police alert our security and triage nurse before leaving, and we try to isolate the mental health patients in a separate waiting room," said Michael Jenkins, the nurse manager for the Emergency Department at OMH. But the Emergency Department only has 21 bends. Nine of them were taken up by involuntary commitment patients Monday morning.

"We average three to five mental health patients a day," Piper told The Daily News on Monday. "It takes an average of 17 hours to have them sent to a mental facility, but it has taken up to 63 hours."

Emergency Department doctors and nurses are trying to provide life-saving services for trauma victims, patients suffering from cardiac arrests or strokes and other acute illnesses while having to deal with three to five mental patients who need one-on-one attention, Jenkins said.
Piper said the mental health patients present a safety issue not only to themselves, but to hospital staff and other patients.

"Many of these mental health patients are coming in with active states of psychosis, schizophrenia, alcohol intoxication, drug overdose, suicidal and homicidal ideations to mention a few," Piper wrote in letters to Gov. Mike Easley, Lt. Gov. Beverly Perdue, N.C. Senator Harry Brown, N.C. Rep. Robert Grady, N.C. Rep. George Cleveland and DHHS Secretary Dempsey Benton.

Hospital spokesman Tim Strickland said the only response the hospital received was from an assistant in Perdue's office who said the lieutenant governor would be in touch, but the hospital has not heard back since.

Piper sent letters to state officials in August, and twice in September. In the Sept. 17 letter, he wrote "our community hospital is being faced with an unmitigated and unfunded duty to serve as a mental health crisis center."

Grady told The Daily News on Monday that he received only the Aug. 14 letter.
"I received a one-sentence letter saying a letter to the governor was attached," he said. "The hospital did not ask for help or money, and I took it to be an informational letter."
Grady said he would be more than happy to sit down with hospital representatives and members of DHHS. He said he looked into the situation after receiving the Aug. 14 letter and found that the state would give the required license to Onslow / Carteret Behavioral Healthcare Services if they would apply for it.

The facility was operating as a mobile crisis unit, which it was not approved for; and so far the facility has not applied for a license, said Tom Lawrence, public affairs director for DHHS.
Lawrence said two new mobile crisis units were just approved by the state to operate in six Eastern North Carolina counties including Onslow.

"Hopefully this will help relieve some of the pressure Onslow Memorial is feeling," he said. "The purpose of these units is to keep people out of hospital emergency rooms by treating them at their home for two or three days."

Strickland said the answer lies in a facility for Onslow County similar to the Oaks in Wilmington where mental health patients can receive proper care without having to go through the Emergency Department at the hospital, which "should not be the portal of entry for mental heath patients into the mental health system."

Contact crime reporter Lindell Kay at 910-219-8456.
Read Lindell's blog at

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