Stay the course

Continuous change has left consumers and providers struggling to understand North Carolina’s mental-health system. A new overhaul is unfolding already this year. Gov. Pat McCrory has mentioned more reforms. A December report by the N.C. Center of Public Policy Research says the mental-health system’s biggest problem is the failure to stay the course on policy, leadership and money.

Charlotte native Mebane Rash, who wrote the report, offers this advice: Leave something in place long enough to see if it works.

Find a middle ground

Since at least 2008, Mecklenburg has wanted a place to take mental health crisis patients other than emergency rooms and jails. It still does not have one. “We should have another option,” says Assistant Charlotte-Mecklenburg Police Chief Eddie Levins. “This community is big enough to have one.”

Mecklenburg General Manager Michelle Lancaster says an earlier crisis-center plan fell prey to problems with Mecklenburg Open Door, a private vendor. A new proposal will be shown to county leaders soon, she says.

Not that the crisis center covers all contingencies. In 2009, Wake County was forced to shut its facility after it was overwhelmed by patients because a nearby state psychiatric hospital ran out of room.

Think regionally

New York state offers a series of regional psychiatric emergency rooms now being studied by Rash and the N.C. Center. Rash says the New York hospitals offer a “single portal” to mental health patients while also providing comprehensive, community-based treatment and support. “These ERs are funded and staffed to identify who needs mental-health care the most, what care they need and where they should get it.”

Think communally

San Antonio sets the bar for centralized and local community-health care. The privately funded Haven for Hope, havenforhope.org, houses in a single campus a variety of mental health services. In Charlotte, Urban Ministries’ Moore Place, a residential facility for the chronically homeless, has just finished its first year. Its goal: to give clients more stable lives, including regular psychiatric care. Dale Mullennix, Urban Ministries’ executive director, says the approach saves money. A year in jail, he says, cost $40,000. “This is $14,000 to change their lives, and they’re not going to jail or the emergency room.”

More capacity for long-term care

To relieve the pressure on crisis response, emergency rooms and other providers say they must have somewhere to send patients for longer-term care. Some progress is being made. Presbyterian added 15 beds last July. Carolinas Healthcare System plans to open a new psychiatric hospital a year from now. Meanwhile, North Carolina is opening one new state hospital this fall, has broken ground on another and is considering a third to serve Charlotte.

More helping hands

In 2006, Vince Melville committed suicide near his family’s Charlotte home. His parents, Roger and Kathleen Melville, say that for years they searched in vain for help for their son. “We had nobody, we were totally in the dark,” Roger says. Today, he is a volunteer with the Charlotte chapter of the National Alliance on Mental Illness, helping other families avoid the isolation he felt. While the situation has improved, he says finding peer counseling and information still is a challenge. Consumers say the Charlotte region needs a regular publication plus a website as a guide. MeckLINK is designed to help ease the confusion. But it will primarily serve Medicaid families.

Helping the cops

Two police programs aimed at reducing mental health emergencies have received national exposure but lag in local support. The Child-Development – Community Policing effort gets mental health professionals to children who have experienced trauma, a trigger for future behavioral problems. But after almost 17 years, it is in barely more than half CMPD’s patrol divisions. Each staffer handles more than 500 cases a year.

Meanwhile, the pace of Crisis Intervention Team training for officers remains slow. CMPD wants 500 officers certified. It now has about 200. Assistant Chief Eddie Levins says the department needs money to get officers in the class. Sarah Greene, who coordinates CIT for the county, says money alone doesn’t solve the problem of organizing and teaching more classes.