NAMI Wake - THE Voice on Mental Illness

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Entry for November 12, 2007

The November 9th memo from Mike Moseley on the State's DMH plan to allocate CIT funds evenly across the 25 LMEs ($2000 each), while keeping the other half for their own purposes, seems like a simplistic attempt to give LMEs a small cookie jar that is unlikely to provide much more than token support for the much needed CIT program. For example, consider the Smoky Mountain Center in the Western part of our state. There are 12 rural counties within the LME. The State's plan would make $166.67 available to each county (if the LME/area director chose to divide the funds equally across the counties) which would hardly cover the salary and travel expense to have the county sheriff to travel to Sylva, NC (location of the area director) for a 1 hour meeting to discuss the need for a CIT program in each county. In contrast, single county urban LME's including Wake, Durham, and Guilford Counties, would receive the $2000 to "expand or improve their existing CIT programs." How is that for state leadership! Furthermore, once the money is parceled out, what indicator of performance will be used to judge how well the money was spent? Or will there be a future audit which indicates how the money was spent for other purposes -- since it was so miniscule to even begin to address the CIT program in each of the LMEs? Or will the twisted logic of the DMH leadership use this CIT funding example as how they have contributed to developing community support programs and hence will be used to justify closing Dorothea Dix and further reduce the number of psychiatric hospital beds in the State?

The truth is that the CIT program was first initiated in Wake County because of leadership from within the county and not the state. It is my opinion that our Wake County program will serve in the leadership role of how this program is implemented across the state. For example, our NAMI Wake president, Frank Edwards, obtained funds for the upcoming statewide CIT conference (November 26th) from the Governor's Crime Commission. This fact is conveniently lost in the discussion of the program.

CIT is a worthwhile program and continues to need leadership to make it work across the State. It is unfortunate that the Div of MH/DD/SAS did not choose to fund a proven community partner such as NAMI to implement expansion of the successful efforts already begun in Wake County.

submitted by gerry akland

2007-11-12 16:08:23 GMTComments: 1 |Permanent Link

Entry for November 5, 2007

Diane Bauknight Comments on Proposed Cuts in Community Support

One of the biggest lies that does not go away is that the reform is

about serving people in their communities. Is that so? While we

continue to freeze and cut state facility beds for people who

de-compensate due to poor community services and supports, our DMH/HHS

continues to erode the foundation of the reform: Community Support

(CS.) We don't even talk about how CS, as a stand alone service, is

inadequate as a service array anymore. It is so bad, we can't believe

they are sweeping up the crumbs of CS in front of our eyes. We have

even lost sight of the promises for a "full array of community-based

care" that the reform promised, including crisis facilities across the

state.

Go to http://www.dhhs.state.nc.us/dma/mp/proposedmp.htm and read as

much as you can stand to read. Learn how MORE hours are being cut

across the board for both children and adults. Imagine how any

private providers might be able to spend only 2 hour PER MONTH

planning step-down for someone (who has been institutionalized) to a

community where services are few, if any---other than giving the

person a ride to the nearest homeless shelter.

Has North Carolina's discharge plan for people coming out of

psychiatric hospitalization "discharge to the streets," where they can

join the rest of the growing population of people who have mental

illness and are homeless due to lack of housing, psychiatric care,

substance abuse treatment, residential care, medication coverage and

basic therapy? Apparently it is, and what community support

services we have continue to be sliced and diced, until they are now

barely recognizable from the services first described in our "State

Plan." We were promised a "rich array of community based services"

that would eradicate the need for institutionalization. Oh, and don't

forget the promise that NO state facility beds would close until such

services were firmly in place.

The only thing consistent in the state reform plan is the shameless

lies that are continuously fed to the public. Only those of us living

this nightmare and our providers know the truth about the reform. The

public officials in charge of this sham are experts at cloaking the

lies in political correct terms, such as "recovery, community-based,

naturally occurring, person-centered" and other empty words that have

no substance behind them, other than to make the cuts in care

palatable to the legislature and the public.

The DMH says they want your comments on recent cuts in CS. You know

they really don't, but go ahead let them know you are sick of the

lies. Tell the emperor he has no clothes. If we are going down, lets

at least go down fighting.

http://www.dhhs.state.nc.us/dma/mp/proposedmp.htm

Diane Bauknight

2007-11-05 18:44:26 GMTComments: 1 |Permanent Link

Entry for November 4, 2007

Across the country states have been closing psychiatric hospital beds in favor of less restrictive community-based mental health care. Theoretically this sounds ideal, yet it presupposes that there really is a community-based mental health care system that can provide the individual care needed. As we are all aware, none of the major, public hospitals in Wake County have any psychiatric beds. The impact of closing the hospital beds has focused on an attempt to keep our mentally ill from needing hospital services by building a generally non-existent community-based mental health system and finding funds to support this system of care. In Wake County there has been a major focus on the issue that without Dorthea Dix, where will our mentally ill receive their short-term psychiatric hospital care? Sometime within the next 2-5 years, Wake County hopes to be able to provide a short-term hospital with some 60 beds, with all but 16 beds allocated to substance abuse needs. Whereas it is important to think about the substance abuse needs, does anyone really think 16 beds will be sufficient to accommodate the needs for our mentally ill? What type of mental illness can the county hope to offer treatment for that wouldn't require more than 16 beds (translated into 480 bed days/month)? It is my understanding that our Dix utilization rate (WC Crisis and Assessment Services plus Wake Med) is historically double that rate, if not more. Are we gearing up for a Wake County Psychiatric Hospital that can only provide a day or two treatment and then kick out the patient so a bed can be available for the person waiting in the admissions room? Are we being short-sighted in proceeding without first doing a needs assessment for what is the "best practice" for hospital psychiatric treatment? Consider that recent data related to psychiatric hospital length of stay for patients in Virginia show that the average length of stay for patients in the state hospital system was 55,3 days, but only 6.1 days for the community beds. (Catalyst, Fall 2007)

Many of us have heard presentations from the Division of Mental Health (DHHS) which included references to a criticism that North Carolina had a higher rate of state hospital bed utilization than (many) other states. This has been interpreted by the Division (and others) as a rationale for closing of hospital beds. With evidence showing that public psychiatric hospital capacity is inversely related to crime and arrest rates, it is even more compelling to ask our state officials to rethink this policy. If the community-based alternative to state psychiatric hospitals results in committing our mentally ill to a life of jails and prisons, our well-intentioned public policy has failed miserably!

2007-11-04 19:12:54 GMTComments: 0 |Permanent Link

Entry for November 2, 2007

A funny thing happen on the way to closing Dorothea Dix Hospital: the closure plan itself. On September 25, the Legislative Oversight Committee on Mental Health was finally given an opportunity to ask questions of the proposed plan. They concluded the document was ill-prepared to continue the process of terminating the facility. Since the report did not measure up to the statutes required by law to shut Dix down, the lawmakers rejected it. By the end of the meeting, the committee was actually contemplating keeping Dix's doors open, at least until the continuum community care promised by this administration is funded properly and working effectively.

Former Vice President Dan Quayle once remarked, " We're all capable of making mistakes, but I do not care to enlighten you on the mistakes we may or may not have made." As humorous as that sounds, none of us really likes admitting being wrong. Politicians, especially, see it as a sign of weakness that can only lead to one thing; political suicide. I am encouraged that the oversight committee is trying to breathe some cautious optimism into a system that has been abused, misused and mismanaged by former DHHS Secretary Carmen Hooker-Odom since 2001.

Mental health issues are finally getting some positive exposure and welcomed understanding from our legislative body. New DHHS Secretary Dempsey Benton has his work cut out for him. Will he work with the oversight committee to build back the infrastructure of our mental health community or will he blindly follow Mike Easley's agenda full speed ahead? Which is more important: keeping Dix open with its intended use in mind or housing more state employees on the site with the looming prospects of selling the land to the highest bidder?

Ralph Waldo Emerson said it best: "Nothing astonishes men so much as common sense and plain dealing." Let us remind our government officials that striving towards a mental health system that is more patient-driven, not politically-driven, better serves North Carolina. Are you listening, Mr. Easley?

Steve Church

Willow Spring, NC

2007-11-03 04:30:08 GMTComments: 0 |Permanent Link

Entry for October 28, 2007

Has anyone noticed how difficult it is to share good news with our community? I'm talking about the program called the Crisis Intervention Team Program (CIT) which is a jail diversion program. It started in Memphis, TN and NAMI Wake County, Wake County Human Services, and all but one of the law enforcement agencies in Wake County (Rolesville) are members. This program, in it's 2nd year has trained almost 300 officers and has had tremendous success. People with mental illness, parents of people with mental illness, mental health workers, and law enforcement officers are all pleased with the outcomes. So, why is it that the news media will not cover this wonderful program or get the word out to families and consumers that they need to ask for a CIT Officer when they are faced with a situation involving law enforcement. Perhaps it takes an unfortunate event to make news and to make CIT relevant to the media. But let's hope not.

2007-10-29 02:00:32 GMTComments: 0 |Permanent Link

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