Position Statement
Efficiency Study of the State Psychiatric Hospitals: NAMI North Carolina’s Position
As advocates for people suffering from mental illness and their families, NAMI North Carolina lends its support to the 20 recommendations by MGT of America, Inc., with the following qualifications:
Any savings realized as the report’s recommendations are implemented must remain in the mental health care system.
A primary thrust of the recommendations involves shifting a number of hospital patients to more appropriate, more cost-efficient community-based programs and then reducing the number of hospital beds.
While we agree certain types of patients do not belong in our state psychiatric hospitals, we emphasize that these patients still have very real needs for care.
The resources freed by shifting these patients out of state psychiatric hospitals must go with them into the community programs.
The recommendations will work only if they are fully implemented. The findings and recommendations detailed in the study report are complex and highly interrelated. Partial solutions will fail.
We strongly question the wisdom of eliminating all accommodations for children and adolescents at all four state psychiatric hospitals.
There are currently few community-based programs offering the full range of services needed by children and adolescents suffering from severe mental illness.
Even with effective community-based programs for children and adolescents in place, we believe there will always be young people who need the level of care only psychiatric hospitals can provide.
For these reasons, we recommend keeping enough Youth Unit beds at the four hospitals to accommodate populations of children and adolescents suffering from severe, persistent mental illnesses.
These needs are urgent and must be addressed right away.
The study is 655 pages long. The issues addressed are broad and complex. We encourage our legislators to keep in mind there are human faces behind the many statistics.
The report’s authors identified viable sources of funding for their recommendations.
These funds are available if we take action now but, as the report’s authors emphasize, they will diminish and perhaps even disappear over time.
While the study’s authors did not emphasize the issue in their report, we believe many people within North Carolina’s psychiatric hospitals share an outdated “asylum mentality” regarding psychiatric hospitals. For the report’s recommendations to be implemented successfully, we must promote a radical shift toward a much more progressive philosophy of psychiatric care.
New, better-equipped buildings and improved management systems are important, but so are the knowledge and attitudes of the people inside.
It may be difficult to practice state-of-the-art psychiatric medicine in buildings built in the 1940s and before, but it is impossible to do so—even in the best facilities—using woefully outdated approaches and attitudes.
If implemented thoughtfully and thoroughly, the study’s recommendations (except as noted) will make North Carolina a leader in progressive, humane mental health care.
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