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A ray of hope in the mental health crisis

When it comes to caring for the mentally ill in North Carolina, there’s been very little good news over the last few years. A 2001 attempt to radically reform the state’s mental health system has been, by nearly unanimous opinion, a disaster. It has wasted millions of dollars and created a system that has too little oversight of patient care, too few facilities, and too much opportunity for mismanagement at the local level.

The breadth of these problems, however, is exactly why a new psychiatric unit at Haywood Regional Medical Center that’s being praised by mental health professionals is so promising, and why it might be the model to start fixing some of what’s gone so wrong over the last several years.

The new 16-bed unit at HRMC opened in November and was paid for with a state grant that also funded another wing at another hospital. The hope was the regional units would reduce the waiting list for patients to get into a long-term bed at Broughton Hospital in Morganton. The Broughton facility is way overcrowded and has suffered its own woes. Besides, those in need of immediate psychiatric help can run into serious problems if they have to put off professional care. It became a very dangerous situation for patients when they could find no facility to check into when their problems needed medical attention.

The new unit at HRMC helps solve of these issues. For one, patients can get care closer to home, which allows more interaction with family members they trust and depend on. The new facility is run under a model that allows the patient to take part in the cure. The program allows patients to make choices about how to structure their day, similar to what life is like on the “outside,” where many of these patients will soon return to and begin taking care of themselves.

“It’s a support network that gives you the strength you don’t have outside,” a 20-year-old patient told The Smoky Mountain News.

The new center’s early success is worth noting. Doug Trantham, interim director of Smoky Mountain Mental Health, said the region has had its lowest transfer rate to Broughton in recent memory. Two other hospitals are looking at the HRMC model with an eye toward possibly replicating it. There’s also hope that the Balsam Adult Recovery Unit may re-open. It closed when the HRMC wing opened because there was only enough trained staff to operate one of the units. When that happens, there will be even more options for patients in Western North Carolina who are in need of residential mental health care.

We’ve got a long way to go before we solve the crisis confronting this state’s mental health system. But increasing the number of available local beds — and increasing the opportunity to receive the necessary treatment right here at home — is a good first step toward helping patients gain access to the kind of treatment they need.

Psych unit improving mental health system, officials say

At a time when the state’s fractured mental health care system seems beyond repair, local mental health officials have hit on a solution that could go a long way toward fixing it.

The key might lie in a new program playing out in the halls of the sixth floor of Haywood Regional Medical Center. The floor has been converted to a 16-bed psychiatric wing, which opened in November and is run by the Smoky Mountain Center for Mental Health. Officials recently took The Smoky Mountain News on a tour of the facility.

The psych ward was established with a state-funded grant given to only two hospitals in North Carolina, one of which was HRMC. Desperate for a way to relieve overcrowding in the state’s mental hospitals, state officials asked HRMC to build a psychiatric unit that would provide more bed space closer to home.

Before it opened, there were no long-term beds for psychiatric patients in all of 15 western counties, and patients had to be transported to Broughton Hospital in Morganton. Often, patients in critical need of immediate care had to wait for days until a bed opened up at Broughton, putting a strain on the patients, their families, and the sheriff’s deputies who had to wait with them.

But with the opening of HRMC’s psychiatric unit, the number of patients going to Broughton from WNC has dropped dramatically, according to the first round of statistics released by administrators at the Smoky Mountain Center. From Jan. 1 through 28, only five patients went to Broughton from WNC — a two-thirds drop over the same period a year ago when 17 patients were admitted from the region.

Smoky Mountain Center officials are hesitant to declare success so early on. But the numbers indicate what is “potentially the lowest admission rate ever to Broughton,” said Smoky Mountain Director Doug Trantham. Trantham said that already, two other hospitals are interested in partnering with the Smoky Mountain Center to instate a similar program.

Smoky Mountain officials believe that the program’s unique model of care, which emphasizes recovery, likely is a big reason for its success rate. The model is in contrast to the institutional model that has traditionally been employed in the psychiatric field.

Under the old model, a patient had to adhere to a strict schedule — waking up, eating, and attending therapy groups at the same time every day. But the recovery model gives the patient more of a say, allowing the patient to decide whether he or she is ready to wake up, or if they instead need more sleep, for example.

Patients in the psychiatric program at HRMC take walks, do yoga, and gather to socialize and play games with other patients.

“It’s a support network that gives you the strength you don’t have outside,” explained a 20-year-old female patient staying at the unit, who spoke about her experience during The Smoky Mountain News’ tour of the facility.

Smoky Mountain Mental Health officials are reporting additional success with their efforts to improve mental health care in WNC. Officials at Smoky Mountain are making steps to re-open the Adult Recovery Unit at the Balsam Center by April, which will provide additional bed space for patients in need of psychiatric care.

“The unit was closed on Dec. 12 following a determination that there were insufficient staff resources, particularly experienced and trained nurses, to safely operate,” both the new HRMC unit and the Adult Recovery Unit, according to Smoky Mountain Center officials.

New job yanked from resigned mental health director

Tom McDevitt, the former director of the Smoky Mountain Center for Mental Health who resigned amid scrutiny last fall, was barely out the door when he was tapped by the state to head up a mental health agency down east plagued by turmoil of its own.

The state’s move to replace one director who was fired for mismanagement with another director who resigned under suspicion of conflict of interest caused a public outcry, forcing the state to rethink its decision.

It was announced on Tuesday, Jan. 20, that Leza Wainwright, director of the state Division of Mental Health, had tapped McDevitt to head up the Albemarle Mental Health Center, based in Elizabeth City. The board of the Albemarle Center had asked the state to assume control of its agency following a period of gross mismanagement that culminated with the firing of agency director Charles Franklin.

Wainwright chose McDevitt, who resigned his position as leader of the Sylva-based Smoky Mountain Center in September following intense board scrutiny over some of his actions, including his pay, perks he provided for himself and his family, and heavy-handed leadership style. McDevitt continues to serve as the director of the Evergreen Foundation, the non-profit arm of the Smoky Mountain Center.

The Elizabeth City-based newspaper The Daily Advance wrote of McDevitt’s appointment last week, pointing out that McDevitt had resigned from his previous job after red flags were raised about his activities.

It wasn’t long before comments from readers began flooding the newspaper’s Web site. Many seemed appalled that the Albemarle agency had put its trust in the state, only to see the state replace one fired director with another who had resigned under scrutiny.

Meanwhile, officials associated with the Albemarle agency were struggling to understand the state’s decision to appoint McDevitt.

“One of the ironies is that Albemarle asked for the state to come in and give them a director because of the problems they were having with a director, and now you have this situation,” said Albemarle Mental Health Center’s board attorney John Morrison. “The state was aware we had similar issues — I wonder why they would send (McDevitt) here.”

Pasquotank County Commissioner Chairman Marshall Stevenson said he was “very concerned.”

“He’s got baggage — we don’t need somebody like that,” Stevenson said of McDevitt.

On Thursday, Jan. 22, two days after McDevitt’s appointment, McDevitt and Wainwright attended a meeting with the Albemarle agency’s board of directors. Before the meeting, Wainwright told The Daily Advance that she was aware of the controversies surrounding McDevitt when she tapped him as director, and that they were greatly exaggerated. Wainwright commended McDevitt’s handling of the Smoky Mountain Center’s finances and the changes he had implemented as its director.

But just one day later, Wainwright did an about-face and announced McDevitt would no longer be appointed as the director of the Albemarle agency. She told The Daily Advance that scrutiny over McDevitt’s alleged activities at the Smoky Mountain Center would make it difficult to cultivate much-needed trust at the Albemarle agency.


State questions McDevitt’s severance pay

Not only has McDevitt missed out on the appointment to head another mental health agency, but he could lose his generous severance package from the Smoky Mountain Center.

The N.C. Department of State Treasurer last month weighed in on McDevitt’s severance package, which is equivalent to a year’s salary. The hefty sum may not be legal under state statutes. Specifically, state statute bars one employee from getting benefits not afforded to everyone else within an agency.

The treasurer’s office investigated the severance pay based on complaints from the public. It consulted with attorneys from the UNC School of Government in the process, which pointed out case precedent as well as state statutes.

“It appears that the one year’s severance pay is not permitted,” the state treasurer’s office wrote in a letter to the Smoky Mountain Center’s board. The state instructed the board to review the matter with its attorney, Jay Coward. Coward has been in communication with the state over the issue, but the board has not yet discussed whether to revoke the severance, something that will likely take place at an upcoming meeting, according to Board Member Dana Jones.

The state will keep an eye on the matter to make sure the board resolves it, said Sara Lang, director of communications for the state treasurer’s office.

“Staff of the Local Government Commission must ensure that this issue has been thoroughly reviewed from a legal standpoint and that public funds are being spent in accordance with the law,” Lang said.

Mental health crisis will need enlightened leadership

By Ed Seavey • Guest Columnist

The recent issue of the Smoky Mountain News (Jan. 16, “WNC Confronts Mental Health Crisis”) on the mental health crisis was interesting. Officials quoted proclaimed diplomatically that the issue is complex, as they wonder what went wrong with the mental health system. Though the issue of mental health is indeed complex, how we got there should be no mystery to those that have been involved in the process. Closed-door politics and the sovereignty of undying local control is what got us where we are.

Long-term fix must be found for state’s mental health care woes

Perhaps it is going to take a complete fracturing of the mental health system before policymakers finally realize that North Carolina needs more inpatient facilities to treat patients who are a danger to themselves and society. Well, if it’s a total breakdown they’re waiting for, things are getting perilously close.

The search for solutions: HRMC steps up to help fix mental health care

By Julia Merchant • Staff Writer

Emergency rooms crowded with mentally ill patients. Sheriff’s deputies spending 96 hours supervising one individual. A sick man or woman whose situation is growing more dire by the second. It all adds up to a recipe for disaster — and North Carolina’s mental health care system is in imminent danger of becoming just that.

The state of mental health care: A fractured system is in danger of breaking down completely, leaving officials wondering — how did it get this bad?

By Julia Merchant • Staff Writer

Patricia Frisbee Meyer’s son needed help.

The mental illness he had battled since childhood stayed mostly under control, but Meyer knew the onset of a bad episode when she saw it. Meyer, along with her husband, took her son to the emergency room at Haywood Regional Medical Center that Sunday — beginning a saga in which her son was restrained for nearly 48 hours before getting the care he desperately needed.

Help for those with mental illness: Waynesville couple helps start local NAMI chapter

By Michael Beadle

When John and Suzanne Gernandt’s son Matthew began showing signs of schizophrenia, it might have been misread as teenage rebellion — a phase he would pass through once the hormones settled down.

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