We can’t leave mental health reform behind
As a newspaper reporter, I followed North Carolina’s mental health reform since its inception. It was like watching a multi-car pileup on an icy highway in slow motion.
The “reform” began by closing down the existing system. Mental health centers that served people with psychiatric illnesses, people with developmental disabilities and addiction, were closed. These centers had one-stop services, all provided by the state.
But reform promised choice. The sunny new day would offer an array of private services, managed by new agencies called local management entities, or LMEs.
It all sounded great, except the state was in such a rush, there were as yet no service definitions or rates when the old area programs closed. Those amount to job descriptions and pay scales. Still, the state expected private companies to flock to the new system.
It didn’t happen. Several of the old agencies spun off their service arms into nonprofits that could see people until more service providers emerged. Few did. And the nonprofits began to fail because of cash-flow problems.
The new LMEs scrambled to find agencies to provide services, and people fell through the cracks. People began to die because there was no cohesive system for people coming out of psychiatric hospitals, which were a mess already because of staff shortages and forced overtime for staff.
Management by then-DHHS Secretary Carmen Hooker Odom was incompetent at best. She dictated change after change to the system, never giving it the time to stabilize. She moved some of the LMEs responsibilities to a national for-profit company based in Virginia and slashed the LMEs’ budgets by one-third. She ignored a legislative oversight committee’s demands for a report on what the new system needed.
As a result, North Carolina’s system fell from among the top half in the country to very near the bottom.
And all this was before the economic meltdown and massive budget shortfalls.
Today the system is truly broken. The current Department of Health and Human Services secretary, Lanier Cansler, has his hands tied by severe cuts in his budget. He inherited a mess and there’s little he can do to clean it up.
We need to roll care for people with psychiatric illnesses, developmental and other disabilities and addiction into the main health care system as we move forward on fixing it.
Many of the 45,000 people who die each year from lack of insurance lost it because of mental illnesses. When these chronic brain illnesses aren’t treated, they get worse, just like any other chronic illness. The problem is, people can’t get into the system until they reach the crisis point.
This part of the system is even more broken than the rest. It’s a waste of human potential and it’s just plain wrong to ignore it.
Patient Pals & Family Friends
Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.
We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.
Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.
Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.
Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.
Family Friends are there to help caregivers and other family members grow into their new role.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
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