Mental health issue needs more than talk

A pilot program in Raleigh is aiming to shift mental health patients away from hospital emergency rooms and into private psychiatric hospitals.

Raleigh faces a problem that many communities across the country are struggling to deal with: Finding psychiatric patients a place to get the mental health care they need somewhere besides general hospitals.

The problem has been building for decades as mental health systems have been largely decentralized, pushing oversight and responsibility for psychiatric care into overwhelmed communities and local hospitals.

North Carolina is dealing with the consequences of its mental health care overhaul more than a decade ago, when state-run psychiatric institutions were phased out and mental health care services were outsourced to local communities and private companies.

State funding for mental health services declined during the Great Recession, with the state now spending 20 percent less on community mental health services than it did a decade ago.

Patients whose primary diagnosis was a mental health condition or substance abuse made up about 5 percent of the more than 6.4 million visits to emergency rooms in 2010, according to the Agency for Healthcare Research and Quality in Rockville, Md.

The number of mental health patients entering emergency rooms in North Carolina was double the nation’s average in 2010.

The pilot program in Raleigh is but one small step toward a piece of a solution to address a big challenge. Emergency rooms and general hospitals simply cannot provide the kind of psychiatric care that these patients need – nor should they be expected to. And local communities do not have the resources to solve the problem on their own.

State lawmakers have talked about revisiting North Carolina’s mental health care reforms, but so far it’s been mostly talk. That talk should be turned into concrete action when the legislature convenes in 2014.