More mental-health admissions to emergency rooms are sign of crisis

Published July 31, 2013

Editorial, Winston-Salem Journal, July 30, 2013.

The state of mental-health care in North Carolina is dire. This should be a priority for our leaders, but unfortunately, it’s more likely to get worse before it gets better.

North Carolinians experiencing a mental-health crisis comprised 75 percent of behavioral health-related hospital admissions through a visit to an emergency department, according to a report by the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services, as reported recently by the Journal’s Richard Craver. The overall number of behavioral health-related admissions has been rising for several years.

North Carolinians are experiencing a wide range of problems, including clinical depression, anxiety and psychotic episodes. Between January and March of this year, 117,337 N.C. patients were diagnosed with having a mental-health episode, 34,064 with substance abuse and 4,610 with developmental disabilities.

Consider that many of these patients don’t have health insurance – many lost it when they lost their jobs – or have policies with high deductibles. Then add the fact that not enough resources are available in the first place. It’s a perfect storm.

In crisis, people turn to local emergency rooms – probably the most expensive way to get help – because they lack access to or can't afford primary physician care.

None of this is surprising to Billy West, the executive director of Daymark Recovery Services Inc., who told the Journal, “Less professional care in the community equals a higher number of visits to the emergency room. It is like closing down all primary-care offices and leaving nowhere for any of us to go when we get sick but the emergency room.”

Mental-health care has made some remarkable strides this century as techniques, therapy and medications have improved. Some innovative initiatives, such as a plan we endorsed recently for a statewide telepsychiatry program for rural hospitals, could help, but it’s not enough. State officials must find ways to speed up reform of mental-health-care services across the state and make them available to more.

July 31, 2013 at 3:30 pm
dj anderson says:

This editorial is needed, for gun control seems to be the cure all in the public mind for our most dramatic mental illness problems.

I'd suspect that the number of soldiers and the amount of drug abuse in NC would increase the incidence in NC?

The one element left off in the "perfect storm" scenario in the blog is that level of effectiveness of mental health treatment in NC. Mental health services must be prepared to show their effectiveness to get more money. The residential hospitals have been decimated across the state. Mentally ill walk the streets. Increased numbers are put on disability and sent home, to stay home, and get checks.

The telling statistics on psychotropic drugs being prescribed in NC is also missing.

People don't want to face the mental health problems because they are hard to diagnose accurately and harder to treat successfully. The mentally ill usually don't recognize they are ill and resist treatment. Treatment is all too often a Rx to mask symptoms by muting emotions. Lots of people 'self medicate' from the street corner pharmacy and out of a bottle, postponing and worsening their situation. Society has a problem.