This story is a follow-up to a series about mental health care in North Carolina. To read the previous stories in this series, go to carrborocitizen.com/main/breakdown/
By Taylor Sisk
Staff Writer
As mental health care advocates call on state leaders to listen to consumers of mental health services, a national organization says that the state has been woefully remiss in its communications with those consumers and their families.
Last month, some 200 mental health advocacy organizations and individuals sent a petition to N.C. Department of Health and Human Services Sec. Lanier Cansler, Gov. Beverly Perdue and legislators asking that the voices of those with mental illness and their family members be heard as the state works to repair our mental health care system.
Then last week, the National Alliance on Mental Illness (NAMI) released its “Grading the States†report card, last issued in 2006. Fourteen states improved their grades since 2006; 12 states graded lower. North Carolina held steady with a “D.â€
That “D,†though, according to the NAMI report, “doesn’t even begin to convey the chaos that now pervades the state’s mental health care system.â€
Three years ago, the report continues, NAMI warned that “the state’s reform initiatives were changing too much, too fast, resulting in an increasingly disorganized environment.â€
The state’s lowest grade by category, an “F,†was for “Consumer & Family Empowerment,†which includes consumer and family access to essential information from the state, promotion of consumer-run programs and family and peer education and support.
Bringing consumers to the table, said North Carolina Mental Hope executive director David Cornwell, would better assure a passing grade.
The petition
“For far too long, individuals with the most direct experience with services and most impacted by system failures have not been invited to have a voice in the solution,†Cornwell said in a press release accompanying last month’s petition. “Not only is this ignoring a rich resource for practical and cost-effective solutions, it is discrimination that reinforces the stigma of mental illness.â€
Cornwell said that the seeds for the petition were planted a year ago when then state Health and Human Services Sec. Dempsey Benton asked 32 people to serve on three committees working to fix the state’s mental health services. Not one of those members, Cornwell said, was a mental health consumer or family member.
The petition states that, given that one in four people is touched by mental illness, any discussion of mental health services in North Carolina should include input from those affected by mental illness and their family members.
In addition to asking for at least 25 percent consumer and family member participation in groups serving those with mental illness, it calls for the fostering of “an attitude of inclusion and openness with respect to dealings with mental health issues and the mental health community.â€
Cornwell said that ignoring the voices of consumers is “basically endorsing the mindset that has been the status quo in North Carolina, a status quo that helps ingrain discrimination and reinforces existing prejudices.
“It’s a mindset that seems to say to consumers and family members that they’re not wise enough or experienced enough to sit at the table to help solve these problems, which is far from the case.â€
The prognosis
In its recent report, NAMI said of North Carolina, “Fortunately, a change in governors in 2009 provides broader hope for the future.â€
Both Cansler and Perdue have expressed the desire to be more open to consumer input. But Cornwell said that no response to the petition had yet been received from any state or elected official.
And with the budget shortfall the state is facing – and despite Cansler’s statement that, “Mental health reform is over. Now we have to focus on building the system.†– no one is optimistic that a dramatic new course is immediately forthcoming.
At a public listening session held last month by a mental health task force convened by Chapel Hill Mayor Kevin Foy, Rep. Verla Insko, co-chair of the joint legislative oversight committee on mental health, said that she believes that once the budget is passed not only will the stimulus money targeted for mental health care services be used to fill holes elsewhere but that an additional $400-500 million of the state’s Medicaid money could be lost.
In response to those comments, Bebe Smith, director of outpatient services for UNC’s Schizophrenia Treatment and Evaluation Program and co-director of the Center of Excellence in Community Mental Health in Carrboro, said, “If there are funding cuts to an already underfunded system, bad things will happen to vulnerable people.
“The current system is not one we can rely on, particularly in this economic climate.â€
Still, consumer advocates are hoping for the best.
“I certainly think advocates in North Carolina have high hopes for Secretary Cansler,†Cornwell said last week, “and his actions and statements so far seem to justify those hopes.
“And while it’s in the best interest of everyone, including the state’s taxpayers, to include mental health clients and their family members in working on solutions to the state’s mental health woes, it would create a tremendous amount of good will for him to just say so.â€
One clear example of whether advocates and yes! (this) provider(s) will be heard will be possible Friday,3.20.09,1 pm, Winston-Salem library,downtown, when citizens will have the opportunity to indicate their concerns about the transferring of 50 PUBLIC MEDICAID psychiatric beds from Broughton Hospital, western NC to PRIVATE FREE STANDING 14% MAX MEDICAID BED psychiatric unit being created by: NC DHHS/ Centerpoint LME/ Old Vineyard Behavioral Health. See details here: http://madame-defarge.blogspot.com/
Marsha V. Hammond, PhD