Hospital executives know all too well the toll that mental and behavioral health patients can have on their health systems.
These patients can show up in emergency departments – and sometimes stay for days – clogging the rooms and halls of an ED, and in rare cases even becoming dangerous to hospital staff or other patients.
“Community hospitals are the safety net for behavioral health; every three minutes, a North Carolinian experiencing a behavioral health crisis arrives at a hospital emergency department,” according to the N.C. Hospital Association. “Not only are these visits and admissions expensive, but they are not providing the appropriate level of care for the patients.”
That is an average of 186 patients per day. ED visits are expensive – about $1,500 on average.
In 2013, North Carolina hospitals had 162,000 behavioral health emergency department visits and 68,000 admissions. Not only are these visits and admissions expensive, they are not providing the appropriate care for patients, according to NCHA.
Indeed it was the care of mental and behavioral health patients that led to a heated battle between WakeMed Health & Hospitals and Rex Healthcare a few years ago. The UNC Wakebrook facility, only a stone’s throw from the main WakeMed campus, is a result from those discussions.
Advocates for better mental health care lament that these services are chronically underfunded and say that society has largely turned to law enforcement as a solution. In 2010, the Wake County chapter of the National Alliance on Mental Illness declared that “Prisons and jails are North Carolina’s new mental hospitals.”
In the fall of 2014, NAMI released a survey asking families and individuals who had a psychiatric emergency to share their experiences from the ER. With more than 1,000 individuals responding, two out of five rated their experience as “Bad” or “Very Bad.”
In an effort to improve care, Gov. Pat McCrory announced intentions to establish a North Carolina Mental Health and Substance Use Task Force, a panel that will make recommendations to improve the lives of those with mental illness and substance use disorders.
“Our goal is to improve collaboration between health care, justice and safety professionals using existing resources,” McCrory said. “If we improve these linkages, we offer the best hand up to those in need – especially our young people.”
The task force has the support from hospitals. “N.C. Hospitals are pleased that Governor McCrory has made mental health and substance use issues a priority in his administration,” according to the NCHA. “We look forward to working collaborative with the task force in developing and implementing workable strategies to address this critical health issue.”
The task force will be co-chaired by N.C. Supreme Court Chief Justice Mark Martin and N.C. Department of Health and Human Services Secretary Dr. Aldona Wos, and will include Sen. Tamara Barringer, R-Wake, and Rep. Susan Martin, R-Pitt and Wilson, as task force members.
“On a daily basis, courtrooms across our state serve those who struggle with mental health and substance use issues,” Martin said. “My hope is that this task force will, among other things, examine the role and effectiveness of mental health and other specialty courts currently operating in North Carolina.”
The task force will submit findings and strategic recommendations to the governor by May 1, 2016, for improving the lives of North Carolina youth and adults with mental illness and substance use disorders and their families.