Lawmakers debate mental illness, care

House, Senate panel reassesses needs

Roughly 5,000 people whose chief diagnosis is mental illness live in North Carolina rest homes, sometimes presenting a danger to other frail, elderly residents, state human services officials told legislators Wednesday.

Such a mix of populations -- with different medical issues, staffing needs and treatment plans -- could be eased with the development of a hybrid facility, where up to 12 people with mental illness could receive the care and attention their conditions require, members of a state legislative subcommittee learned.

"I think this committee must consider special-care units for people with mental illness," co-chairwoman Rep. Verla Insko, a Chapel Hill Democrat, said after the presentation. Members of both the House and Senate serve on the committee, which met for the first time Wednesday to address long-standing concerns.

A 12-bed home could be specifically developed and financed as a place for people with mental health problems -- anxiety, phobia, depression and schizophrenia among others, a Division of Medical Assistance staffer told the group.

The state would not build homes under the program -- for which no cost estimate was available -- but would pay providers for care, Insko said. The state has been struggling to change the way it provides care for people with mental illness, moving treatment from institutions to care in communities. After years of allocations that mental health advocates called inadequate, legislators this year approved an additional $74 million for mental health services.

Separately, the state pays a portion of the bills for many patients in long-term care.

"Are [adult care homes] set up to deal with that kind of thing, and if not, how are they dealing with it?" asked Rep. Debbie Clary, a Cherryville Republican.

Complex details

The mixing of rest home residents and people with mental illness presents many troublesome issues, state and industry representatives said. Aides at rest homes aren't trained to deal with younger residents who suffer from mental problems, and facilities often are asked to admit residents without being given full information about their conditions.

When residents with mental illness do create problems for themselves or others, it's often difficult to discharge them, because there are few alternatives.

"Where's the person going to go?" asked Barbara Ryan, chief of the division of adult licensure.