When it began in 2001, mental health care reform in North Carolina was supposed to downsize state mental hospitals in favor of treating patients through community support closer to their homes. But adequate community networks proved difficult to establish. Money was wasted. Patients often were left to cope with the worst of both worlds.

The magnitude of the failure finally became evident a couple of years ago. Its effects continue to be felt, and patients and their families feel them most acutely. A report conducted through the state Department of Health and Human Services illustrates problems that persist. Nine community hospitals were surveyed about their experiences with the mental health system, and the results were not encouraging, to put it mildly.

A department official acknowledged that the report, which was obtained by The News & Observer and The Charlotte Observer through a public records request, "wasn't supposed to go anywhere." To be fair, the department was on a fact-finding mission and probably knew the feedback wouldn't be good. And DHHS Secretary Lanier Cansler is charged with fixing things that came apart during the administration of former Gov. Mike Easley (although Cansler was involved for a time back then as well).

A bottom line on the report: People in need of mental health care are sometimes left to wait in hospital emergency rooms that are ill-equipped to handle them. Some are handcuffed. Others are sedated. And hospital officials report that admissions at Dorothea Dix in Raleigh and Central Regional in Butner, two state mental health facilities, are difficult to arrange. The mental hospitals don't admit people in a timely way, and their staff members often don't return phone calls, says the report.

Budget-cutting in mental health money by the administration of Gov. Beverly Perdue won't help. Cansler is trying to add some space here and there, but it appears the best that can be done is patchwork.

Compounding the problem is that regular hospitals aren't happy about the idea of creating or expanding mental health services. They are costly, and many patients don't have insurance. Another factor may be that the regular hospitals often are treating people in life-and-death situations. Mental illness of course can have deadly consequences, but in many cases care may not seem as urgent.

This situation cannot be tolerated. A feeling of desperation can consume families unable to deal with those who suffer from mental illness, and without treatment the sick get sicker. The state is hurting for money, but must do more. And in terms of improving how the bureaucracy performs in working with hospitals, that is an issue Cansler can address, and he must.

In addition, some hospital administrators such as WakeMed's Bill Atkinson say arcane rules put too many limits on what types of patients can be admitted to government-funded care in private mental health facilities. Again, that's something upon which Cansler can act.

Even with the secretary doing his best, however, the Perdue administration will have to keep mental health care high on its priority list. These people in need are our fellow North Carolinians, our neighbors. The fact that their care is being limited or denied because of inadequate funding, inefficiency or bureaucratic snafus is outrageous and inhumane.