Cody Trivette survived a rare cancer at age 12 only to become so anxious and depressed that he tried to kill himself.
Cody, now 17, is one of six children who remain in a treatment unit at Dorothea Dix Hospital that is set to be closed at the end of June because of budget cuts.
Robin and Eric Trivette, who live in the tiny mountain community of Sugar Grove, say the Dix program is the only place where their son has shown improvement. They fear what might happen when he is forced to go to another facility.
"Without Dix, Cody would be dead or in jail," said Robin Trivette, a registered nurse. "It has taken Cody months to build trust with the staff at Dix. What they are doing is taking his treatment away from us just when it is working."
With the state facing an $800 million revenue shortfall, there is just not enough money to keep the adolescent unit at Dix open, said Rep. Verla Insko, a Chapel Hill Democrat. Other units will continue to be downsized in coming months in anticipation of the long-planned closure of the Raleigh hospital; the date has not been announced.
The Dix unit, which typically housed about a dozen children before the closure was announced last month, is one of a handful of psychiatric residential treatment facilities in the state certified to treat children 13 to 17 with serious mental and emotional disorders.
About 40 Dix staffers will lose their jobs or be transferred to other positions. Most of the patients are on Medicaid, ensuring that taxpayers will cover the cost of their treatment regardless of whether they are sent to a public or private facility.
The closure would be the latest in a series of short-sighted decisions that reduce options for people who need help, said Gerry Akland, president of the Wake County chapter of National Alliance on Mental Illness. Opened in 1856, Dix once had thousands of patients. There are now about 200.
"When you talk to a lot of legislators about the plans to close Dix, they tend to say it is just a Wake County problem," Akland said. "What they don't realize is that these patients come from all over the state."
The Trivettes travel to Raleigh at least once a week to attend therapy sessions with their son, a drive of nearly four hours each way.
Cancer diagnosis
Cody's problems began when he was diagnosed with rhabdomyosarcoma, a fast-growing cancer that attacks muscle. Only half the children who develop the tumors survive more than five years.
After two surgeries and months of chemotherapy, Cody's cancer was in remission. By the time he returned to school, he had problems relating to other students. He began to resist getting out of bed in the morning and fought with his mother and father about leaving the house.
That began an odyssey for the family, with Cody being diagnosed with depression and post-traumatic stress disorder. Over the past five years, his mother has fought with insurance companies and government bureaucracies to find effective psychiatric treatment for her son.
Suicide attempt, assault
The problems came to a head last year after Cody swallowed a bottle of antidepressants in a suicide attempt. In November, he assaulted his mother during an argument.
Desperate, his parents went to a Watauga County magistrate to have their son involuntarily committed to a mental facility. Instead, the magistrate ordered Cody's arrest on charges of misdemeanor assault and battery and sent him to jail.
After a few days, he was admitted to Broughton Hospital, a state-run psychiatric facility in Morganton. During his stay, Cody used a shard from a broken light bulb to slice into his arms. He later told his parents he had also tried to hang himself with a twisted bedsheet.
He was admitted to Dix in January. In his six months there, Cody earned his high school diploma while undergoing intensive therapy.
"I've been in therapy for five years now, and no one has ever been able to paint a solid picture of what is going on with me," Cody said this month. "I can't fool them. My doctor at Dix has a good B.S. radar."
Since Department of Health and Human Services administrators announced May 19 that they were going to close the Dix unit, the Trivettes have been working with the staff to figure out where Cody will go.
Cody's history of violence makes his placement challenging. He has been rejected for admission to private psychiatric residential treatment facilities in Asheville and Greensboro.
The Dix patients who cannot be placed in private facilities will be sent to the Whitaker School, a Department of Health and Human Services facility for emotionally handicapped teens in Butner. Whitaker is not a psychiatric residential treatment facility, though DHHS officials are working to earn it that level of certification.
Rock and a hard place
Rosemarie Poeppelman, whose 15-year-old daughter was transferred from Dix to Whitaker on Tuesday, said she was not happy about the move.
Echoing Cody's parents, she said Dix was the only program in the state where she has seen her daughter's behavior improve.
The Butner facility is not equipped to provide the daily sessions with a psychiatrist and weekly therapy sessions that include family members, which Poeppelman's daughter had gotten at Dix.
Poeppelman said her daughter was kicked out of a private psychiatric residential treatment facility near Asheville and left sitting in a hospital emergency room for nine days awaiting admission to another facility.
"The state has us between a rock and a hard place, but we accepted the transfer because we didn't want her to go back to a private facility," said Poeppelman, who lives in Asheboro. "But she won't be getting the level of treatment in Butner that she has been getting at Dix, and that is of great concern to me."
For Cody, the planned closure of the Dix unit could not come at a more stressful time. At a recent medical checkup, scans revealed a new tumor on his liver. He is scheduled to undergo a CT scan next week to see whether the cancer has grown.
The Trivettes are faced with the choice of Cody's going to Whitaker or to a small psychiatric residential treatment facility that recently opened near Statesville.
Tuesday night, the family attended a candlelight vigil to protest the continued downsizing of the state's oldest psychiatric hospital.
"This place literally saved his life," Robin Trivette said, as she began to cry. "What they have done for Cody is above and beyond. Now, we'll have to start all over."
