North Carolina shouldn't have to be dragged through the courts or through the disciplinary agencies in the federal government bureaucracy to do right by those who are mentally ill and cannot afford to care for themselves. But it appears that may be happening because of an investigation by the advocacy group Disability Rights North Carolina and law students from UNC-Chapel Hill.
In May, they visited 15 adult care facilities where the majority of residents had been diagnosed with mental illness and found bad conditions in some. Those conditions included mentally ill patients parked in wheelchairs, drooling on themselves, complaints from patients about abuse and neglect by staff and facilities in need of repair.
Disability Rights has filed a federal complaint about its findings, claiming that North Carolina is in violation of the Americans With Disabilities Act for not adequately supervising adult care homes and not having satisfactory housing for the mentally ill.
Short on space, money
Housing those with mental illness in places designed for the infirm elderly is not a good solution to the shortage of space for psychiatric patients. Lanier Cansler, secretary of the state Department of Health and Human Services, says there are no good solutions, under the circumstances, and that if the mentally ill weren't in these facilities they might well be homeless.
One issue, the main issue, is money, or rather a lack of it. The state must address this problem and address it quickly, and look for solutions through public-private partnerships, by certainly maintaining the psychiatric beds it does have (not going ahead with an ill-conceived downsizing) and by looking for foundation grants, private contributions, and for any and all possible sources of help.
As The News & Observer recently reported, there have been four slayings in North Carolina rest homes in the last two years, cases where residents were killed by fellow residents with a history of severe mental illness. Now consider that there are over 6,000 people with serious mental illness in adult care facilities throughout the state. That is a statistic that ought to be sounding alarms in state government, just as it does in the homes of the loved ones of those patients.
Urgent review
No one expects the state to provide taxpayer-funded palaces for those who are unable to afford extremely expensive private care. But at least it could, right now, undertake an emergency intervention to thoroughly inspect and review all adult care homes in the state and ensure that holes in the walls are fixed, conditions are clean and through surprise monitoring, that workers are not neglecting people.
It's vitally important to say that most people who work in adult care homes are dedicated and care about the residents who are under their supervision. It takes a really devoted person to face the frustrations of being part of caring for people who often can do little for themselves.
Those who are doing a good job around the state are doubtless as angry about those who are not doing the job as anyone else is.
But the state is the body with the authority to step up here, and this is an area of need that is only going to grow. More people are diagnosed with mental illness now, for one reason because there are more people, period. And as "baby boomers" age, there will be an even greater need for adult-care facilities.
This is not, in other words, a cyclical challenge. It's here to stay, and conditions and regulations and space as they stand now are not adequate. They will become more inadequate in the future. Unless something is done. As it should be. As it must be.
