RALEIGH -- The state-run Dorothea Dix Hospital will send away most of its psychiatric patients by year's end, a move that raises questions about what will happen to the 306-acre campus.
Lanier Cansler, secretary of the state Department of Health and Human Services, told hospital staff Tuesday that all but one unit of the hospital will close. Most patients will be moved to the new Central Regional Hospital in Butner and Cherry Hospital in Goldsboro, resulting in new assignments for the 803 medical and support staff who work on the campus caring for patients.
"We want to make sure the patients are taken care of," Cansler said in an interview. "We're going to be maintaining the same number of beds; the costs will be significantly less."
The call to shutter most of the programs that serve the 183 patients on Dix's campus is a familiar refrain from the state, which has set closing dates for the Dix campus several times.
State officials decided in 2002 to close Dix and another hospital in Butner and replace them with Central Regional Hospital and by steering more patients to community-based programs. At the time, Dix had 390 beds for patients, about half of whom came from Wake County. The moves were supposed to save the state money, but as community-based services have failed and faltered in recent years, the state has struggled to find enough psychiatric beds to treat those on waiting lists around the state.
Dix was set to close in 2008, but a lawsuit over safety concerns with the new hospital in Butner led a judge to block the shutdown. There have also been extensive problems with patient abuse and neglect at Cherry in Goldsboro.
But this time, the state's budget has all but sealed the fate of Dix, which became the state's first mental health institution when it opened in 1856. The state legislature didn't provide any money for Dix in this year's budget, and there are available beds at the new Central Regional Hospital, which was designed to replace Dix, Cansler said.
"We have been forced to make some very difficult decisions to address this shortfall," Cansler wrote in a memo sent to Dix staff.
Most of the staff will be offered jobs in Butner, a 45-minute drive from downtown Raleigh, or at Cherry Hospital, where 30 beds for adult patients are being added.
Only 54 medical staff members will remain on the Raleigh campus to run a small minimum-security forensics unit for patients that have been involved in the criminal justice system. The bulk of the forensics units will be sent to Butner. An additional 10 workers will be on the Raleigh campus for a child outpatient clinic, according to DHHS.
Vicki Smith, director of Disability Rights North Carolina, an advocacy group for patients and their families, said she was not surprised by the move to close most of the hospital.
"When the General Assembly didn't appropriate anything for it, this was inevitable," Smith said.
Her organization, which represents North Carolinians with disabilities and educates them on their legal rights, will be watching the patient transfers closely to "make sure the places are appropriate," she said.
Disability Rights also wants to focus on long-term goals of providing more community-based mental health programs to decrease the number of patients kept in mental health facilities for long periods, Smith said.
The move to rid the campus of its psychiatric patients will revive debate about what should happen to the 306-acre property, which lies just southwest of downtown Raleigh. Five years ago, the state hired a planning firm to come up with options for the land. The firm suggested either a park with gardens, walking paths and museums or "a new urban neighborhood," with retail space, offices and 1,200 homes.
Meanwhile, a citizens group has been pushing the state to turn the campus into a park.
"I'm hoping it'll be designated as a park," Raleigh Mayor Charles Meeker said.
A spokesman for Gov. Bev Perdue said no decision has been made about what should happen to the Dix property.
The plan to move most of Dix's patient services doesn't mean the campus will be empty. The nearly 1,300 people who work in various health and human services administration offices on the property will remain, according to DHHS staff.
In his letter, Cansler lauded the "outstanding care and treatment" the staff at Dix has provided in what he termed an uncertain time. He urged those losing their jobs to seek new positions at the hospital in Butner.
He said the staff has known the facility was going to eventually close, but having the target date change so many times has created some stress.
"The staff has been on an up-and-down roller-coaster ride," he said.
Staff writers Leah Friedman and Michael Biesecker contributed to this report.
