A risky gap

State and federal help for young adults with mental illness must be stepped up.

January 2, 2013 

Last year, lawmakers in North Carolina cut $20 million from funds used to purchase mental health treatment. Local health offices had to use reserve money to make up the difference between the need and the money available to provide it. That’s serious, particularly in light of the fact that there seems to be inherent gaps in the public mental health care system that make it difficult for young adults to get treatment.

As The News & Observer’s Lynn Bonner reported, the transition from mental health care for children to that for adults is awkward. Medicaid, the federal/state health care plan for lower-income and poor people, may require those in that transition to apply for help on their own, something those individuals may not be inclined to do, or may not even be aware of. Thus, they go without treatment, and their conditions can worsen.

Broken system

Pat McCrory, the incoming governor and a Republican, sounds the right note when he says, “Frankly, we have a broken mental health system in our nation and in our state. We’ve got to do some serious work to close those deficiencies.” He’s right. Now the challenge for McCrory is to push his GOP majorities in the state House and Senate, where the inclination is to cut budgets in all directions, to invest in better mental health care, with something of a focus on that young adult group.

The issue is Topic A in the community of mental health professionals these days because of the killing rampage in Newtown, Conn., and the deaths of 20 children at the hands of a 20-year-old man with mental problems. But while that tragedy has brought the issue to the fore, a psychiatrist who directs mental health programs for Community Care of North Carolina, a network of Medicaid managed-care organizations, fears that younger mental patients will be stigmatized. “Few people,” Dr. Michael Lancaster says, “with mental illness are capable of violence.”

After a failed mental health reform effort dating back more than 10 years, the state has changed the structure of offices providing services, consolidating local ones into regional groups. That may work from a structural standpoint, but one problem is that patients and families have seen several such changes over the years and can be understandably confused. The key is not just to make the services available (which will take more money) but to make patients aware that they are available.

Close the gap

In the meantime, there remains a gap through which those young adults dependent on public help may fall. The new governor and the General Assembly need to face the funding shortage that lawmakers helped create and recognize that a state without adequate care for the mentally ill hurts patients and the state itself. Neglected, the problems of individuals become worse. And those problems remain the state’s problems.

Solving them now is in the hands of a new governor and a (fairly) new majority in the General Assembly. The test for any government is not to take better care of the haves, meaning the business community for which McCrory wants to do more in reducing regulation and cutting taxes, but to address responsibly the needs of the have-nots, in this case those with mental illness who are not getting what they need. They deserve better from the state of North Carolina.

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