RALEIGH - Less than a month before patients are set to arrive at a new state mental hospital in Butner, administrators have not fixed several safety problems with the $120 million building.

An internal report from a May 13 inspection at Central Regional Hospital lists 16 unresolved safety and security issues, including hundreds of door handles and bathroom handrails that suicidal patients could use to anchor nooses made from bedsheets or clothing.

Required evacuation and fire plans have yet to be developed, and a state safety inspector noted design flaws that could allow patients to enter unsecured areas or escape to the woods.

A second internal checklist of problems notes that lights in a medical unit used to call a nurse were installed above the ceiling where they cannot be seen. Some of the hospital's signature floor-to-ceiling windows have glass that is not shatter-proof.

State mental health administrators are pushing ahead with plans to close Dorothea Dix Hospital in Raleigh and John Umstead Hospital in Butner by July 1. Patients from the two hospitals are to start moving to Central Regional on June 13.

A centerpiece of the foundering effort to reform the state's mental health system, the hospital's opening has been delayed twice since a Dec. 16 article in The News & Observer revealed an earlier accounting of safety problems.

Dempsey Benton, secretary of the state Department of Health and Human Services, said Tuesday that he is confident that Central Regional will open by July 1 and that safety reviews of the new building are likely to continue even after patients arrive. Some problems identified in the May 13 safety report may not need to be fixed, he said.

"We believe that any and all safety issues identified are being addressed and, if needed, corrected, and the hospital will be ready to open safely within our schedule," Benton said. "Some of them are judgment issues, preferences. ... We're going to maximize the changes where we can make them, but if we're getting down to what one preference is versus another one, we'll have to make a call on that."

Gov. Mike Easley, however, has said all safety problems will be resolved before the building opens. His office repeated that pledge Tuesday.

"The governor does expect that to happen, and the secretary is taking care of that," said Renee Hoffman, a spokeswoman for Easley.

Suicides not uncommon

Among the problems identified in the report are the horizontal door handles used in patient rooms, which a safety official said could be used to anchor a noose. Standards for mental facilities call for using vertical door handles. State consultants have identified hardware similar to the existing handles as a hanging hazard in other hospitals.

There are other problems at the new hospital for which there is no obvious remedy, however, such as restraint rooms that are too narrow for workers to safely transfer a patient from a gurney to the bed. The hospital director has said the staff would just have to find narrower beds.

In the last seven years, at least a dozen patients died by suicide or nonmedical accident in state mental hospitals.

In March 2005, Darnell Jamarr Harrell, 22, used a belt to hang himself in a shower at Umstead Hospital. Deborah Lynn Bishop, 45, used a brassiere to hang herself in 2001 at Broughton Hospital in Morganton.

Stephen Adams Matthews, 31, ran through a third-story window at Dix Hospital in 2005, falling to his death. An investigation later determined the window should have been made of shatter-proof, laminated glass.

At Central Regional, some of the makeshift fixes attempted so far have compounded the problems, according to the internal report.

An example: the grab bars bolted to the walls in patient bathrooms throughout the facility. After an inspection last year raised concerns that patients could use the bars to hang themselves, the state installed metal plates intended to fill the gaps between the handhold and the wall.

Even with the new plates, safety officials were able to loop a bedsheet through the opening. Worse, the new metal shields have "sharp razor like edges" that pose an additional suicide threat, according to the safety report.

Another problem is that workers installed the plates using standard screws that could be loosened with a coin or some other improvised tool. The doors to the private bathrooms in patient rooms have no locks, raising concern about how staff could keep patients out if needed.

Terry Hatcher, director of property and construction for DHHS, said in a written statement that the grab bars will be fixed before the hospital opens and that some other problems identified in the report are not major.

But rank-and-file employees are worried about what might happen after patients arrive. The N.C. Public Service Workers Union wants to delay the move for a year, saying state administrators and employees need more time to prepare.

State Sen. Ellie Kinnaird, a Carrboro Democrat active on mental health issues, agrees.

"There is not adequate time to make the move in an orderly way," Kinnaird said Tuesday.

(Staff writer Lynn Bonner contributed to this report.)

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