It's clear from the N&O series on mental health reform that the problems we face are multiple, widespread, and deep-seated. Consequently, there are no quick and easy solutions to North Carolina's mental health system problems.

Many parts of the system are broken or don't function well together. These include how some services are over-reimbursed while others are underfunded, how state psychiatric hospitals are used, how the work force is trained and deployed, how community care is organized, how state and local government interface, and how leadership is exercised.

Solving these systemic problems will require the capacity to analyze proposed solutions, check out their costs and benefits in advance, monitor policy and program implementation, and assess outcomes on an ongoing basis.

No multibillion-dollar enterprise in corporate America operates without this type of intelligence function.

Yet the state of North Carolina, which now spends upwards of $2.7 billion a year on mental health, developmental disabilities and substance abuse services, has not had this capacity internally for the past 15 years. And our universities have never been asked to help out in this way.

Our state and private universities have the expertise to address these policy, financing, organization, management, performance and evaluation challenges.

Indeed, universities represent the major untapped resource for mental health system improvement. But they must augment their traditional role (training workers and developing clinical interventions) by mobilizing faculty to take on the set of urgent system problems that undermine effective care and treatment.

We envision a nonpartisan mental health policy institute based at UNC-Chapel Hill in collaboration with Duke University.

The institute would work proactively to provide reliable information on these issues to the General Assembly, to the governor, to state and local agencies, to consumers and their families, and to the citizens of North Carolina.

Helping the state be a better purchaser of services would be a top priority. The institute, with no policy axe of its own to grind, would dispassionately examine concrete policy proposals and funding options with these diverse stakeholders to generate feasible solutions.

This effort can get under way right away. But within ten months, a new governor will take office, and, shortly thereafter, new leaders will be appointed in the state agencies responsible for these services. The challenge of finding workable long-term solutions for our current problems will fall to them.

Trust must be restored at all levels of the system before the blame game of "what went wrong with reform" will end. No one branch of government can hope to accomplish this task on its own.

With vision and leadership, the governor will have to forge a new partnership with legislators, local government, private providers, consumers and families, and others.

Universities have a huge role in this new partnership. The people of North Carolina are in urgent need of a high-quality public mental health system. It's time for our universities to recognize this need and answer their call.

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