A task force on mental health and substance abuse, meeting under Gov. Pat McCrory’s direction, is looking at the intersection of drug addiction, mental illness and incarceration. The goal is to get policies, and money, directed toward improved care.
The task force has reviewed two dozen recommendations that included providing more affordable housing, education for health care providers and prescription drug tracking. State Health and Human Services Secretary Rick Brajer and state Chief Justice Mark Martin are leading the group, whose members include doctors, judges, patient advocates, legislators and law enforcement representatives.
The task force was divided into three work groups that reported their recommendations last week. From here, the task force will decide which recommendations it will forward to the legislature.
The group aims to craft a package of proposals for lawmakers to consider during the session that begins in April, Brajer said.
It’s a chance to knit policies and assistance programs into a coherent plan. It’s also a daunting task.
“It’s hard to describe it as a broken system, because it’s not a system,” said Brajer, paraphrasing another task force member.
The state has scattered resources that people can’t get to or that aren’t effectively organized, he said. “What are the building blocks, the foundation for building a system as much as we can?”
McCrory dropped in on the task force last week to give members a pep talk, saying he shared their sense of urgency.
“I’d like for North Carolina to be a leader in dealing with the mental health issue,” McCrory said. “They’re in emergency rooms, they’re under our bridges. They’re in our families stealing, or doing other things or harming themselves or harming family members. Or they’re primarily in our county jails or in our state prison system.”
The state in 2001 passed a law that overhauled public mental health, and it has seen significant change since then.
It’s hard to describe it as a broken system, because it’s not a system.
State Health and Human Services Secretary Rick Brajer
Some of the major recommendations to the task force addressed acknowledged shortcomings or took on issues the state has debated for years.
For example, one work group within the task force had affordable housing as a priority. Creating more housing for people with mental illness is central to a legal settlement the state has with the U.S. Justice Department. The Justice Department had threatened to sue the state over a lack of such housing, maintaining that North Carolina had relied on adult care homes rather than helping people live independently.
Another top recommendation was to stop charging as adults 16- and 17-year-olds accused of crimes. One of the arguments is that such a change would open to these older teenagers some age-appropriate treatment that is available to juveniles but not to adults.
For years, legislators have tried unsuccessfully to “raise the age.” Since at least 2006, bills that would have transferred to the juvenile system 16- and 17-year-olds charged with misdemeanors have either died in committee or passed the House but not the Senate.
Other suggestions include developing public awareness campaigns on prescription drug abuse, finding grant money for substance abuse treatment for people in jail, and putting more behavioral health specialists in schools.
The task force will meet again this winter to pare its list to this year’s priorities.
Jack Register, an executive director of the advocacy group for people with mental illnesses called NAMI NC and a task force member, questioned how much would be accomplished this year.
Register said in an interview that his work group was told early that its proposals would have to be “cost neutral,” meaning that they should not result in higher costs for the state
And he and others were taken aback last week when they heard that they were expected to work to get the legislature to approve the task force’s proposals, Register said. The assumption was that the legislators appointed to the task force would guide the recommendations through, he said. Many of the task force members don’t have experience working to get laws passed, he said.
NAMI appreciates the McCrory administration’s engagement and all the work that has gone into the task force, he said, but he added: “We’re concerned the work is not going to go anywhere.”
“It feels like we’re sort of back to the beginning of reform,” Register said. “It’s exhausting.”