Mental health patients need stable care environments providing a continuum of care from emergency treatment to support services in appropriate settings.

Such ongoing care results in greatly improved mental health patient outcomes, along with a marked decrease in expensive emergency room visits.

Improved patient outcomes are achieved when high-quality treatment and support services are provided by primary care physicians, psychiatrists, and other mental health professionals working together to address all of the patient's mental and physical needs.

The statewide deterioration of North Carolina's psychiatric work force in urban and rural areas has greatly impaired the primary care provider's ability to coordinate mental health care, leaving many patients with nowhere to seek mental health treatment other than local emergency departments.

To combat the current lack of psychiatric and mental health work force, North Carolina needs to determine a set of core crisis mental health services. The services would include physical exams to exclude physical causes of psychiatric symptoms; psychiatric evaluations; referrals to appropriate inpatient or outpatient treatment facilities and community resources; and follow-up care that should be easily accessible to all citizens within a reasonable distance of their homes.

Patients would get safe and appropriate care where their needs are best met. The place may be a local clinic; a hospital emergency room; a doctor's, psychiatrist's or psychologist's office; or a mental hospital.

To provide core crisis mental health services in the most cost-effective manner, all citizens should be assigned a psychiatric safety net -- a clinical home -- based on their home address. This would ensure direction and coordination of crisis mental health care by qualified professionals.

Local law enforcement, hospital emergency rooms, and mental health professionals should have easy access to this information to ensure patients receive timely, necessary treatment.

While North Carolina needs to increase its psychiatric and mental health work force, better and more efficient use of existing resources will provide great improvement as we seek to reform the current system.