Safety lauded at mental hospital

Central tops Dix, Umstead in report

RALEIGH -- A state report says most of the problems with a new mental hospital in Butner have been fixed, but cautions that no psychiatric facility can be made "100 percent safe."

Dempsey Benton, secretary of the state Department of Health and Human Services, in February appointed a committee of state officials and outside experts to review the construction of Central Regional Hospital.

Their report, dated July 7, emphasizes that the new $130 million facility is "significantly safer" than the two aging hospitals it is to replace, Dorothea Dix Hospital in Raleigh and John Umstead Hospital in Butner.

According to an internal timetable released last week, the first patients are set to move from Umstead Monday and from Dix sometime after that.

DHHS spokesman Tom Lawrence said he could not confirm that the move would start on that date, though he hoped it would happen by the end of July.

"We continue to reassess the opening," Lawrence said Monday, citing what he was told by Benton. "We are putting the final touches on those plans now."

That opening of Central Regional has been delayed repeatedly over the last year because of concerns about projected staffing shortfalls, incomplete worker training and design flaws that safety inspectors said might offer suicidal patients ways to harm themselves.

Internal reviews of the facility identified dozens of problems, including grab bars and shower nozzles in patients' bathrooms that could be used to anchor a noose, and overlooks in stairwells from which a patient could jump. Those issues have been addressed.

In a major reversal of policy, the state has also added dozens of surveillance cameras in restraint rooms and seclusion rooms.

Three officials who served on the committee -- Anthony Lindsey, vice chairman for psychiatry at UNC-Chapel Hill; Eileen Spahal, director of psychiatry at UNC Hospitals; and Mary Beck, senior vice president for UNC Health Care -- wrote that they were heartened by changes made since their first visit to Central Regional earlier this year.

"The improvements ... were significant and sincere," they wrote. "First and foremost we recognized that the facility is significantly safer than either Dix or Umstead hospitals. This reality should not be underestimated."

The committee's report remained incomplete for months as projected opening dates for the new hospital came and went.

Two other groups that Benton appointed to examine operations in the state hospitals and review community-based crisis services statewide issued scathing reports in May. The groups called for a major influx of tax dollars and workers to help a mental health system hobbled by years of budget cuts and bungled reforms.

Though the new report on Central Regional is generally laudatory, the group did point to some unresolved issues, such as locks in interview rooms in the admissions area that were installed backward, potentially allowing patients to barricade themselves.

According to James M. Hunt, an architectural consultant, the door fixtures installed in hundreds of patient rooms are an issue of "particular concern."

DHHS safety inspectors previously suggested the door handles could be used to anchor a noose, but administrators have decided against replacing them.

Hunt says, however, that overall the hospital's design is "quite good" and will "set a new standard for state psychiatric hospitals."