According to the Wake County Magistrate’s Office, 8,500 people were involuntarily committed in Wake County in 2014. These people were deemed to be a danger to themselves, others or property and in need of treatment in an inpatient psychiatric bed.
Some are children, some are elderly, and all are suffering. Some are having their first mental health crisis, and others have been here before. Some know their brains are not working properly, and others think they are just fine and they are being held for no reason. But many were perfectly normal and enjoying their families and friends in the weeks and months leading up to their episodes. And they will be OK again if they can get the help they need. In Wake County, getting that help is a real problem.
These patients have brains that aren’t working properly resulting in a crisis that needs immediate intervention. Just like with other illnesses, the longer it takes to get treatment, the more the patient suffers and often the more difficult it is to treat.
In Wake County, when people are having a mental health crisis, they can go voluntarily to Holly Hill Hospital, to the UNC Wakebrook facility or to a hospital emergency department. The Wakebrook facility is staffed by competent mental health professionals and is also the drop-off point for patients picked up by the police and under involuntary commitment orders, although with capacity for only eight patients in crisis. With over 8,000 commitments in a year, the facility is often full, resulting in a transfer to a local ER.
It is inevitable that patients whose brains are malfunctioning
will join a multitude of others in the ER for medical emergencies like chest pain, abdominal pain, broken bones, respiratory infections and trauma. Most medical patients will be treated and released or admitted to an inpatient bed in the same hospital in less than eight hours. Patients having a mental health crisis will wait, on average, 3.5 days for an inpatient bed, somewhere in the state, to become available.
While the ill are waiting, treatment does not begin except for administration of sedating drugs. For patients with a history of violence or co-occurring illnesses, the wait may be weeks rather than days because most hospitals are not staffed to handle them. Some local hospitals have special “holding areas” for psychiatric patients, but when ER beds are full, patients are often left in corridors on gurneys. When a bed does become available, it is not unusual for patients to be restrained and driven hundreds of miles before they are admitted for inpatient care.
A WakeMed spokesperson recently reported that the hospital had 60 people
in their ER waiting for an inpatient psychiatric bed to become available – somewhere. Although WakeMed is by far the largest hospital in Wake County with approximately 700 licensed beds, the hospital has no psychiatric beds to help provide critical care to Wake County patients. In 2011 WakeMed, rather than open an inpatient psychiatric unit itself, with involvement of the N.C. legislature negotiated an agreement with the UNC Healthcare system to open 28 beds in Wake County in return for withdrawing its unsolicited offer to buy Rex Hospital. UNC/Rex has opened 16 inpatient beds on the Wakebrook campus and has begun construction on the remaining 12. But even with these additional beds, the state estimates there is a need for an additional 43 beds for adults in this area of the state.
Now, some Wake lawmakers are championing a budget provision that is likely to result in inferior care and waste $25 million of the precious proceeds from the sale of the Dix property. The proposal uses these funds to pay rural hospitals to convert “medical” beds to “mental health” beds. These are hospitals in locations where it will be difficult to find psychiatrists and other qualified mental health staff. And it will result in further demeaning transport for patients out of Wake County, away from their family and support systems, for psychiatric treatment.
People experiencing a psychiatric crisis deserve better treatment in a county that is ranked as one of the best places to live, work and play. A better use for a portion of the $25 million cost of the proposed pilot program is to supplement funding to establish a psychiatric unit at WakeMed, right here in Wake County. That would be consistent with its mission statement which is “improving the health and well -being of our community by providing outstanding and compassionate care to all.”
Gerry Akland is president
of NAMI Wake County.