N.C. pushed for mental services

Meetings call for bigger budget

The word "reform" suggests improvement, but for advocates of the mentally ill in North Carolina who marched on the state legislature Tuesday, there is too little progress.

Services are available to some, not to others. Space in state mental hospitals is shrinking, and counties don't have enough beds in community hospitals to use as alternatives. And people with lifetime mental illnesses are treated differently by insurers and the state than people who suffer physical ailments.

It's "sitting on a fence," said Frank Edwards, president of Wake County chapter of the National Alliance on Mental Illness, which organized Tuesday's "Reform the Reform" march. "I'm not quite sure where it's going to fall."

In addition to the march, which about 30 people attended, hundreds of people with disabilities and workers in the mental health services industry met in legislative offices and committee rooms Tuesday, trying to ensure the next round of changes cut their way.

They want more money for the state mental health system and a new law requiring health insurance companies to handle mental health treatment and drug abuse counseling just as they do physical illnesses. The money looks iffy, but the new insurance law is getting its most serious consideration in years.

A House budget passed last week has $34 million in added and redirected spending for mental health services, far less than the $190 million sought by a coalition of advocates for people with mental illnesses and disabilities want. Much of that money is wanted for treatment and services in communities, which were supposed to be operating by now so that people with mental illness could get care outside of state mental hospitals.

Sen. Martin Nesbitt, an Asheville Democrat with an interest in mental health funding, told rally planners he was optimistic that the Senate would approve a larger mental health budget than the House. He didn't know how much more, but he said more money is needed for community crisis services that keep people out of state hospitals.

In addition to state money, mental health advocates want better insurance coverage, arguing that it would help working people get proper treatment for mental illnesses and addictions. Currently, few private insurance policies cover mental illness or substance abuse treatment for more than short periods, and they often impose a lifetime cap that can be reached with just one hospitalization.

Members of the House Insurance Committee seemed inclined to go along with a proposal to cover mental illness in the same way as physical illness, but many committee members wanted to remove the provisions requiring equal coverage for substance abuse treatment.

Harry Kaplan, a lobbyist for the N.C. Association of Health Plans, said many companies with 100 employees or more would not have to live by the law because they are self-insured. Small companies of 25 employees or smaller would feel the law's force, Kaplan said, and they are scared of the prospect of unlimited coverage for drug or alcohol treatment.

"In many cases, these folks are not ever cured," he said. If unlimited drug and alcohol treatment is required, he said, some companies might drop their insurance.

Gregory Crawford, a Rowan County resident who is being treated for alcoholism, said he did not understand the legislators' reluctance to have insurers cover substance abuse counseling.

Steve Church, of Willow Spring, marched with about 30 other people past the Legislative Building to bring attention to the state system's problems.

Church, 53, said he was a patient at Dorothea Dix in Raleigh about seven years ago because he suddenly lost his memory.

"I think a lot of these reforms were just done without a lot of forethought," he said.