Midtown Raleigh News

Overflow of mentally ill patients at WakeMed highlights holes in treatment

WakeMed closed its emergency department to some new patients for several hours about two weeks ago, and a big reason was that dozens of mentally ill patients had filled it past capacity.

At the height of the backlog, WakeMed had 65 patients in its emergency department, said CEO Donald Gintzig.

Mentally ill patients, along with traumas and a high number of flu patients, forced WakeMed to have ambulances take some patients to other emergency centers. The emergency department was always open to people having heart attacks, strokes or those with severe trauma, he said.

“We rarely go on diversion, but we had to,” Gintzig said.

State lawmakers on a health and human services budget committee on Wednesday discussed the buildup of mentally ill patients in WakeMed’s emergency room.

The state’s three psychiatric hospitals are often full and unable to admit people in emergencies.

Legislators discussed possibilities for creating more psychiatric beds, including using a site on the Dorothea Dix campus, which housed the state’s first psychiatric hospital, or using Pungo Hospital in Belhaven.

A replacement for Cherry Hospital, the state’s psychiatric hospital in Goldsboro, is about two years behind its original planned opening. With 316 beds, the new Cherry will be larger than the old hospital, which Sen. Tommy Tucker, a Republican from Waxhaw, said would relieve some of the problem. He’s also suggested leaving at least part of the old Cherry Hospital open, or using the hospital in Belhaven.

“Make that into mental health beds,” he said in an interview. “That’s a fix for county unemployment and state hospital beds.”

In 2001, the state decided to rely less on expensive psychiatric hospital treatment in favor of more extensive care based in communities. The state has cut space in its psychiatric hospitals by more than half, and went from running four psychiatric hospitals to three.

Some legislators say the state went too far. A national report using 2010 figures ranked North Carolina 44th in the number of state psychiatric beds per 100,000 people.

Wait times for mentally ill people in emergency rooms grow when caseworkers have trouble finding placements for them. Mentally ill people waiting in hospital emergency rooms has been a persistent problem for years in the state.

The crowding last month in WakeMed’s emergency room helped bring new energy to finding solutions to the problem, Gintzig said. The hospital, state Department of Health and Human Services Secretary Aldona Wos and lawmakers have been working on solutions, he said.

Wake is one of four counties in the Alliance Behavioral Health group, which is run by local governments and uses state and federal money to purchase mental health services for people on Medicaid or those without insurance. Alliance has workers at WakeMed during the week to help find places for mentally ill patients to go.

UNC runs a mental health crisis center near WakeMed, but that was full off-and-on over the week, and some of the patients at WakeMed weren’t medically cleared to leave the hospital, said Sean Schreiber, the chief clinical director for Alliance.

“There were not available hospital beds for people who need inpatient (treatment),” said Schreiber. “It was taking longer than average to get placements.”

Rep. Verla Insko, a Chapel Hill Democrat with an interest in mental health issues, said state spending has not kept up with population growth.

“We’re just reacting to emergencies instead of building up a sustainable system,” she said.