Wake County

Wake County asks: How can we coordinate better mental health care?

Daniel Knight, a nurse, takes the vital signs of a patient at WakeBrook Recovery Center in Raleigh on Thursday June 27, 2013.
Daniel Knight, a nurse, takes the vital signs of a patient at WakeBrook Recovery Center in Raleigh on Thursday June 27, 2013. 2013 N&O file photo

Wake County wants to provide better mental health care and spend less money cycling patients through hospitals, jails and shelters.

On Thursday, local leaders and representatives who work in social services, education, health care and the justice system will gather at the Raleigh Convention Center to talk about ways to do that.

The goal of the Behavioral Health Summit is to help agencies collaborate and decide how to best use their resources, said Wake County District Attorney Lorrin Freeman.

“There are a lot of really good ideas out there about steps we need to take to address what really is a crisis in our community,” she said. “But it’s kind of like trying to eat an elephant in that you have to figure out where you want to start.”

People with severe mental health issues often experience higher rates of homelessness, arrest and emergency room visits. Those who repeatedly experience all three account for a large portion of the county’s social services spending, said Sig Hutchinson, chairman of the Wake County commissioners.

“The number one housing complex in Wake County for people with behavioral health problems is the jail,” he said.

Hutchinson, who will speak Thursday morning to kick off the summit, said the state’s decision in 2013 to have counties contract with various private providers has hindered efforts to create partnerships among insurance companies, law enforcement agencies and other social services. Before the change, Wake provided clinical mental health services on its own. About 200 county workers who provided direct care lost their jobs under the switch.

“You get all these siloed levels of care through various private service providers who aren’t integrated, and then couple that with the lack of expansion of Medicaid, and the closing of (Dorothea Dix Hospital), the lack of facilities,” Hutchinson said. “And you’ve got a mess on your hands.”

But the system does have benefits, said Denise Foreman, the Wake assistant manager coordinating the county’s mental health response. She said the shift has helped patients receive better care because they are treated by private health care providers who do specialized, high-quality work.

Mental health has been a focus of the mayoral election in Raleigh. City leaders are most often responsible for coordinating police responses to mental health crises and helping patients access long-term services, including housing.

Hutchinson said the county was pursuing a “housing-first” model to help keep patients off the streets and out of jails and hospitals.

“You give them a shelter, you give them a case manager, and then you ask them to start working on that drug problem,” Hutchinson said. “But most importantly, we get them off the street. Once they’re off the street, they stop calling 911, they stop showing up in the jails and in the emergency room.”

Gargan: 919-829-4807; @hgargan