news-record.com

Providing mental-health patients with care in their hometowns after they leave state hospitals is the linchpin of a struggling reform program.

But according to a new study, only about half of the people released from state mental hospitals get such follow-up attention. Inadequate post-release response could mean funding cuts for five community-based agencies, including the one serving Alamance, Randolph and Caswell counties.

Connecting released patients with locally based psychiatric care was supposed to reduce the number of re-admissions to state hospitals, which, in turn, would play a lesser treatment role. That was the rationale for the costly reform package legislators approved several years ago.

However, the well-intended emphasis on community care hasn't panned out as reformers had hoped. The report indicates people who received services in their communities actually were more likely to be rehospitalized than those who didn't.

While that could be because they were the sickest, it also could be blamed on a shortage of psychiatric beds at local hospitals and limited access to local psychiatric treatment. Only about half of discharged patients getting community care, the report said, ever see a psychiatrist.

This disconnect is symptomatic of a dysfunctional mental-health delivery system in desperate need of repair. Addressing those nightmarish problems should be one of incoming Gov. Bev Perdue's top priorities.

With four state mental hospitals having lost or facing the loss of accreditation, there could be even more pressure for early release and community-based treatment. Yet patients still must get the level of care the state promised and they deserve.

Straightening out a mental-health system left to languish on Gov. Mike Easley's watch will be a challenge. Perdue has proposed a tighter patient safety net, spot checks on mental-health centers and special mental-health courts for defendants with mental illness.

These are worthy objectives, no doubt, but a system in disarray requires an extensive overhaul. Short-term measures should include keeping open Raleigh's Dix Hospital in light of inspection reports that, without modifications, the new Central Regional Hospital in Butner is unsafe for patients.

Beyond that, Perdue and the General Assembly must forcefully address management and staffing inadequacies that have led to inexcusable patient abuse and neglect at state facilities.

This most recent report again questions how much treatment can be effectively shifted to the community. And just another indication that parts of the ill-fated reform plan aren't working.