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The bad news?

A Greensboro psychiatric patient’s five-day stay in Moses Cone’s emergency room until a bed came open May 7 at the state’s at-capacity Central Regional hospital was the longest case of “ER dumping” state officials had heard of — but only by 24 hours.

The worse news?

A committee of state legislators Thursday recommended a minimum 25 percent slash in the human services budget. The proposals, if enacted, include cuts that mental health officials say would deepen the crisis.

“We will have more (mentally ill) people in the emergency departments,” warned Michael Lancaster, chief of clinical policy for the N.C. Department of Health and Human Services.

“This is just going to exacerbate the situation. We’re not going to be able to fund Mobile Crisis Teams, the ACT Teams,” Lancaster said of the community support programs potentially jeopardized by the health subcommittee’s cuts.

Amid a looming budget crunch, the story of the man handcuffed to a bed and placed under round-the-clock police guard at Cone hospital tripped an alarm among patient advocates.

Vicki Smith, executive director of Disability Rights North Carolina, a Raleigh-based nonprofit that investigates neglect and abuse allegations, said attorneys for the organization will investigate the case.

The five-day ER wait was the longest known admission delay because of a state psychiatric bed shortage, Lancaster said.

Such situations are hidden from the public by strict HIPAA rules guarding patient confidentiality. But to those working in the trenches, growing wait times to get patients admitted to state hospitals are common knowledge.

“I had to chuckle when I read that story,” said Eden police Chief Reece Pyrtle. “The Reidsville police just had one (patient to guard) for 52 hours, and our record is 96 hours. I can tell you, this is a problem.”

In contrast to the metro police department in Greensboro, however, Pyrtle has no reserves to call in — only seven officers on duty at a time, assuming no one is in training, on vacation or sick.

Though Pyrtle declined to give specifics about the 96-hour ER guard duty, he was no doubt referring to a commitment order served in early April on a young Eden man awaiting transfer at Morehead General Hospital.

Schizophrenic and off his medication, he needed treatment at a state hospital, but there were no beds available. As with the Cone patient, he was handcuffed to his bed under police guard.

The man’s father, a longtime Eden resident, periodically checked in on him over four days in the ER. He asked that his name not be used to protect his son’s privacy.

“This is a small community. Everybody knows us,” said the father, who added that he did not blame the police or the hospital for his son being handcuffed.

“He kept saying he hadn’t done anything, and I said, 'I know you haven’t done anything.’ They’re being punished for something they can’t help.”

During the time the young man in Eden was waiting for hospital admission, the same pattern was being repeated elsewhere in the state.

According to an April patient delay list obtained by the News & Record for Cherry Hospital, a 274-bed facility in Goldsboro, admission wait times ran from four to 92 hours.

Meanwhile, at Central Regional, which serves the Piedmont, 299 people could not be admitted during April, according to the HHS Web site, because the hospital was at capacity and operating on delay status.

Why the crunch?

The ostensible goal of mental health reform was to close the big state hospitals except for the most ill people and replace them with services in people’s home counties.

Toward the first goal, the state has eliminated 100 beds since 2007 and, in the governor’s proposed budget, would eliminate another 50 beds between Cherry and Broughton state hospitals.

The problem is that the community beds are not in place to meet the need — putting the cart before the horse and now overloading the cart.

“We’re now bringing people from all over the state to one hospital that was overcrowded by the time it was built,” Mike Weaver, Guilford chapter president of the National Alliance of the Mentally Ill, said of Central Regional, which opened last summer.

“The services in the community are not adequate, and there are not enough hospital beds. They blew it.”

Longtime advocates such as Paula Cox-Fishman worry about the fallout of patients being cycled through the system too quickly and getting less treatment in the community.

And county mental health officials are bracing for the battle over nebulous items in the subcommittee cuts such as an unspecified $50 million in “state-funded services provided by LMEs,” the bureaucratic jargon for the county mental health authorities.

“That’s a whole bunch of money,” said Billie Martin Pierce, director of the Guilford Center, the local mental health agency. “I wonder what in the world LMEs do that don’t get a contribution from their counties?”

Pending Guilford County commissioners’ approval, Martin Pierce said, her agency will receive $12.5 million in local funding for crisis services — doctors, nurses, a crisis center.

That means, for example, that when a Sheriff’s Office van brings the five-day Cone patient back from Central Regional after his discharge, it will no longer drop him off at his apartment or at a homeless shelter, as was the past practice.

Beginning in March, the van has stopped at Guilford Center, where the discharged patients now have lunch and go over their after-care plans and their medical follow-up.

The trouble is, that wasn’t how it worked last month in Eden. After 96 hours in Morehead General — the charge nurse doing the best she could, calling all over the state to try to find a bed, the police as nice as they could be — the man’s 28-year-old son was finally transferred to a psychiatric ward in Rutherfordton.

That’s a four-hour ride up to the mountains. There, according to the father, doctors determined there was nothing wrong with him and released him after two days.

“He’s a real good kid, a good person,” his father said. “It started when he was 16. He just gets off his medication. All wounds are not visible.”

Contact Lorraine Ahearn at 373-7334 or lorraine.ahearn@news-record.com