According to an AP story run in several papers this week (linked to the CharO because they leave their links up for longer, it seems), North Carolina's mental health system is stiill a mess. The good news is that the General Assembly stopped trying to simultaneously radically restructure the system while simultaenously cutting funding, and finally realized that the restructuring was probably going to cost more money in the short term.
Nonetheless, the privitization/community-based care push which has gone forth under Department of Health and Human Services head Carmen Hooker Odum still looks like a train running off the rails. I'm all in favor of community-based care; you're much more likely to serve someone if you treat them in the circumstances they live in, rather than try to isolate them and address the issues there. (The old system is based on such a funny modern concept—let's cut the person off from their context, and then address the mental issues as if they begin and end inside the skull, and are as readily apparent in a hospital room as in their day-to-day lives. Not saying there's not a time and place for hospitalization, mind you...) But even so, what started out with the noble goal of more local-based treatment turned into a big excuse for the General Assembly to gut the mental health budget. The big cost cutting moves meant that well organized local agencies such as the Durham Center got pounded and scattered to the wind. At the same time, there were reports last year of the DHHS agencies with no more resources dropping mental health patients off at homeless shelters for lack of anything better to do, thereby dumping the problem on homeless support services which are certainly not flush with resources.
All of this is on my mind at the moment because of a recent e-mail exchange with a friend and local neighborhood activist regarding the now-defunct roadside panhandling ban Durham was considering. To be frank, there aren't many people in the world who, given the choice, would spend their days in the cold wind breathing exhaust fumes holding a sign that asking for money. Despite what Sherlock Holmes may have found on the matter, no one is getting rich standing in the median. Most of those who do suffer either from mental illness or drug addiction, or more frequently a mangled combination of the two. Of those I've talked to, some have tried rehab services, but don't want to go back, for what I can only describe as reasons of mental health. I truly believe that if we took mental health seriously and improved these services, we would see many fewer people on the streets begging for money, which would make the public disorder folks happy along with the homeless advocates.
Another AP story by the same author as the one above, the price tag for fixing things up would come to $2.7 billion over the next five years. Martin Nesbitt is probably right that there are a lot of effective things that could be done with lower amounts, but at least these reports are addressing the scope of the problem, which is vast. Here's hoping it leads to positive results.
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