September 05, 2006

Crisis for North Carolina's Mentally Ill Due to Funding Shortfall

Crisis in care for North Carolina's mentally ill: State's lack of funding and planning forces patients into adult-care homes ill-equipped to meet their needs

The Charlotte Observer newspaper of North Carolina reported this weekend that "More than 100 out of about 600 adult-care homes across the state admit high concentrations of mentally ill residents, even though such facilities aren't designed to care for them."

For years, experts have warned that North Carolina and other states create a dangerous mix by allowing people with mental illness, some as young as 18, to live in rest homes with frail, elderly residents. The homes can also prove a troublesome fit for those with Alzheimer's disease or dementia. The combination is not ideal for any group.

"It's putting people in great jeopardy," said Florence Soltys, a University of North Carolina (UNC) Chapel Hill professor of geriatrics. "You don't have staff trained. They don't know about psychotropic drugs. And it's not their fault."

The problem is not uncommon, the paper noted:

"North Carolina, like many states, has moved mentally ill patients out of hospitals and large institutions into smaller settings over the past few decades. Some experts say mentally ill people fare better with more freedom living in smaller neighborhood settings.

But even as the state scaled back its larger institutions, it struggled to replace them with smaller ones.

"They started dismantling the mental health system without having an infrastructure to care for them," said UNC's Soltys.

The state's adult-care homes emerged as the convenient, if not ideal, solution. ...

[A recent] analysis turned up 115 rest homes where more than half of the residents have documented mental illnesses. That represented about 19 percent of the total surveyed.

Experts say people with mental illnesses need staff who know how to monitor their behavior, medication and treatment plans. They need stimulating activities and crisis intervention plans. Experts say many rest home staffers would struggle to respond correctly to a mental health crisis.

For complaints about nursing and adult-care homes:
--In North Carolina, call 800-624-3004.
--In South Carolina, call 800-868-9095.


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