Mental-Health Privatization Not Working in North Carolina?

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Four years into a massive overhaul of the state's $2.3 billion mental-health system, there is little proof that treatment has improved and there is growing evidence that the state's complex system of care is worse than ever.

"To be blunt, we're not seeing mental-health reform working," said Allison Breedlove, the interim executive director of the Gov.'s Advocacy Council for Persons with Disabilities, told the Winston-Salem Journal, which published a two-part series this past weekend about the state's mental-health system.

"Unfortunately what we're seeing is people are ending up on the streets. They are ending up in emergency rooms in hospitals. Unfortunately, some people are ending up in jails because they are not being monitored and they are not maintaining their medications."

That's not what state officials envisioned when they developed what they believed was a plan to get North Carolina out of the mental-health business.

Legislation approved in 2001 called for the dismantling of the state's system of locally-run public mental-health agencies and turned the care of people with severe mental illness, substance abuse and developmental disabilities over to private agencies.

Money saved by shrinking state hospitals was expected to cover much of the costs of privatization. And care for the more than 358,000 North Carolina residents with mental illness was expected to improve.

But since 2001, total admissions to the state hospitals have not dropped as expected, and adult admissions have grown rapidly.