Dec. 2, 2013. Dave Richard, Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, will hold a Twitter town hall on Monday, Dec. 2, to discuss and answer questions about the McCrory Administration’s Crisis Solutions Initiative. Announced in November, the Crisis Solutions Initiative is a new statewide effort to improve mental health and substance abuse crisis services in North Carolina.
To participate or follow along, please go to the NC Department of Health and Human Services website,www.ncdhhs.gov, or use the hash tag #ncmentalhealth on Twitter. You can also follow the Department on Twitter, @NC_DHHS, to see responses.
DHHS Invites Leaders to First Meeting of Crisis Solutions Coalition
Nov. 26, 2013. N.C. Department of Health and Human Services Secretary Aldona Wos, M.D., issued an invitation today to leaders in mental health and substance abuse issues to join the new statewide Crisis Solutions Coalition at its first meeting on Monday, Dec. 9 at 2 p.m. on the Dorothea Dix campus.
“Our current system of providing care for people in a mental health or addiction disorder crisis is not working,” Wos said. “We have come to rely too much on local law enforcement and hospital emergency departments to provide mental health or addiction interventions.”
“Not only does this sap resources, but it also bypasses community-based treatment options that could be of more long-term help to patients,” she said.
The Crisis Solutions Coalition will bring together a diverse coalition of stakeholders, including hospital and law enforcement professionals, mental health care providers, patient advocates, legislators and advocacy groups to look at and implement evidence-based best practices for crisis care. Dave Richard, director of the DHHS Division of Mental Health, Developmental Disabilities and Substance Abuse Services, will lead the coalition.
“We want to work towards better alternatives to crisis response, as well as strengthening the support system with earlier interventions and crisis prevention,” Richard said. “The over-dependence on emergency departments and the lack of alternative resources ends up costing limited resources without giving the real help needed by individuals and families during crisis episodes.”
North Carolina sees high levels of emergency department admissions for patients with mental health and substance abuse issues. In 2012, there were 17,000 more behavior-health-related visits to EDs than in 2010.
Extended lengths of stay in EDs for patients needing mental health and substance abuse inpatient care can range from multiple hours to several days. Known as ‘psychiatric boarding,’ the recommended standard is not to exceed four hours, according to the Joint Commission on Accreditation of Healthcare Organizations. In N.C., psychiatric boarding averages more than three days as individuals wait for care in a state-operated facility.
A 2010 report stated that EDs are not a therapeutic environment for treating mental health symptoms that may include paranoia, out-of-control thoughts and personal nightmares. The report also estimated that more than $7 million is spent ‘boarding’ psychiatric patients in emergency departments.
FY 2012 saw a 27 percent repeat-rate for persons seeking emergency department help with a primary diagnosis of mental health or substance abuse. The rate of repeat within 30 days was 13 percent, suggesting that EDs are not the best places for individuals to get the right treatment, medication or planning to avoid a future crisis.
A person in crisis may come in contact with law enforcement, and even end up in jail instead of a hospital. Current estimates indicate that close to 17 percent of the jail population nationally has a serious mental illness, more than three times the 5 percent of those not incarcerated. Three-quarters of the jail population with a serious mental illness also has a co-occurring substance abuse disorder.
The Crisis Solutions Coalition will look at pilot programs and current best practices within North Carolina, with an eye toward their expansion statewide, as well as at promising programs being piloted in other states. The Coalition will also try to identify the best use of public funding to support services that are working and phase out some that are not.