by Vicki Smith, Guest columnist
The year just passed was a dangerous one for individuals living in state psychiatris hospitals.
A veteran lawmaker was skeptical of the abuse recently reported at Umstead Hospital, saying, "Well, I seriously doubt that it happened, but if it did, it certainly is a travesty and should be addressed." Asked to elaborate, he said, "We just don't usually beat folks. It's not the kind of thing that usually goes on in our mental hospitals."
Unfortunately, he is wrong. Cherry, Broughton and now Umstead have been cited by the federal government for treatment conditions so poor that residents have been abused and in some cases died. Who is responsible for the increased violece in our state hospitals?
Umstead Director Stephen Oxley was recently quoted as saying, "This is not a problem of our hospitals screwing up, of not doing what they're supposed to do ... we're being confronted with a significant increase in violence ... "
If it's not a problem of the hospitals screwing up, of not doing what they're supposed to do, then what is the problem? Apparently, one solution would be to blame the victims of violence, the residents with mental illness who are in the hospital, often not voluntarily, to receive treatment. But how could this be their fault? There are more suitable places to look for the cause of this systemic problem.
First, the inevitable consequence of understaffing, overwork, and low wages is poor employee morale. Poor employee morale often results in staff turnover, making it even harder to ensure that workers are appropriately trained. Poorly trained workers provide poor services. This translates to poor patient care, which means increased abuse and neglect.
This is the fault of the system that sets the ratios of patients to health care workers and establishes salaries. It cannot be resolved by isolated, after-the-fact firings.
Second, there must be adequate, community-based services including crisis facilities to prevent [emphasis in original], when possible, the necessity for hospitalization. Without appropriate community services, especially crisis intervention, people with mental illness can experience rapid escalation of symptoms.
Added to this dangerous lack of services is the long transport from local neighborhoods to overcrowded state hospitals. How it is beyond crisis. It is a tragedy waiting to happen.
A community-based service delivery system for people with mental illness, substance abuse issues or developmental disabilities cannot be built by simply closing down institutions. There must be an array of regionally based community services. There must be adequate housing, supported employment opportunities, safe recreation and other service options readily available across the state.
As people move through the service delivery system, there must be crisis services including trained first responders.
But, and this is perhaps the most important factor, we have to stop thinking that the bottom line is preceded with a dollar sign and recognize that what we are really spending--not saving--are human lives.
-- The writer is executive director of Disability Rights of North Carolina.