Julia’s Musings: Secretary Benton Calls MH/DD/SAS Reform "A Work in Progress”

Department of Health and Human Services Secretary Dempsey Benton held a press conference today promising a “major” announcement regarding Mental Health/Developmental Disabilities/ Substance Abuse Services Reform. Promptly at 2pm Secretary Benton took his seat and began the press conference. I was very impressed with the calm nature of the new Secretary and the direct approach he took regarding issues facing reform. Secretary Benton opened the press conference by stating again that he was given clear marching order by Governor Easley to “fix the state’s public mental health, developmental disabilities and substance abuse services system”. The Secretary then went on to state that the “system is in a state of transformation”. Secretary Benton went on to lay out the key components necessary in restoring the public faith in Mental Health/Developmental Disabilities/Substance Abuse Reform. These steps include:
*A Hospital Management and Operations work group will be convened to work with the State Hospital Directors. The Committee will be comprised of individuals external to the department and will include academics, former state facility managers, advocates, the North Carolina Hospital Association and private providers. Areas of review will include protocols for violence, for placement of restraints, and administrative guidelines that can be consistently implemented throughout the state hospital system. (Committee will include; UNC School of Medicine/Department of Psychiatry, NC Hospital Association, Former State Facility Mangers, Representative from National Alliance on Mental Illness, and a Private Provider)
*A work group will be established to review the implementation of the state’s Crisis Service System, and the state’s overall strategy for providing inpatient services (beds) across the state. The group will review the current implementation activities and refine the definition of the core level of crisis services which should exist in all areas of the state.(Committee will include; UNC School of Medicine, Department of Psychiatry, NC Hospital Association, Local Management Entities, NC County Commissioners Association, NC Mental Health Association, NC Psychiatric Association, Dr. Marvin Swartz/Mental Health Commission and a Private Provider)
*Creation of a new web site to improve public understanding of the activities in the State operated facilities and to ensure transparency. The site can accessed at ncdhhs.gov and will be fully operational by the end of January. It will include a broad array of information, including admissions/discharge data, patient deaths/injuries and staff injuries.Delaying the closing of Dorothea Dix and Umstead hospitals 60 days, giving the new Broughton Hospital management time to improve operations and also assuring sufficient time to address any remaining construction issues with the new hospital.
*Forming an external work group to assess the construction and operational questions associated with opening of the Central hospital. The group will meet with the architect and project manager to review these questioned areas. Also, they will ensure the new facilities at Cherry and Broughton meet high quality standards. The group will also review the plan for the transition of services from Dorothea Dix Hospital and John Umstead Hospital to the new hospital.
I was impressed by Secretary Benton’s candor. He displayed a clear understanding of the charge given to him by Governor Easley to “fix” the system. In the six months that he has held the position of Secretary, it is evident that he has developed an understanding of the fragility of mental illness system transformation. However, I was concerned that during the press conference his understanding of the fragility of developmental disability reform was not as clear. Aside from being mentioned during the opening statements, when Secretary Benton referred to Mental Health/Developmental Disability/Substance Abuse Reform needing to be “fixed”, there was nothing in the press conference that addressed the concerns of people with developmental disabilities and their families. There was an opening for this to occur when the plan on how to improve crisis services was being discussed, but that opportunity was missed by the new Secretary. People with developmental disabilities are still waiting to be included in a discussion regarding Crisis Services.
Crisis Services or the lack of them is not unique to people with mental illness. People with developmental disabilities daily face the lack of Crisis Services to address their needs. Looking at the composition of workgroups to address the "crisis" in Crisis Service delivery, we find no advocacy organization representing people with developmental disabilities . Not including organizations that represent people with developmental disabilities in solving the problem of Crisis Service delivery is an example of the confusion regarding MH/DD/SAS Reform. System Reform should be addressing the needs of all the groups affected by the legislation -Mental Illness, Developmental Disabilities and Substance Abuse. By failing to include advocates for people with developmental disabilities on the committee that will address Crisis Services, we ignore people who have a dual diagnosis of developmental disabilities/mental illness. We aslo ignore the many other issues regarding Crisis Services delivery to the Developmental Disability community. The fragility of system reform is not unique to mental illness transformation. The fragility of developmental disability transformation must also be addressed.