A local man who was having a mental-health crisis spent more than eight days in the emergency department of Forsyth Medical Center -- at times handcuffed by Winston-Salem police -- before being admitted yesterday.
Local mental-health advocates said they are worried that such lengthy waits are becoming more common because of a lack of beds in local and state hospitals and psychiatric facilities.
"Having someone having to wait that long for mental-health assistance, even as their basic needs are met, is getting excessive and almost cruel," said Andy Hagler, the executive director of the Mental Health Association in Forsyth County. Hagler said he is monitoring the patient's stay,
"Would we keep someone dealing with Alzheimer's disease or a major chronic medical issue waiting like this?"
"I'm just concerned that with all the talk of budget cuts for mental-health care, we're going to see more of these situations happening," Hagler said.
When law-enforcement officers pick up someone having a mental-health crisis, they are responsible for the person until he is admitted to a health-care provider, no matter how long it takes.
Officers tend to rotate the hospital emergency-department shifts every two hours, said Capt. Patricia Murray of the Winston-Salem Police Department.
Freda Springs, a spokeswoman for Forsyth Medical Center, said that because of federal privacy rules, she could neither confirm nor deny whether the man with the mental-health crisis is in its patient system. Murray said that the man was picked up as an involuntary commitment on May 20. She declined to identify him because of federal privacy rules.
"There was not a bed available to this person locally or within the state until 10:20 this morning," Murray said. "This is the longest period of time I can recall officers having to be with one person, but it's not unusual for it to be several days."
For example, a person was similarly restrained for five days earlier this month at Moses Cone Hospital in Greensboro before being admitted to Central Regional Hospital in Butner.
Last July at Forsyth, Winston-Salem officers had to stand guard over a mental-health patient for at least six days.
Springs said that Forsyth has 10 private beds in its emergency department and 43 beds in a locked inpatient unit dedicated to behavioral-health cases.
In most instances, mental-health patients at Forsyth are given short-term medical and mental-health care -- lasting from a few hours to a few days -- or stabilized for transfer to another facility, Springs said. The hospital does not serve violent and unstable patients who need longer-term care, she said.
If a person having a mental-health crisis has to wait for a bed longer than 1½ to 2 days, "it's often because of a lack of beds amid an increase in admission requests and people being sicker and staying longer," said Luckey Welsh, the director of state-operated services for the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services.
"It is very unusual to have a patient be kept in a hospital emergency department for eight or nine days," Welsh said.
Local health-care officials said that another factor that causes delays in admitting mental-health patients is finding appropriate housing for patients who are ready to leave care.
Old Vineyard Behavioral Health Services is pursuing a certificate of need for a proposed $13.8 million center at 3637 Old Vineyard Road. The center would have 50 beds and a 24-hour psychiatric-emergency department. CenterPoint Human Services is participating in the application.
State regulators said they expect to respond to Old Vineyard's application by June 29.
The transfer of the 50 beds, which includes 12 dedicated to a geriatric unit, from Broughton Hospital in Morganton has been approved by the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services.
■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.
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