The state's approval of a psychiatric emergency department for Winston-Salem is a good step toward correcting the many problems created by the failed overhaul of North Carolina's mental-health-care system. Given that mental patients have waited for hours, even days, for treatment in conventional emergency rooms in our area, this emergency department can't open soon enough.
Old Vineyard Behavioral Health Services hopes to finish construction on the 24-hour, 50-bed emergency department by July 2011.
The state's overhaul shifted most of the responsibility for mental-health care from the state's hospitals to community programs, which were unprepared for the crushing case loads. Many people with mental problems have landed on the streets, in homeless shelters, in jails and in conventional emergency rooms. Often, law-enforcement officers have had to wait with them in emergency rooms, keeping them from enforcing public safety on the streets.
The officers are responsible for people undergoing a mental-health crisis from the time they pick them up until they are admitted for care. That often means the long waits, or long drives to a state hospital -- only to have patients be quickly released or not admitted at all. Leaders in law enforcement and mental-health care have been calling for an emergency department such as the one Old Vineyard plans.
Old Vineyard's services already include a facility for youths with mental conditions. Some local mental-health advocates have worried about how Old Vineyard would handle patients between the ages of 21 and 64 who are dependent on Medicaid, the Winston-Salem Journal's Richard Craver reported. Specialized psychiatric operations, such as Old Vineyard, are not allowed to bill that age group for Medicaid services by federal law.
Rob McCartney, the chief executive of Old Vineyard, said that it will serve all patients to the point of being stabilized "regardless of their ability to pay."
But another problem could remain: Where will the patients go when they are stabilized? It is hard to find a bed in the state's psychiatric hospitals. Some patients could end up back on the streets, in jail or back in the Old Vineyard emergency department.
The new emergency department won't fix all the problems. Also needed is more state money for enhanced community services that serve patients better, including personalized care. But Old Vineyard's emergency psychiatric department will be a good step in the right direction. And for the sake of thousands of hurting people and their families, it can't open soon enough.
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