Mental health license still an issue

As local and state officials continue to disagree whether a local mental health unit needs a license, Onslow Memorial Hospital is inundated with potentially dangerous patients.

Dan Jones, the director of Onslow Carteret Behavioral Healthcare Services, said he had operated the same way for eight to 10 years.

"Then I received a piece of paper saying, 'You can't do this anymore," he said.

Jones, who will be presenting his annual report to Onslow County commissioners today, said the mobile crisis unit that provided services in Nonhospital Medical Detoxification at 215-B Memorial Drive did not need a state license because facilities are licensed and the crisis unit was a mobile program of the facility.

State officials disagree. The N.C. Department of Health and Human Services determined that the mobile crisis unit operating in conjunction with Detox was operating without a valid license and ordered the crisis unit to stop providing certain mental health services at Detox on July 18.

Despite Jones' objections, the state maintains Detox will need to secure a state license before receiving involuntary commitments again, said Tom Lawrence, public affairs director for DHHS.

Since July, OMH has had to take in the county's involuntary commitments. And there has been no movement at the state or local level to ease the pain felt in the hospital's emergency department, said OMH spokesman Tim Strickland.

Lawrence said two new mobile crisis units were approved for eastern North Carolina by the state and are expected to be up and running very soon.

"Hopefully, this will help relieve some of the pressure Onslow Memorial is feeling," Lawrence said when he announced the openings. "The purpose of these units is to keep people out of hospital emergency rooms by treating them at their home for two or three days."

Strickland said he doesn't feel the additional mobile units will help.

"We have serious concerns whether those mobile units will be able to help patients here," he said, adding that the units will be spread over six counties and only be able to assist one patient at a time.

Lawrence said the state would place Detox on the fast track for approval if local officials apply for a license.

Jones stands firm that Detox does not need a license to allow a mobile crisis unit to operate within the facility.

"Licenses are for facilities, not for programs," he said, adding he did not understand why the state was suddenly requiring a license when it never has before.

When the state did demand the mobile crisis unit to cease operations at Detox, local law enforcement began to bring involuntary commitments to OMH's emergency department.

Hospital CEO Ed Piper sent letters to Gov. Mike Easley and state representatives from Onslow County asking for help in resolving the issue.

Involuntary committal begins with a law enforcement officer's concern that a person is a danger to themselves or others. A magistrate determines whether the person should be sent to an entry point in the mental health system. If so determined, the person is taken to a 24-hour facility to be evaluated.

At that point, the person must be seen by a psychiatrist or doctor. If commitment is needed, medical officials look for a facility with space. When found, law enforcement transports the person to the facility, all according to interviews with local and state mental health officials.

"The hardest part is finding a bed," Jones said, adding that the state mental health system deals with overcrowding of facilities in two ways: diversion and delay.

Larger facilities like Cherry Hospital have contracts with smaller facilities like Brynn Marr Hospital for overflow patients. The delay tactic requires patients to stay were they are, Jones said.

Jones said he knows an emergency department is designed to flow, and extended stays for mental health patients causes the whole hospital problems.

"I cannot say enough good things about the doctors and nurses at the hospital," he said.

Jones said he wanted the public to understand that mental health services are still available. He said anyone with questions or concerns can call Onslow Carteret Behavioral Health Services at 910-219-8000.

"The petitions for commitment moved from Detox to OMH," Jones said. "But there has been no reduction in service at mental health and no license lost."

Contact crime reporter Lindell Kay at 910-219-8456. Read Lindell's blog at http://onslowcrime.encblogs.com.