Last week, the Civitas Institute published the first article in a three-part series about North Carolina’s mental health system. The article described the disastrous effect of deinstitutionalization, the process by which state mental hospitals were closed in order to provide “community care” for the severely mentally ill. Of course, as the first article described, many of those services never materialized. And patients outside the state hospital system could not be given medication without their consent – a crucial obstacle when many severely mentally ill patients are not aware of their conditions.
Using data from the state Department of Health and Human Services, we compiled this illustration of deinstitutionalization.
From 1992 to 2007, there was steady growth in the number of people served by the state mental health system. The following year, the bottom dropped out: the number of people served dropped from more than 18,000 to about 4,500. That is approximately a 75 percent decrease in the number of people served by the state mental hospitals. Those people didn’t just magically get better – many of the people who might have had access to a state hospital before Gov. Mike Easley’s vaunted “mental health reform” would end up on the street or in jail today.
Another interesting thing to note: the resident population of the state hospitals also dropped markedly over the course of “mental health reform.” These are some of the riskiest patients, whose conditions make them unfit to live outside of the mental health system. Until 2001, the resident population remained relatively steady. After “mental health reform,” the resident population was cut by more than half. Those people didn’t magically get better either.
This graph illustrates nothing less than a full-blown crisis. In the next article, we will be examining the tangled web of the mental health system in North Carolina from the perspective of the people who know it best – families of the severely mentally ill.