Wednesday, May 28, 2008

NC Psychiatric and Psychological Associations Have Avoided Mental Health Reform Tragedies

As a clinical psychologist, it pains me to no end to hear the deafening silence associated with----so far---the NC Psychological Association and NC Psychiatric Association.

As noted in a recent article about the concerns of the NC Psychiatric Association, as pertaining to the premature opening of Central Regional Hospital (Gov Easley has to try and redeem himself in some way for all the failures of NC Mental Health Reform), Dr. Stephen I. Kramer, president of the NC Psychiatric Association, stated: ".... to his knowledge, the group has never before felt the need to voice its members' concerns to the state...."

The NC Psychiatric Association finally had something to say, issuing a concerned statement as per its 900 members in NC, as pertaining to the danger of opening the new Central Regional Hospital on the heels of closing two other psychiatric hospitals.

While I have gotten used to professionals simply avoiding confrontations or pointed statements, it still amazes me. I sometimes wonder if we live on different planets.

Last week, in Haywood County in Western NC, under the jurisdiction of Smoky Mountain Center (SMC) LME, the largest LME in terms of geographic area in NC, four mentally ill patients sat in the local emergency room for DAYS as there were no psychiatric beds for them.

The Balsam Center, the small, temporary, psychiatric emergency hospital in Waynesville, NC, is the smartest thing that SMC LME ever did. Though managed by the very competent Doug Trantham, it is no substitute for mental health care being available in the community----as was promised by NC Mental Health Reform.

Instead, SMC LME utilizes one private Endorsed Provider, Meridian Behavioral Health, headed up by a retired SMC LME employee, Joe Ferraro.

Such patients' mental health concerns could be addressed if professionals were encouraged and indeed, allowed (read: paid), to work with mentally ill clients under SMC LME.

Instead, several years ago, a unique contract was created between SMC LME and Meridian. All SMC jurisdiction clients are encouraged to move into Meridian's Recovery Education Center (REC), which is run by non-professionals, rather than be accorded the necessary, bedrock mental health services of therapy and psychiatric follow-up, made available by well-trained mental health professionals.

I struggled for almost two years to provide mental health services to a state funded client under SMC LME, with the Clinical Director, Dr. Puckett, again and again directing me to funnel the quite ill client into Meridian's REC.

There was no pay for me, the clinical psychologist, who was seeing the client at the client's home, deep in rural NC.

Instead, what SMC LME created was barrier after barrier to therapy, something which had been requested by the client. I gave up and dissassociated myself from SMC LME when the Utilization Management Director, Charles Barry, threatened the company with which I am associated with an across the board audit if I attempted to utilize Community Support Services for therapy.

The client awaits mental health services. The client continues to cut and take pills after years of sexual and physical abuse.

Seeing that SMC LME was never going to pay me for any of the services which I had provided and was willing to provide, I directed the client to file for disability (SSI) and Medicaid, not the best of choices as this precludes the client from working any more than $200/ month of earned income. I was trying to avoid moving the client into that direction but it was move towards disability and Medicaid or simply write off the client.

The client is waiting for a Medicaid appeal which will take several more months after a Medicaid denial (the usual).

But there was sure money for Meridian.

Marsha V. Hammond, PhDClinical Licensed Psychologist


Post a Comment

<< Home