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N.C. county’s mental health services overwhelmed

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The one million people who live in North Carolina’s Mecklenburg County are served by a single 66-bed county mental health facility. Charlotte Observer reporter Ames Alexander found that, given those numbers, the math just doesn’t add up. Demand for mental health services has increased in recent years, while the supply of care has actually contracted. Problematic or dangerous patients are “given medicine and sent home,” and the percentage of critically ill patients actually admitted to the hospital is below past numbers as well as those of comparable facilities around the country.

In a 2003 study, the 66-bed hospital concluded that it would need up to 67 more beds in the coming decade – an expansion that was expected to cost as much as $49 million.

“The current facility can not meet the needs of existing volume, much less future needs,” the report said.

Since 2003, the needs have only intensified. Visits to the hospital’s emergency department have grown 25 percent.

In March, when Chapman sought help, emergency department visits jumped to the highest number in 10 months and the hospital’s adult units were running at 105 percent capacity. That same month, the number of calls to the hospital topped 24,000 – a record.

As you may have guessed, the needed expansion never materialized and, with budgets being cut in the county, it doesn’t seem likely any time soon. In addition to a number of well-chosen anecdotes and an exploration of the consequences of untreated mental illness, Alexander helps illuminate the problem by framing it as part of a larger discussion of who is responsible for public mental health treatment: The state or the county?