In the waning days of this year’s legislative work session, lawmakers abruptly revived and passed a bill aimed at revising North Carolina’s laws to address the flood of people with mental health crises in hospital emergency departments.
Officials from the state’s hospital association had convened administrators, advocacy organizations, academics, mental health professionals and others over several years to examine some legislative fixes. Those leading that effort say they’ve come up with a bill that will improve processes for people who find themselves in crisis.
“We did this because we were tired of seeing these people, these humans trapped in a system that there really was no escape, this system of [involuntary commitment],” said Julia Wacker who leads mental health policy analysis for the North Carolina Healthcare Association. “This is far too often the way of treatment … stick these folks in handcuffs, put them in a squad car, and take them to the emergency department.”
But trust is hard to come by in North Carolina’s mental health system, and people who have been part of that system as consumers of services say they feel let down by a process that excluded their voices, as many of the state’s most prominent self-advocates were not invited to participate. They say any result will fail to account for the pain they’ve experienced as a result of the state’s fractured behavioral health system.
“They did not tell us about this bill,” said longtime advocate Martha Brock, who has been hospitalized for mental illness in the past.
Brock, who serves on the state Consumer and Family Advisory Committee, which informs the Department of Health and Human Services on behavioral health issues, said that she was frustrated after being shut out of the negotiations around the bill. She also has problems with some of its provisions.
Another longtime advocate Laurie Coker complained that the bill was revived suddenly, moved quickly, and that they were given little time to respond to changes made in the final draft. Both women expressed concern about definitions of “incompetence,” about who gets to make decisions for a person once they’re engaged in the behavioral health system, and about the privacy rights of people in that system.
And their complaints hint at some of the long-standing divisions within the mental health advocacy community itself, as well as the problems that come when institutions communicate with a limited pool of advocates.