Tuesday, March 03, 2009


February 27, 2009

Lanier M. Cansler, Secretary
NC Department of Health & Human Services
2001 Mail Service Center
Raleigh, NC 27699-2001

Dear Secretary Cansler:

I am a person with a psychiatric diagnosis, I have family members with a psychiatric diagnosis, and for the past twenty years I have been an advocate for those of us with a mental illness both here in North Carolina and when I lived in Florida. I say this only to make the point that the mental health arena is not new to me and it touches my life and those I love.

I have served on the governing board of a state hospital, the mental health planning council for a county of 1.5 million people, started programs, did trainings, spoke at national conventions, and have helped run a nonprofit for twenty years. I understand that unsolicited advice is seldom welcome, but I am going to take the risk of offering some based on the above experiences I have just mentioned.

First let me make the disclosure that I am presently a member of the Human Rights Committee at Broughton Hospital, but I am writing this letter as a private citizen and not in any way on behalf of the Broughton HRC.

Number 1: Abuse & Neglect in North Carolina’s State Psychiatric Hospitals

I appreciate your standing up for us and taking a “zero-tolerance” policy towards abuse and neglect of us in state psychiatric hospitals and I do not doubt you mean it. However, there are some things you might want to look at. When an allegation is made that a serious crime has taken place such as rape, what are the qualifications of the person doing the investigation? Is the possible victim taken to a rape crisis center? Who decides when the outside authorities are called? Which outside authorities are called since it is state property? Should state employed advocates be deciding substantiated or unsubstantiated when serious crimes (possibly felonies) are being investigated?

Number 2: Transfer of State Psychiatric Beds To Private Corporations

In a release dated February 5, 2009 from your Dept. it is revealed that Old Vineyard Behavioral Health Services which is owned by Universal Health Services has filed an application for a Certificate of need to relocate 50 beds from Broughton to their for profit operation in Winston-Salem. Dr. Michael Lancaster working in one of your divisions (MH/DD/SAS) is quoted as saying, “They are essentially paper beds” in the WSJOURNAL. There are a couple of problems with this statement. First, in an article in the February 6, 2009 issue of Psychiatric News there is an article titled “State Hospital Admissions on Unexpected Upswing”. It says “The number of admissions to public psychiatric hospitals in the United States dropped from a peak of 475,000 in 1971 to fewer than 160,000 in 2002. … The number of admissions rose by 21% from 2002 to 2005 after a historic decline since 1971 because of deinstitutionalization.” It also says, “Historically, when the economy gets bad, inpatient use rises.” This being said it is logical to assume the western part of this state that Broughton Hospital serves will need those beds. If not in Morganton then west of Morganton not east making it harder on families living in the western part of the state. Then ask yourself how a company looking to make a profit and hire the very best people and provide the latest evidence- based recovery person-centered services can do it without cutting corners somewhere? What about quality control? If you are having a hard time now controlling abuse & neglect, what do you think a for profit corporation will do to make sure you do not find out what is going on at their operation? Almost anything was my experience when they turned over South Florida State Hospital to a for profit company who had been building and running prisons.

Number 3: Including Persons With Psychiatric Disabilities In Decision Making & Planning

Here one is always tempted to find the closest or the easiest to get along with or maybe a person with degrees already working within the system. Sometimes even a person who has made a career out of being a person with a label and is now a consultant is called in. Let me suggest at times you might want to hear from grassroots folks. People living each day in the trenches with their mental illnesses. My point here is you might want to consider some horizontal lines rather than just vertical lines when looking at your organizational chart. Horizontal management is not a new concept in mental health. The first Veterans Administration hospital I was ever in had what they called ward government. The patients handled most of the problems that arose on the units. There have been many models down through the years. Peer run programs which by the way cost less. Peer joined with Faith-Based is not a new idea either.

My point here is you need professionals and I am not trying to say otherwise. I would not have wanted my abdominal aortic aneurysm surgery done by a friend. I would not want a friend writing my psychiatric medication prescriptions. However, there are things that we do better than someone who does not have a mental illness which I call “ chronically normal people” or even a family member of a person with a mental illness and that is a give a very different viewpoint of the services being offered.

For example when I look at North Carolina’s Person-Centered Planning model I am struck by how many people they ask in addition to me about what I should be working towards in my life. It does not even seem like the process understands it is my life. It doesn’t belong to my family. It doesn’t belong to my friend. It doesn’t belong to anybody but me. Would it not be wonderful if Carl Rogers could come back to life and remind folks what person-centered is?

OK! Enough and I thank anyone who has taken the time to read it.


Ed Cooper

Cc Governor Beverly Perdue
Leza Wainwright, Director /MHDDSAS
Sen. Jim Jacumin

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