The MHA/NC sees a strong role and a strong need for a community-based, publicly managed mental health system. With this being the foundation, the MHA/NC believes that there needs to be strong partnerships between public managers and providers of service (both private and public), including those providers of services that are locally based through community hospitals (both private and public). Additionally, the MHA/NC believes that there is a safety net role for our state’s psychiatric hospitals, but the psychiatric hospital should be used sparingly and only as a last resort.
The MHA/NC believes that local community mental health, which should be administered by a public entity, should have strong, formal relationships with other agencies and organizations ranging from law enforcement to social service to public health to vocational services to educational systems and beyond. The MHA/NC believes that part of the negative results that have existed since mental health reform was instituted has been due to a lack of strong, local relationships.
The MHA/NC also believes that an imbalance between the legislative and administrative branches has been created during this age of reform. While certain segments of the administration have been engaged, this has not been a priority area throughout most of this period. This can be seen most clearly by the raiding and inappropriate use of the Mental Health Trust Fund and lack of prioritization of mental health needs by the previous Governor.
Additionally, the MHA/NC believes that this imbalance between the legislative and administrative branches can be clearly seen in the advent and ongoing efforts of the Legislative Oversight Commission on Mental Health., Developmental Disabilities, and Substance Abuse Services (LOC). While the intent of the LOC and its legislative members has not been negative, the result is that key persons and constituency groups have not always been adequately represented. The MHA/NC believes that to overcome this imbalance, a return to the Mental Health Study Commission’s concept needs to be examined. The Commission’s makeup included legislators, administration officials, and local constituents who were policy makers, individuals served within the system, their families, volunteer advocates from partner areas, or leaders from businesses and industry meeting together so that multiple ideas could contribute to clear policies and goals.
Finally, the MHA/NC strongly believes that while people of good conscience can disagree, we have ignored some of the advantages and opportunities that have been presented during the reform era. The MHA/NC believes that policy should be driving funding. It is our opinion that there have been opportunities for advancement in policy areas that were not taken because funding was driving policy. Examples of this come in areas such as crisis services and mental health courts.
Additionally, the MHA/NC believes that a strong, professional – and valued –workforce needs to be - must be - in place. The State, most notably through the lack of legislative and administration efforts, has not fostered this concept in meaningful ways. The MHA/NC believes innovative and creative initiatives should be put in place to develop and strengthen North Carolina’s MH/DD/SAS workforce. This could be done through efforts such as tuition-forgiveness programs and additional certification initiatives.
In closing, the MHA/NC believes that during this system transformation, opportunities are available for advancement. The MHA/NC believes that if we do not put strong community partnerships in place and see our state’s psychiatric institutions as a place of last resort, we will continue to miss opportunities to move our system forward. Lastly, the MHA/NC strongly believes in our citizens – this is where our ultimate strength lies. The voices of service providers, service recipients, families, and citizens concerned with the future direction of our State must be heard as we seek to make North Carolina’s mental health system the best for all of those it touches.
