STATE HOSPITALS

The first public meeting I attended in Florida in the early nineties I got in trouble with a segment of the consumer advocates in Broward County. When it was time for public comment I stood and spoke forcefully for the need for a state hospital. I spoke against closing it and using the money for community programs. The phrase “in the community” was the popular and trendy idea to support, but I saw it a little differently. In the community for most of us meant living in isolation and poverty. Alone without much of a support system and besides I thought the person should be asked where they wanted to be.
My point was that if the state said it had a right to lock me up then it had an obligation not just to put me back into the community when it was convenient or cheaper for the state. I should have a say. I was not a very popular person at that meeting and I have found myself in a similar position at other meetings. I am not always on the side of the majority to say the least.
South Florida State Hospital changed from a state run hospital to a private run hospital. Yes they got a new building, but they also got other things. Like more restrictive movement on the grounds for example. A much more authoritarian environment. In my humble opinion a place much less conducive to healing. What a price is being paid by those of us with mental illness for the state to get a new building and spend a few less dollars.
Here in North Carolina Broughton Hospital, the state hospital here in Burke County, is going through some rough spots. They lost more than $1 million in Medicaid and Medicare money a month and are working hard to get it back. It is state run with the culture that comes with a state institution. It is making progress and may have a bright future. Is it needed? Yes.
They removed in from the division that was directly responsible for mental health to the North Carolina Department of Health and Human Services. The other division was in the same department, but now the state hospitals are directly under the Secretary of HHS. Is this a good idea?
In my opinion no. Here again I am running against the current. In this state we have what are called Local Management Entities that control the state money for certain geographic areas. The state hospitals should be under local control. The LME that make up the area served by the hospital should form a governing body to run the state hospital in their area. Funds saved by wisely using the state hospital could be used in the community. Local control always makes more sense than top down control.
Who knows best? The people on the frontlines. Give them the power to make the decisions and you will see better decisions being made. Make sure they include primary consumers and their families on these governing boards and you will see better state hospitals.
How do I know? I saw it work before South Florida State Hospital was turned over to a for profit company to run. In fact one who’s only experience had been running prisons. Let the people closest to the problems solve them. Believe in ordinary people. They will surprise you. They really do know something.
You can reach me directly at edcooper@projectdreamagain.com
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