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State Must Report All Deaths at Mental Health Facilities

Posted March 26, 2008

— Gov. Mike Easley says patients are dying in North Carolina's psychiatric hospitals and that needs to stop. One response has been new guidelines that went into effect last week and that require all deaths in state-operated mental-health facilities to be reported to the local medical examiner's office.

Before, hospitals told medical examiners only if a death was the result of suicide, violence or an unknown cause.The policy was changed to increase openness and oversight in the mental-health system, Department of Health and Human Services officials said.

Autopsies will be conducted at the discretion of the medical examiner.

Dempsey Benton, secretary of the department, talked to lawmakers Wednesday about their efforts to improve the mental-health system.

“I think what you're putting forward is a good first step, but as they say 'the proof is in the pudding,'” he said.

“This is only one step in a comprehensive re-examination of our procedures covering the death of anyone in the care of our facilities,” said James Osberg, chief of State-Operated Services Section, which oversees the state's 15 mental heath, developmental disabilities and substance abuse facilities.

The state's mental-health system has been struggling with problems and claims of abuse for years.

For the first time in two months, Benton addressed the legislative Mental Health Oversight Committee Wednesday.

A committee report identified areas that need immediate attention, including the state's psychiatric hospitals and crisis centers and accountability of mental-health services.

The department is working on legislation it wants to see proposed.

“We're very much working on the details in order to get our package to the governor's office,” Benton said.

“We need to attack the problems swiftly and justly,” said Rep. Van Braxton, D-Lenoir.

The package, which won't be ready for Easley for several more weeks – includes the mental-health department's agenda for the legislative session – which begins in mid-May.

“But I think we'll be able to get our package together, so it gets reasonable consideration,” Benton said.

The department plans to ask for increased funding for more hospital beds, cameras in all hospital restraint rooms, staff increases and incentives.

The agency needs more workers, “especially in the skilled jobs because our ratios are on the low-end,” Benton said.

Just last year, turnover among nurses was more than 30 percent at Dorthea Dix state psychiatric hospital in Raleigh.

Benton said he will ask the General Assembly for an additional $65 million to $70 million to improve mental-health care.


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  • cranky Mar 27, 2008

    Oh & by the way, the turnover at Dix for healthcare techs & other clinical jobs, & administrative positions are probably just as high, maybe higher. Who wants to go to Butner with the gas prices, it being almost in Virginia?????? However some of us have no choice, in order to stay with the state!!!!!!!!!!!!!!1

  • cranky Mar 27, 2008

    Guess why the turnover rate for nurseds is 30% at Dix?????Can you say closing?????????

  • Adelinthe Mar 27, 2008

    "WHY would death's NOT be required to be reported in the first place?"

    I was wondering the same thing. Does it not take a coroner to pronounce death??? Or maybe just a doctor can do it, and ones at some mental facilities may have a conflict of interest.

    Just not sure, but am glad this law was put in place.

    God bless.

    Rev. RB

  • NCMOMof3 Mar 27, 2008

    WHY would death's NOT be required to be reported in the first place? WHY is this just now being required? I thought ALL deaths were required to be reported. If I died peacefully in my bed at home and my husband didn't report it, just buried me in the backyard, wouldn't he be guilty of a crime? Sheesh. Just because they are mental patients they are treated differently. Talk about insane

  • coolwill Mar 26, 2008

    The state was getting money from the feds to help take care of mental heath patients, but the feds cut them off because of something they were not doing right. No incentives need to be given other than the lost of your job. Because it is a mental institution does not mean it should not have the ability to treat medical conditions. Quit given incentives and just pay a good wage, give merit increases and not blanket across the board increases, give raises based on hire date. And impeach the governor.

  • raleighlynn Mar 26, 2008

    Acute care hospitals must stop doing minimal care on medically unstable psychiatric patients. Many of these patients have no insurance and hospitals do not want to spend money to do needed tests. Psychiatric patients get medically illnesses too. Our state psychiatric hospitals are not set up for medically ill patients. Yes, it's tough on the hospitals when a psychiatric patient acts irrationally, but it's even tougher on the state hospitals when a medically fragile patient comes in. The state hospitals are extremely limited in what can be accomplished medically. Many hospitals transport psych patients to the state hospitals in physically poor condition and then the state hospitals get the blame for patient deaths. These deaths need to be tracked back to the source.....the hospital or facility who sent the patient in the first place. I say YAY to staffing incentives to hire and retain quality personnel for the state hospitals.