Group: State Discharges Mental Patients Without Planning

In a 20-page report entitled "Deadly Transitions," Disability Rights North Carolina raised questions about how mental hospitals plan for follow-up care of discharged patients. The group said a lack of planning is a key symptom of the failure of mental health reform in the state.

The report details the recent release of three men from state hospitals who each had a history of mental illness. The men killed themselves or died of drug overdoses within two weeks of being discharged, the report said.

"It's life or death for those who are most vulnerable," said Patsy Thames, whose 16-year-old son was among the three profiled cases.

The teen was having hallucinations when he was admitted to Umstead Psychiatric Hospital last fall. Five days later, he was discharged with a new medication, but no local support services were arranged.

Before his parents could obtain help, the teen ran away and died of a drug overdose.

"We're trying to make his life meaningful to help others," Thames said.

Advocates said the cases highlight a failure to coordinate support services in the community. In one of the cases, a man was discharged from Dorothea Dix Hospital last year to a homeless shelter that has been closed, so he was then dropped off at a hospital emergency room and later was found dead of an overdose at a motel.

"The current system is rife with ambiguity and is without accountability," said Vicki Smith, of Disability Rights North Carolina.

Dr. Jim Osberg, who oversees the state's psychiatric hospitals, said the Division of Mental Health continually evaluates discharge policies. He said the deaths are troubling, but are rare occurrences.

"We think that's an area where we do need to improve," Osberg said.

More than 17,000 patients are discharged from state psychiatric hospitals each year, sometimes because of pressure from a waiting list for admissions. Osberg said that volume of patients is challenging.

"There's no question we're under a huge demand for services in the state hospitals," he said.

The state mental health system is already being examined by federal investigators for suspicious deaths inside psychiatric hospitals.