Durham County, N.C., Commissioners Weigh Options on How To Oversee, Administer Mental Health Services

County commissioners in Durham County, N.C., are debating how to handle the administration of mental health services in response to new state laws reforming the system, the Raleigh News & Observer reports. As part of the reform, oversight and administration will be separate from the actual delivery of services (Barrett, Raleigh News & Observer, 8/27). Also, private companies will provide services, but patients who meet certain criteria will receive treatment in state-run facilities (Washington, Fayetteville Observer, 8/28). County commissioners have until Oct. 1 to decide whether to bring oversight of community-based services under county control or give control to a board of appointed citizens. At a public hearing on Aug. 26, Ellen Holliman, the interim director of the county's mental health agency, said both methods have advantages. While a county department may reduce some administrative costs and give the commissioners more control over "day-to-day spending decisions," Holliman said the citizens board would offer "more flexibility." After the hearing, commissioners said they are still "torn" on their decision and will "raise more questions" about the issue during a work session scheduled for today, the News & Observer reports (Raleigh News & Observer, 8/27).

Money, Not Reforms, Needed
In Cumberland County, N.C., John Tote, executive director of the state Mental Health Association, said during a seminar on Aug. 27 that while the reforms to the mental health system are the "biggest changes in more than three decades," the system needs additional funding, not an "overhaul," the Fayetteville Observer reports. While local mental health programs do "a great job" of providing care, Tote said that mental health care has not been a priority for the state government. As a result, patients end up receiving more expensive care in emergency rooms or jail, Tote said. "Until it's a priority at the state level, until you see money where their mouth is, you're not going to see reform at the local level," he added. While utilization of services has increased from 155,000 to 375,000 people per year during the last 10 years, Tote said funding has not kept pace, rising from $160 million to $180 million. "Did we need reform? No. Did we need tweaking and money? Yes," he said (Fayetteville Observer, 8/28).