County Looks to Keep Mental Illness Patients out of ER

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Keeping Wake County’s residents with mental illnesses out of hospital emergency rooms was a top concern for Wake County Commissioners during their work session Monday.

Last August, the county partnered with UNC Health Care and the state Department of Health and Human Services to evaluate how the county is addressing the needs of residents who have mental diseases, developmental disabilities or problems with substance abuse.

The result of the partnership is a plan to restructure WakeBrook Recovery Center to use all 48 beds in the facility. Today, 16 go unused; the remaining 32 are used for non-hospital substance abuse rehabilitation.

Photo Credit: Wake County

WakeBrook recovery center provides substance abuse treatment.

Health officials say the change will help ease the burden of patients waiting for beds.

Dr. Jack Naftel of the UNC School of Psychiatry explained that with the number of available beds decreasing statewide, people in crisis are finding themselves staying in emergency departments longer than the 24-hour maximum, sometimes staying for days or weeks at a time.

Space is not just a problem in Wake County, Naftel said.

β€œAll across the state, people are waiting for beds,” he said.

But the concern isn’t just about space or ER costs. UNC Heath Care’s Kevin Fitzgerald said most ERs are not set up with the equipment or staff necessary to handle a person in crisis.

People in crisis are having difficulty coping with an extremely stressful situation. Depending on the case, this person may be a danger to themselves or others.

Naftel said if more money isn’t put into treatment before patients are released, it is likely they will visit the emergency room again.

Increasing the number of beds at WakeBrook won’t solve the problem, but county staff say they hope it will alleviate some of the stress on hospital emergency rooms and get patients the care they need more quickly.

WakeBrook will turn 16 of its substance abuse rehab beds into inpatient psychiatric beds, which will enable hospitals to release patients directly to the center. The center will still house 16 detox beds and use the empty beds for facility-based crisis, enabling people to stay longer than 24 hours.

What’s Next
Wake County, along with Alliance – the county’s new local management entity – and UNC Health Care, still have to finalize any agreements before moving forward. The switch in bed uses also requires a change in the center’s license.

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