Most readers are familiar with the excellent investigative report into the mental health system conducted by the N&O. But if you want more background and context on the history of mental health reform I would recommend the series “Breakdown,” by reporter Taylor Sisk in The Carrboro Citizen.
The series draws heavily from interviews with families and psychiatrist Nicholas Stratas, who worked as statewide director of professional education and training for the Department of Mental Health in the 1960s.
Sisk traces how Stratas and others built a public mental health system that stressed continuity of care. In the early 1970s Bob Scott’s administration demoted mental health from departmental status and housed it in DHHS. The system was then neglected during the administrations of Jim Holshouser and Jim Hunt, according to the articles.
Then came privatization under Mike Easley.
Stratas spent a good deal of time during the reform debates warning about the dangers of a fragmented system of private providers. He wrote this open letter to the outgoing Easley administration.
Today, advocates say that all is not lost. We can still build on the broken system we have by taking an inventory of existing services, creating a public safety net, and coordinating care. Psychiatrist and advocate Thomas Smith has written a “Rescue Plan for Mental Health,” which describes some basic steps we can take to fix the state’s mental health mess. We have to try something new, and the suggestions of Smith and Stratas are good places to start.