Mar. 11--Since Wilson Medical Center closed its psychiatric unit two years ago, resources in Wilson County have been reduced, mental health officials said.

Closing the unit, known as New Foundations, meant the hospital started assessing mentally ill patients in its emergency room while trying to help patients find appropriate placement. The unit closed when medical director Dr. Bush Kavuru moved out of state.

According to a quarterly report issued in January by the N.C. Department of Health and Human Services, 1,142 Wilson residents sought treatment for mental health issues through the emergency room between July 1 and Sept. 30, 2009.

Mental health reform has been an ongoing issue throughout the state for years. State budget cuts have also targeted mental health services.

"Unfortunately, because of funding cuts, the portal of entry for the mental health system for many people is through hospital emergency rooms," said Janelle Clevinger, executive director of the Mental Health Association in Wilson. "The closing of the Wilson Medical Center's psychiatric care ward in early 2008 left a huge void in the care of local citizens with mental illnesses."

Hospital officials say they are looking at options for the psychiatric unit.

Looking to the future

Melinda Laird, vice president of Clinical Services at Wilson Medical, said a variety of options are being weighed.

"We consider the closing temporary, and we are in the assessment phase right now. We are looking at what our options are," she said.

Those options include operating a voluntary unit, operating an involuntary unit or operating a unit that serves both clients, according to Connie Rhem, manager of corporate communications at Wilson Medical.

New Foundations only accepted voluntarily committed patients when it was in operation. All involuntary commitments were transported to other facilities such as Cherry Hospital and Coastal Plains in Rocky Mount.

As of last week, the space on the sixth floor that housed the unit was being used as on-call rooms for physicians and to store specialty beds, Rhem said.

Search for psychiatrist unsuccessful

Hospital officials said a poor economy and difficulty recruiting a director for the unit are two reasons New Foundations has not yet reopened.

"As we see some economic recovery and once effective mental health reform in the state occurs, we hope to re-open the unit," Rhem said. "We have recruited for a psychiatrist nearly 18 months without success. After our unsuccessful recruiting efforts and as the economy continued to worsen, we believed that reopening the until would put a financial strain on the rest of the organization."

Diana James, the local representative for the National Alliance on Mental Illness (NAMI), said doctors who come to Wilson to provide services need more support.

"Having the sixth floor at the hospital allowed them to provide services for people who voluntarily wanted to receive help," she said. "We believe that the hospital has declined to offer these services in Wilson."

Dealing with mental health issues is a difficult situation for all involved, James said.

"Mental health issues are not profitable and a lot of these mentally ill patients don't have insurance," she said. "Our hospitals are not nonprofit and without state support we are never going to have decent mental health care in North Carolina."

ER changes

Changes have been announced at Wilson Medical's emergency department following a February incident involving a mentally ill man.

A Wilson couple and two hospital employees were allegedly assaulted by a mentally ill man who was also in the emergency room waiting to be seen.

As a result, investigators with the state Health and Human Services Division traveled to Wilson to investigate the incident. In response, the hospital instituted a plan of action.

Security guards are now stationed in the emergency room around the clock. In addition to stepped up security, now when a patient comes into the emergency room with a behavioral complaint, the staff member who checks in patients will immediately notify the charge nurse.

Laird said the staff in the lobby is not clinically trained, but if they notice changes in behavior for any patient, security will be notified and maintain an increased presence in the emergency room.

Staff members will undergo more training to help them identify when to call for extra help, Laird said.

If New Foundations remains closed, Clevenger recommends all emergency room personnel be trained further in crisis intervention.

"Patients with mental illnesses may be confrontational and we have to remember that logic does not always prevail," she said.

gina@wilsontimes.com -- 265-7821

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