RALEIGH — North Carolina hospitals that were stretched to their limits during the coronavirus pandemic have seen a dramatic decrease in the number of COVID-19 patients this spring.
But now hospitals say they’re struggling with another health crisis, one that predates the pandemic but has been made worse by it, and they’re asking the state’s political leaders for help.
People with behavioral and mental illnesses are increasingly ending up in the emergency rooms of North Carolina’s medical hospitals, which are ill equipped to treat them. In December, 20% of patients discharged from an emergency room in the state were diagnosed with a behavioral health problem — up 7.5% from a year earlier. That’s according to data compiled by the N.C. Healthcare Association, which represents the state’s hospitals.
The increase was much higher for children. Nearly 1 in 10 children treated in a hospital emergency department in December were diagnosed with a behavioral health problem, up 70% from a year earlier, according to the association.
Barbara-Ann Bybel, director of psychiatric services at UNC Medical Center in Chapel Hill and UNC WakeBrook in Raleigh, says the trend has continued in 2021. Bybel said patients with mental illnesses can wait days, sometimes weeks, in hospital emergency departments for openings at psychiatric hospitals or other facilities where they can get treatment.
“It’s a second pandemic. We’re referring to it as the mental health tsunami. And this giant wave is coming and it’s continuing to grow and it still hasn’t even made landfall yet,” Bybel said.
Last week, the hospital association and nearly a dozen other organizations appealed to Gov. Roy Cooper and Republican leaders of the General Assembly for help. In a letter, they said North Carolina is failing to meet the growing demand for mental health services.
“Quite simply, the behavioral health crisis across North Carolina has reached a state of emergency,” the letter said.
The letter was signed by several medical organizations, including those representing doctors, nurses and psychiatrists. But also lending support was the N.C. Chamber, the state’s top business organization, and Blue Cross and Blue Shield of North Carolina, its busiest health insurer.
Gary Salamido, the chamber’s president and CEO, said businesses understand that improving the state’s mental health system is critical to recovering from the COVID-19 pandemic.
Blue Cross said the pandemic helped bring attention to the problems.
“The COVID-19 crisis has further highlighted gaps in North Carolina’s behavioral health system and is requiring everyone in the health care community to work together,” the company wrote in a statement. “We have a unique opportunity at this time to bring together the organizations that can make a difference and help determine how behavioral health is provided in this state.”
The groups did not say what they thought the state should do to help with the prevention and treatment of mental illness. Instead, they asked for a meeting with state leaders “to immediately address this crisis.”
Senate leader Phil Berger of Eden and House Speaker Tim Moore have not formally responded to the letter. A spokeswoman for Berger said he is open to meeting with the organizations to discuss their concerns.
Cooper replied last week in a letter that indicates the effort may falter over old disagreements between Democrats and Republicans in the state. Cooper, a Democrat, wrote that expanding Medicaid, the government insurance program for low-income people, would make treatment available to more people with mental illness and substance abuse problems. He has long pressed for making more uninsured people eligible for the program and this spring proposed adding 600,000 using money from the American Rescue Plan Act passed by Congress in March.
But Republicans have staunchly opposed enrolling more people in what they consider a federal entitlement program the state can’t afford.
Cody Hand, the N.C. Healthcare Association’s vice president for government relations, said he was disappointed that the Senate’s proposed budget released last week didn’t include additional funding for mental health programs, even though the state enjoys a surplus fueled in part by federal coronavirus relief money.
