Though hospitals like Dorothea Dix and Broughton once did a creditable job, North Carolina has a dismal recent record of caring for the mentally ill.

Now, as a result of that sorry performance — part “mainstreaming,” part a failed attempt at privatizing or localizing, and part fiscal distress — our state may be about to land in court or on the federal carpet — or both.

A study released this past week by the Wake County Chapter of the National Alliance on Mental Illness (NAMI) found that patients in desperate need of care routinely have to wait days for admission to state psychiatric hospitals. In the first six months of this year, 212 mentally ill people were kept waiting for more than a week without care.

Partly as a result of that, hundreds turn for help to local hospital emergency rooms, which are typically ill-equipped to care for them. Patients often languish for days there as well.

Lamentable Conditions

“Emergency departments and crisis centers are not a therapeutic environment for paranoia, out-of-control thoughts, emotions and personal nightmares,” said Gerry Akland, president of Wake NAMI. “As a society, we would not condone this treatment for our pets. It is time for the state of North Carolina to solve this problem.”

It certainly is, though solutions don’t come easy.

Then there are the adult care facilities around the state, which are designed for the aged and infirm and are not a good place to keep the emotionally disturbed. Yet that is too often where they are dumped and warehoused.

In May, investigators from the advocacy group Disability Rights North Carolina, working with a group of law students from UNC-Chapel Hill, visited 15 such facilities and found nightmarish conditions in some. They heard complaints from patients about abuse and neglect, found examples of physical facilities in need of repair and saw mentally ill patients parked in wheelchairs and drooling on themselves.

‘Reforms’ Backfired

Much of this goes back to an ill-advised “reform” effort that began in 2001. The number of beds in state psychiatric hospitals was cut in half, and the idea was to route patients toward private treatment providers. Predictably, that produced horror stories even before the current spate of criticism. The recession has, of course, made matters much worse by reducing the number of state beds even further.

“We are all concerned about North Carolina’s ability to provide appropriate care for residents of the state who need mental health services, most especially for individuals who are in crisis,” said Lanier Cansler, secretary of the state Department of Health and Human Services. He said the state was making progress, but those steps are “restrained by the limited availability of funding, particularly in these difficult economic times.”

Those efforts are too little, too late, according to Disability Rights, which has filed a complaint with the federal government. It alleges that North Carolina, because of its inadequate housing and treatment of the mentally ill, should be found in violation of the Americans With Disabilities Act.

Even if there were no lawsuit, the state can no longer delay righting the obvious wrongs in this area. And foisting responsibility off on local units or private providers won’t cut it.