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Mental hospital filled with inmates, while other patients wait for help

Patients, particularly men, needing long-term treatment for severe mental illness often can't get a bed in Western North Carolina's only mental hospital.

The problem? Inmates charged with a range of crimes are taking up beds, state hospital administrators and healthcare professionals said in an investigation into causes of emergency room crowding at Mission Hos[ital.

Mission administrators have said repeatedly the region is having a mental healthcare crisis, and Copestone, the hospital’s behavioral health ward, often doesn’t have enough beds to handle the volume of mental and substance abuse patients coming into the ER.

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A hospital source familiar with ER crowding said Broughton used to be a place the hospital could transfer patients. But Laura White, assistant director for state hospitals, said the number of inmates designated as incapable to proceed continues to increase. She said inmates take priority over regular patients when they are deemed incompetent to stand trial, or ITP, and are given beds at Broughton. White said, at times, of the 100 beds designated for male patients, sometimes 70 are taken by ITP inmates, leaving just 30 beds for transfers of male patients across the region who need in-patient mental illness treatment.

“There's a pretty substantial delay to get into Broughton hospital,” White said.

She said there are a range of individuals facing charges for various crimes housed at Mission. “Assault, breaking and entering, some more serious, such as murder or rape.”

State doctors perform forensic evaluations at Broughton. Then, the inmate will go before a judge and the defense attorney will state the results of the evaluation. In a case where an inmate is determined to be mentally incompetent and unable to assist in his defense, a judge will often order an involuntary commitment to Broughton. Re-evaluations take place after several months with the goal to get the inmate to be mentally fit to stand trial.

“They take precedence over other people who are referred to the hospital,” White said. “People who are waiting in community emergency departments.”

White said that includes Mission.

“Think about it, if it's your loved one in Mission, in the emergency department, and they really need the highest level of psychiatric care that's available here at Broughton and not anywhere else and instead they're in the ED for several days, maybe even a couple of weeks, they're not getting the care they need."

White said there is no immediate solution.

Built in 1887, Broughton and it's staff of nurses and doctors once cared for 4,000 patients. The hospital, at that time, was called the Western North Carolina Hospital for the Insane.

But, over decades, society moved toward de-institutionalization and thought bringing mentally ill patients together in a large hospital was a violation of their civil rights.

The trend moved away from treating mentally ill in large facilities. But Julia Gibson, an expert in elderly care and group homes, said there are not enough smaller facilities to care for the volume of mentally ill patients who were once housed in large hospitals.

Broughton now has just 297 beds and will close it’s historic building as soon as a hospital under construction opens in July on the Morganton campus. The facility will have an 80 additional beds.

But White said the challenge to find bed space is only getting worse. White said some states have set up programs to assist the inmate population in the cities and counties where they are housed in jails to reduce the number sent to state hospitals. News 13 was not able to learn of any cities or counties in the west doing anything to ease transfers of inmates to Broughton.

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