The old State Hospital serving the mentally ill has been recommended for sale by Gov. Mark Sanford, and its decline in patient population says that it surely qualifies as surplus property. But as the state moves to put the Columbia property on the block, it should ensure proper long-term accommodations for the 25 patients who still reside there.
The Department of Mental Health plans to move the patients into other facilities, making room for them by shifting other patients into the community. A DMH spokesman says the transfers will provide appropriate settings for long-term care, and that there is no expectation that the long-term patients will be transferred to less secure community settings in the future.
The National Alliance for the Mentally Ill, however, says that the long-term patients will be moved into facilities that now provide for acute care. The sale of the Bull Street campus will mean the loss of a residential facility for long-term adult patients, and their transfer will put more pressure on the already straitened acute care system, the advocacy group contends.
And that will increase the pressure on local hospitals that provide acute care for mental health patients in emergency rooms, while they wait for beds to become available in state mental health facilities.
"These are people with severe mental illness who can only be treated in a secure setting," says J. David Almeida, director of the state chapter of the alliance. Moving the patients to facilities that are generally viewed as transitional to community release is not a solution, he says.
The alliance supports the sale of the DMH property, acknowledging that the large campus is severely underused. But the proceeds should be spent, at least in part, to accommodate the construction of a new long-term facility to treat those patients with severe mental illness, who are not responsive to medication.
Mr. Almeida says his organization has a philosophical difference with the department over the necessity to provide long-term care for patients who should never be released in the community, and who aren't appropriately served in acute-care facilities. The alliance contends that the state needs to provide for long-term care of about 200 adults, some of whom already are in acute-care facilities.
Plans for these patients notwithstanding, DMH has been committed to transferring patients into decreasingly secure settings, with the goal of eventually returning them back to the community. That policy has resulted in some very questionable decisions in recent months, as DMH has moved patients who have been found innocent of terrible crimes by reason of insanity into community group settings.
As the Legislature considers selling the Bull Street facility, it should take a careful look at DMH's plans for its remaining patients, and the need to accommodate long-term patients in a separate facility. Presumably, the proceeds from the sale of the large Columbia campus could provide for a comparatively small long-term facility, with money left over for other capital needs.
The Legislature also should review the potential effect of DMH's patient transfer plans on local hospitals that are forced to provide acute care in their emergency rooms. Lawmakers should pay particular heed to the alliance, and its 1,000 state members. They all have family members who are mentally ill and have dealt closely with the problem of intractable mental illness.
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