Georgia's mental health care under review

The man who recently took over Georgia's troubled system for mental health and developmental disabilities knows he must start hiring more staff and reaching out to the state's universities for partnerships.

However, parents of patients at the Gracewood campus of East Central Regional Hospital want to ensure those vulnerable patients aren't dragged along in the push to move to community-based services.

Frank E. Shelp is the commissioner of the new Georgia Department of Behavioral Health and Developmental Disabilities, which was created July 1 during a reorganization of Georgia Department of Human Resources. He is making his way around to the state's mental health hospitals and community mental health centers and will be in Augusta next week. The department is also working on a needs assessment that Dr. Shelp hopes will be completed by September.

The state had been pursuing what had been dubbed the "Game Plan," which called for privatizing some mental health services, closing most regional hospitals and moving to community-based services for many patients. That worried parents including Theresa Senior, whose daughter, Terral, has been at Gracewood for 18 years and could not function on her own.

"It's not that we don't think people should be in group homes. We certainly do," Mrs. Senior said. "But those who can't function shouldn't be there."

Worse is how some of the Gracewood patients might be coerced into it, said Ann Knighton, whose daughter, Erica, has been at Gracewood since 1975 and suffers from severe deficits and seizure disorder. Mrs. Knighton said during a conference Thursday that her daughter was shown pictures of houses by a social worker and asked whether she would like to live in the community.

The problem with that?

"She's never talked," Mrs. Knighton said. Asked how her daughter was supposed to answer the question, she said, "That's what I want to know."

The state is under a mandate to move patients to the less restrictive setting and to provide as much freedom for them as possible, but it should be the patient's wish, Dr. Shelp said.

"I would say I do understand the anxieties of the families involved, the vulnerability of their loved ones and maybe even their satisfaction with how things have gone up until now," he said. "We need to be sensitive and professional and still inquire as to other changes. Is there progress? Is there some hope that we need to be mindful of for something different? The answers for each individual may be different."

Part of the problem the state faces is staffing, Dr. Shelp acknowledged.

"I've inherited a hospital system that is significantly understaffed, in all areas," he said.

Part of it might be training.

"I think that we need to be concerned that we have a trained and skilled and professional staff that serve in these kinds of positions to help determine what people's true desires are," he said. "And I don't know that we have that right now. In fact, I'm pretty certain that we don't."

What might help is a greater affiliation between the state hospitals and the state's medical schools, including Medical College of Georgia. Dr. Shelp helped initiate a program in North Carolina between a state hospital and Duke University Medical Center that proved highly successful.

"Over a very short period of time, that state hospital became the most favored rotation site of both residents and medical students," he said. "It's a situation where everyone benefits."