Impetus for this website comes from the fact that I was chosen to be a ‘fellow’ of the Association of Health Care Journalists in the fall of 2010. The fellowship was designed to get reporters thinking about health care ‘systems’ rather than just following the breaking story of the day. Think large. Think system-wide.
My original idea was to compare NC’s mental health system to that of another state that ‘looks like’ us. However, as I started digging, I learned that’s just not possible. States have so many varied ways of organizing mental health care delivery – Local-control or state-control? Combine with substance abuse services and developmental disabilities or not? Pull in lots of federal dollars or depend on state dollars? Rely on institutions or more on community-based services?
On top of that, states have many ways of paying for mental health services – Medicaid? State dollars? County dollars? Private dollars? Public-private-partnerships? Tax dollars? Insurance dollars? Fees?
So, instead, I’m looking at specific issues in the mental health system and comparing how North Carolina handles those issues with how other states do it.
The website will have three kinds of content:
1) special reports aired in 2011 on North Carolina’s mental health system.
2) all my old stories on North Carolina’s mental health system. These stories date back to 2005 or so (some have been lost due to computer hiccups, but I’m trying to get as much as I can here).
3) I’m also blogging! I’ll do as much as I can about mental health in NC, as often as I can. I’m also following what others are writing about North Carolina’s mental health system, and putting links up (to the right).
So, who am I anyway?
I’m Rose Hoban, the health reporter for North Carolina Public Radio, WUNC. I’ve been reporting on health care in the state for 6 years. Before that I was a nurse for a dozen years. I also have a degree in public health policy.
A Restraint Key
Over my desk hangs a long, skinny aluminum key. It’s the key used for leather restraints, the kind that used to be commonly used to tie down people who were ‘crazy.’
Once upon a time, I worked in an emergency department where it was the standard of care to put people who were brought in for psychiatric evaluation into four of these leather restraints – tying down both wrists and ankles. That drove ME crazy.
Before going to nursing school, I had worked with kids who had ‘behavioral problems.’ Some of them had psychiatric problems, some had substance abuse problems. We worked with them using words, consequences, negotiation, whatever we could. But we never locked them up, we never physically restrained them. So, when I came to work in the ER, and found psychiatric patients being routinely restrained, I got myself a restraint key and started talking to these patients.
My co-workers never permitted me to take off all the restraints, but I was usually able to negotiate with the patient to ‘behave’ so that I could take off one, two or three, allowing the person to do things like scratch, or wipe away their own tears. It just seemed wrong to make a person who was in a vulnerable emotional state call me every time they wanted to scratch their nose, relieve themselves or change position.
I keep that restraint key pinned above my desk as a way to remind myself of those patients – and it’s a physical touchstone of my passion for reporting on what’s happening to folks with mental health problems in North Carolina.