Smoke and mirrors?

Dr. Tom Smith of Asheville doesn’t mince words. The retired psychiatrist serves as spokesman for the Friends of Public Mental Health of North Carolina, a Raleigh-based group whose roughly 1,600 members include both retired and current mental-health workers and others.

He’s unabashedly critical of the state’s mental-health-reform plan, which he and other group members believe may end up costing twice as much as the present system while serving only half as many people. The real winners, Smith asserts, will be big commercial rest homes, which will reap the benefits of one of the plan’s stated goals: reducing the number of beds in the state’s mental hospitals.

“There’s a lot of smoke and mirrors in what’s going on right now — in terms of how much it’s going to cost, in terms of how many people it’s going to leave stranded without any access to treatment — and about the fact that, you know, it’s closing every last residential bed for children in this state,” he declares.

Smith notes that he’s worked in both the private and public mental-health sectors — most recently as president of the medical staff and director of the long-term-care unit at Cherry Hospital in Goldsboro.

He says he’d rather fix the problems in the system without dismantling it altogether. And he scoffs at some of the arguments for reform — including the one that services are not uniform across North Carolina.

“There’s some truth in that, but that’s not a reason to tear down the whole system,” counters Smith.

And though they’re not sure whether they’re going to file it, the Friends of Public Mental Health have prepared a class-action lawsuit against the state on behalf of patients who wouldn’t get treatment under the reform plan, Smith reports.

In the meantime, he says he’s been buttonholing legislators, urging them to put the brakes on reform pending further study. But that effort, says Smith, has met with at least one potential stumbling block: “They don’t know beans about mental health.”


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