Dix future in limbo

Political will needed to ensure hospital closing results in best use.

By Michael S. Pedneau

[04.21.04] — Without a major expression of bipartisan political will by Wake County’s elected leaders, the planned closure of Dorothea Dix Hospital in 2007 will leave the county for the first time since the 1850s without a hospital unit that treats the mentally ill regardless of income or health insurance.

Absent such a unit to care for the crisis psychiatric needs of those with severe mental illness, Wake County sheriff’s deputies will annually transport hundreds of mentally ill patients in crisis to a new, smaller state psychiatric hospital in Butner or elsewhere out of the county.

Wake citizens would be better served by a psychiatric inpatient unit operated in a general hospital, and the county would benefit from a unit that could qualify for Medicaid payments, although the barriers may be insurmountable to created a hospital-based or standalone psychiatric unit prior to the planned closure.

If Dix closes in 2007, what will happen to all that prime real estate?

It would make a great park and a profitable development. But could all or part of Dix’ remaining 300 acres be used for or sold for the benefit of the mentally ill?

There are state government precedents and deals in addition to the state gift in the 1980s of 2,500 Dix acres to N.C. State University that seem to indicate it’s at least possible.

But what bodes ill for the Dix property ever again benefiting the mentally ill in Wake County or elsewhere is the fact that in nearly all of the previous transfers of land and/or buildings out of the Department of Human Resources, no substantial benefit accrued, much less a quid pro quo for the mentally ill, deaf children, children in the juvenile justice system, the elderly or any of the people with disabilities that the DHHS is charged with advocating for and serving.

It’s easy to do lopsided deals when one party, DHHS, represents the neediest and weakest among us and generally lacks the support of monied interests that finance political campaigns.

The precedents are there for Wake County’s leaders and those from other counties whose citizens rely on Dix Hospital, or that provide such services in their local hospitals, to make a strong play for some benefit from the Dix property.

If Dix Hospital closes, the benefits should accrue to services to the mentally ill in all these counties.

If there is enough political will in Wake County, that could even include a local inpatient unit.

Otherwise, in the case of Wake County’s mentally ill, they may get a glimpse of the university’s hotel and golf course from the sheriff’s cruiser on their way to Butner.

Michael S. Pedneau is a former hospital director at Dix and a former director of the state Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

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