Mental health workers fight for safe, effective treatment

Second of two articles.

Workers at the Dorothea Dix mental health hospital in Raleigh, N.C., have staged weekly rallies involving more than 150 workers to prevent the closing of their hospital. On June 6, more than 25 workers attempted to barge into Department of Health and Human Services Secretary Dempsey Benton’s office to demand a one-year moratorium on closing the hospital.

A recent stage of a 2001 DHHS reform plan was to close Dix and John Umstead Hospital, two of the state’s four psychiatric hospitals, and merge them into one Central Regional Hospital. However, the number of patient beds in the new hospital is much fewer than those served by the two hospitals combined, and already-low staffing ratios are to be significantly cut.

Workers at Dix are being asked to drive an additional 40 miles to and from work each day, during a time of exorbitant gas prices. The DHHS administration is trying to rush to close down Dix and move those patients and workers to the new hospital, despite huge safety design flaws, unwritten policies, inadequate training and orientation, and hidden and incomplete major reports from assigned legislative and DHHS committees.

The workers have been able to turn around unfavorable press coverage and a public perception that the workers were the cause of the crisis. Due to the workers’ organizing efforts and public pressure, Secretary Benton announced that there would be an initial six-week delay on the closing of Dix hospital.

Many countries and states have privatized what were previously public services. Often this results in grave social consequences, as is now being displayed in North Carolina.

Many of the privatized mental health providers do not provide quality care for patients. In North Carolina and other states, psychosocial treatment under privatized care commonly consists of a trip to a grocery store or movie theater with the patient, accompanied by workers who are paid low wages and have not been properly trained in mental health. There is rarely the proper intensive, around-the-clock care that is needed and is provided in the public psychiatric hospitals and developmental disability centers.

“This job is important and the need is growing,” stated UE Local 150 member Raymond Howard, youth program assistant I at the Caswell Developmental Center in Kinston, N.C. “Mental health is an issue in the U.S. and we don’t need them cutting funds. We need them to add funds. We need to have proper staffing levels.”

With an economy now superdependent on credit, privatization of social services is a way for private capital to get a guaranteed profit on their investment. Banks have turned to investment in education, health, transportation, waste management, prisons and mental health. Corporations receive governmental subsidies to ensure that they receive profit on services that the government should be providing to the people.

The privatization of social services also serves as a union-busting tactic, as union contracts are voided with the turnover to a private company. Lower wages for the workers always follow.

When the North Carolina mental health system was partially privatized in 2001, many workers were laid off. Public beds were supposed to be absorbed by private “community services” which did not exist in many areas. Many patients, including some of the neediest, were dropped from programs.

Instead of community clinics, the place to go in an emergency became the regular hospital emergency room or emergency ward, at inflated costs and poorer services, as practitioners were not familiar with the patients.

Meanwhile, the privatized local mental health offices often ration care. For example, a doctor may recommend six therapy sessions for a patient, but the local office may approve three. Some corruption and abuse of public contracts has also been reported.

Massive discharges of patients have increased the homeless and prison population. There are now more than 4,000 people with mental illnesses in North Carolina prisons, where they are not being treated. The state Department of Correction said in August that over the past five years, there has been “a steady increase” in the number of inmates with severe and persistent mental disorders. North Carolina has opened 13 new prisons since 1997 and all of them are now full. A new 1,500-bed prison is scheduled to open in September.

Only through the class struggle will this crisis be resolved. Public workers in North Carolina, through the efforts of UE 150, have been struggling for years to establish the right to collectively bargain with their bosses. They believe that if they had this right, most of this crisis could have been avoided.

A document circulated by UE 150 reads, “Through this struggle, the workers must be brought into the wider struggle for health care, including the demand for a Single Payer system, and in defense of social programs that benefit the working poor. Being part of this larger struggle will expose them to other militant and politically active workers, who bring a level of trade union and worker consciousness not readily seen in North Carolina or the South.

“Our members and other workers at these institutions want their voices to be heard on the issues and want to build power to change and improve their working conditions and their image as mental health workers. Many have been reluctant to speak out, not knowing if it would represent a violation of patient rights or insensitivity about people with mental illnesses. Thus the need for an organized fightback that makes the issues of worker rights an essential component of patient care.

“Working class unity and consciousness must be built through organization and struggle. It must be a struggle that engages the rank-and-file in actions that enable their collective voices to be heard on the issues impacting them, so that they are not dismissed in any proposed plans to address the problems related to patient care. This will help workers to gain a sense of their own collective power and recognition of the importance of having a fighting union”