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Shaky in Wake

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Recent meetings of NAMI's Wake County chapter have been nervous ones. The members are mostly parents of mental health consumers. They can recite the sad litany of budget cuts throughout former Gov. Jim Hunt's 16 years in office, so what Gov. Easley's threatening isn't new, just disheartening. But if the state closes Dix, it will pull the one reliable prop out from under the county's shaky structure of emergency and critical services, says Lois Cavanaugh-Daly, NAMI's chapter president. Of the 500 or so patients at Dix at any one time, about 60 percent come from Wake County.

Already, the Wright Building at Dix is starting to close. On June 30, it will be empty. Wright's a transition house for 30 Dix patients before they are released to community-based housing of some kind. Wake County has no comparable facility, nor does it have the capacity to absorb several hundred more clients from Dix. Whatever problems await the counties as they try to comply with their new responsibilities in mental health, Wake County, because of its reliance on Dix (and Durham, because it's dependent on Butner) are going to experience them first, it seems.

Iris Kapil, for instance, worries what will happen to her daughter, Manisha, when she's gone. She and her husband are in their 70s. Manisha, diagnosed with schizophrenia after a breakdown five years ago, is 44. Manisha says she's getting stronger. But the breakdown damaged her in much the same way a heart attack hurts, except that the schizophrenia continues to sap her body and mind. "I live with such stress, it's difficult to get through the day," she says. Manisha would like to live with her parents. They want her to stick it out in her apartment in Cameron Village, fearing that if she remains dependent on them now, she'll be in terrible trouble when they're gone. Living on a monthly SSI check, though, leaves Manisha feeling "socially isolated." She doesn't drive, and she depends on the county to deliver her to therapy and counseling sessions weekly.

Eight years ago, Wake County started CASA, which it spun off as a nonprofit organization to build and acquire housing for the mentally ill. To date, using a mix of local, state and federal funding and some contributions, CASA has 130 units of its own plus federal housing vouchers for 70 more that it rents from private owners. Their tenants are people like Herbert Tucker and Richard Pearce. Pearce used to be homeless. Now, with housing help and counseling, he lives in a one-room apartment, one of the six in a house CASA owns next door to its headquarters in Raleigh. "I didn't have the stability before that I have now," he says, shrugging. Pearce is a good illustration of the principle that housing and services are inseparable, says Debra King, CASA's executive director. How does 200 units compare with the need? "It's a drop in the bucket," she says.

Maria Spaulding, director of Wake County Human Services, is bracing for the onslaught if the state closes Dix. The county will need to create an emergency care unit, she says. It will need to beef up a 24/7 "crisis and referral center" that it operates now for the purpose of "triage" as patients check themselves in or are brought in by the police or from a private hospital. She'd like to have at least one more clubhouse to add to the two already operating. The clubhouses are places where people can spend the day, talk to each other and get counseling if they need it.

Most of all, she'd like to have more support teams--like the PACT teams Joe Donovan describes in the accompanying story--to go out and rescue clients who've missed their appointments, gone off their meds or never had meds in the first place. "The frustrating thing is, we know how to do this, we know where to look, we just need more resources to be able to go out and find them," she says.

But after a "summit meeting" last week with their unhappy Human Services officials, the Wake County Commissioners made it clear they are adamantly opposed to any tax increase this year. Said Commission Chair Linda Coleman: "It's such a bad economy, I don't see how we can put an additional tax burden on people at this time."

Coleman is one of four incumbents seeking re-election this fall. Two others are running for state legislative seats. Only Commissioner Betty Lou Ward is not running--and she is the only one of the seven who favors a tax hike. "Human services have been underfunded in Wake County for years," Ward said.

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