Richmond County psychiatric patients may languish in an emergency room or crisis center for up to a week before being admitted to a mental hospital.

A report released Friday by a non-profit found the average wait time for psychiatric patients across the state was 2.6 days, but a provider in Richmond County said the wait can be up to a week for patients here.

Ultimately, the report from the Wake County chapter National Alliance of Mental Health Illness found about a quarter of the patients put on a waiting list for a state mental hospital during the first six months of 2010 checked out before being admitted either because their condition improved enough for discharge or they got tired of waiting.

Daymark Recovery Services Clinical Operations Director for the Sandhills Region Jerry Earnhardt said the wait times have grown since the state began its latest push for privatization of mental health services. He is based in Rockingham.

He spoke to involuntary commitments, because those are the cases he primarily handles. They don’t have the option to leave, and are often restrained and guarded while they wait.

“It used to be unusual if a person waited three or four hours to get in,” he said. “Now, we’ve seen people waiting for up to seven days. It’s really uncommon in the counties served by Daymark if you can get a person out of the emergency room in three days.”

Earnhardt said the LME set up plans with hospitals for indigent patients, or patients who have no way of paying their bill, which has helped, but it is still frustrating for patients who have to wait.

The NAMI chapter found 3,339 patients across the state were put on a waiting list to be admitted to a state hospital from January through June 2010, and 212 of these waited longer than a week, while more than 900 checked out within two days.

For involuntary commitments, who can’t just check out when they get tired of waiting, the report says they are often restrained and/or medicated instead of being treated.

“If a person is waiting to go to (Raleigh’s Dorothea Dix Hospital), it is usually because the case is too severe for the local hospital or they’re all full,” Earnhardt said. “Sometimes, people get upset just waiting through this process ... They’re often still in the emergency room, and many times they’re in handcuffs and under the supervision of a police officer.”

He explained the state built Central Regional in Butner to address the situation, but put fewer beds there than at Dix.

“They still don’t have enough beds,” he said.

Once a patient is admitted to a hospital, they are either taken directly into Dix or Central, or are put on a waiting list and have to wait for enough patients to be discharged to make room for them.

“There’s just no way of knowing how long that will take,” Earnhardt said, adding “it’s unusual for the state hospitals to not be on delay.”

N.C. Sen. Bill Purcell co-chairs the Senate’s Health and Human Services Committee, and said mental health services was an area that received cuts in the two-year budget the General Assembly passed in 2009.

Some of that funding was restored in the most recent budget, according to Purcell, including $9 million to provide new beds in general hospitals for emergency psychiatric care.

Of this money, $1.7 million will go to Moore Regional to add six additional psychiatric beds.

For many Richmond County patients, this is the first stop on their journey to a state hospital.

Sandhills Center Spokesman Sid Linton explained the regulatory agency has “three-way contracts” - or contracts between the state, hospital and Sandhills Center - with seven hospitals, both inside and outside its eight-county area, to take on emergency psychiatric cases.

While he acknowledged there are extreme cases, he said the typical wait time for a patient in the Sandhills region “is similar” to those found in the report - about three days.

“We first check for availability, then get the patient transferred to a facility with an open bed,” Linton said. “Our goal is to get the patient admitted to a facility that is near to their home.”

There are also two programs in place in the Sandhills Center region to hurry along the evaluation phase for patients, in a tele-medicine program that allows patients to be seen by a psychiatrist via satellite, and a pilot program to allow health care professionals other than doctors to provide the evaluation.

“But once they get their first evaluation, they still have to find placement, and go through the same holding pattern of waiting,” Earnhardt said.

Another complication that has arisen is the state hospitals often require labwork as part of their evaluations, Earnhardt said, and the emergency rooms and general hospitals are the only venue to provide these in a timely fashion.

“So, it’s set up so that every person involuntarily committed has to end up in an emergency room - and there, they sit and wait,” Earnhardt said.

Staff Writer Philip D. Brown can be reached at (910) 997-3111 ext. 32, or by e-mail at pbrown@yourdailyjournal.com.