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NC mental health facilities plagued by big and chronic staffing shortages

Credit: iStock

by Clayton Henkel, NC Newsline
April 3, 2024

When a person is having a mental health crisis in North Carolina, often the fastest option for care is the nearest emergency department. But proper treatment and referral to one of the state’s psychiatric hospitals could be weeks away.

Currently, 94 of North Carolina’s 100 counties are designated as health professional shortage areas for mental health.

Kelly Crosbie, director of the state Division of Mental Health, Developmental Disabilities and Substance Use Services, told lawmakers Tuesday that 68 counties do not have child and adolescent psychiatrists.

Crosbie said North Carolina is making strides in its vision of moving people from crisis to care, but the state must bolster its behavioral health workforce.

Mark Benton testifies next to Kelly Crosbie
 Mark Benton, chief deputy secretary for health with the state Department of Health and Human Services (Photo: NCGA Screengrab)

Mark Benton, chief deputy secretary for health with the state Department of Health and Human Services, said while there has been some improvement in the past year, recruitment and retention challenges can be seen over and over again in all three psychiatric hospitals.

Benton said the vacancy rate at Morganton’s Broughton Hospital is 32% or 499 positions.

For Central Regional Hospital in Butner, it’s the same story with 32% of the positions vacant, the equivalent of 579 staffers.

Cherry Hospital in Goldsboro has 24% of its positions unstaffed, 332 vacancies.

Benton said equally troubling was the turnover rate — individuals who come to work for the hospital, then leave within 12 months. At Broughton, the turnover rate is an alarming 46 percent.

“As a whole, roughly half of our vacant positions right now are covered by temps,” Benton told the Joint Legislative Oversight Committee on Health and Human Services.

Because of the high vacancy rate and reliance upon temp workers, the state is not able to staff all of the beds at its psychiatric hospitals.

“It’s roughly about 100 beds in each of the three hospitals that comes in just shy of 296,” Benton explained. “What is interesting to note is that right now, the most recent data we have on individuals, both adults and children, who are waiting for placement, so they have been screened as needing inpatient psychiatric care, totals 225.”

a charts shows the staff vacancy rates at state hospitals
 Source: NCDHHS

If NCDHHS had the ability to fully staff and open all of the unstaffed beds, according to Benton, it could eliminate the waiting list for care across the state.

“What three things, if you had the power to change, would you change so that you could staff and open all of your beds?” Senator Jim Burgin (R-Harnett) asked Robyn Whalen, who heads up Central Regional Hospital.

“We desperately need to raise our salaries for those staff members who are here 24-7,” said Whalen.

Labor market adjustment rates have helped in recruiting health care technicians.

“But for my registered nurses, it has been very difficult. Our salaries are ranging around $64,000. And for an agency, they can make over $110,000.”

Whalen said Central Regional is in an area where competing health care facilities can offer significantly more with added benefits.

“Again, I’m not going to be a Duke. I’m not going to be a UNC, but I’m thinking like if we got to $70,000, we could make a good starting salary and raise our midpoints, but that will take some funding for that.”

Whalen said state hiring practices also could be smoother, with latitude to hire someone on the spot, especially in hard to fill positions.

“I remember when I started with the state, I was so proud. I still am every single day, and I want us to be a preferred employer.”

 Sen. Ralph Hise (Photo: NCGA screengrab)

Senator Ralph Hise (R-Mitchell) said the nursing shortage is bigger than just a state’s salary issue.

“If I brought in any of my local hospitals, they would all tell you the exact same thing. They cannot find a nursing workforce.”

Hise suggested community colleges and universities could be doing more to maximize its number of healthcare graduates and then place those students where needed most.

As for the private staffing concept, Hise said the state may be creating its own problems.

“I understand the emergency situation you’re in, but there’s no way out until you cut it off.” said Hise. “Because if you’re a new nurse coming out, which path do you think you’re going? You can go work for the staffing agency and make more for the same job than you can working for the facility and have more control over your hours and your process to those kind of things.”

Rep. Hugh Blackwell (R-Burke) said it was a case of “everybody chasing after too few people” and what was needed was some “fresh thinking.”

Hise told his colleagues that the solution can’t just be to make salaries competitive.

“We are not seeking nor asking that we match dollar for dollar for perhaps what Duke Hospital may pay one of their nurses or physicians and other staff, but we very much need to be in the ballpark,” said Benton. “Where we are is in one of the outlying parking lots right now, just to use an analogy.”

Robyn Whalen testifying
 Robyn Whalen explained how better wages and less red tape in hiring could help the state’s psychiatric hospitals. (Photo: NCGA screengrab)

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This story is republished from NC Newsline under a Creative Commons license. Read the original story.