Dismantling the Dix Legacy: The End of Compassion

The physical abandonment of the Dorothea Dix campus in Raleigh is a final exclamation point on the state’s moral abandonment of the mentally ill, essentially returning us to mid-19^th century conditions when the mentally ill were confined to jails, locked in attics or hidden from sight in poorhouses.

Dorothea Dix, a champion for the mentally ill, visited our state in 1848 and was distressed with what she saw in more than 30 counties. State budgets were strained and champions for the mentally ill were few but Dix had a passion for better mental health care that included more moral treatment, seclusion from family and society, less use of mechanical restraints and useful tasks to keep patients busy. She lobbied our legislature valiantly to build a mental hospital, succeeding only because fate stepped in.

While in Raleigh she stayed at a local hotel. Another of the hotel residents was the wife of the highly influential legislator James Dobbin of Fayetteville. When Mrs. Dobbin became terminally ill Dix nursed her. Mrs. Dobbin’s deathbed request was for her husband to use his influence to obtain passage of the “insane asylum” to repay Dix’s kindness. He did, the state passed two bond issues, and in 1856 the Hospital formally opened. For over a century Dix Hospital was a beacon for enlightened treatment and care for the mentally ill, with as many as 4,000 inpatient and outpatients under its care.

Now it is shuttered, the result of unsuccessful mental health reforms, diminished funding and an unspoken retribution against Wake County lawmakers. North Carolina has abandoned our core responsibilities to the mentally ill, resulting in jails once again housing those turned out on the streets, inadequately equipped nursing homes and long-term care facilities being forced to deal with them and even less capable families having to manage as best they can.

Leaders may call this mental health reform, believing providers closer to their homes should care for the mentally ill, but reform theories are not yet supported by proof. Noting the bungled care and wasteful expenditures of the initial reforms our lawmakers have taken the axe to mental health funding, stating we have neither the money nor the willingness to house these patients in mental hospitals. Advocates are scratching their heads over the insane logic which says we don’t have enough money to properly fund mental health care and treatment but we can find funding to abandon the Dix campus, which houses much of the Department of Health and Human Services in buildings the state long ago paid for, and rent one million square feet of additional office space around Raleigh. The frosting on this ill-baked cake is that the state is about to “sell” these 400 acres of prime Raleigh real estate to create a public park.

Like many, my family has a mentally ill relative and can testify to the lack of treatment and facilities for them. Those without insurance and in poor circumstances are at the mercy of hospitals, assisted living and nursing homes, which have neither the trained staff nor the facilities to adequately care for them. We are dismantling the Dorothea Dix legacy and appear to have come to the end of our compassion as a society, a sad commentary of our time.