The North Carolina state government is weighing the fate of public mental health care facilities and potentially shutting down locally controlled centers in a bid for “efficiency.”

The state of North Carolina currently hosts nine state-run local management entities (LMEs), but that number could be dropped to four as soon as next year if the proposed consolidation passes the General Assembly.

This bid for consolidation comes as a result of ongoing budget cuts, with another nearly $25 million cut from the Division of Mental Health, Developmental Disabilities and Substance Abuse Services 2014-15 budget, which funds the LMEs.

Many people, including mental health care professionals, believe this cutting and consolidation is a mistake and is going to cause serious damage to the North Carolina population as a whole through knock-on effects in increased crime, recidivism, homelessness and use of the jails and prisons to house the mentally ill.

This round of proposed consolidation follows on the heels of previous efforts, including the forced merger of Guilford Center into the Sandhills Center in 2013. Around that time, the director of the Guilford Center stepped down, citing budget cuts and damage to patient care.

One unintended result of this merger was that many people lost access to care and, with nowhere else to go, landed in the local justice system.

“Jail is no place for people with mental health problems,” said Kay Cashion, Guilford county commissioner to The News & Record. “But, that’s where too many of them are ending up right now. That’s where we’re putting them because we’re not given the money to do what we’d like to do, what we really should be doing for them.”

Keep in mind that this is just the effect of two small organizations being merged. It is difficult to imagine the effect of more extensive consolidation across the entire state.

Some LMEs such as Coastal Care, serving five counties in eastern N.C., don’t know exactly what to expect from the consolidation or whether there will be personnel reductions.

“It’s in the weeds right now,” said Kate Murphy, communications specialist and media representative for Coastal Care. “The individuals receiving services are our top priority.”

Other LMEs such as Eastpointe, covering 12 eastern N.C. counties, seem more optimistic about the change.

“Ultimately, consolidation will provide a number of benefits, including cost savings for the state,” said Penny Casto, media representative for Eastpointe, via email. “Providers will benefit from standardization and streamlined processes.”

There is, so far, very little evidence to suggest that savings can be achieved without significant loss of access to quality care.

As for streamlining procedures, Victoria Whitt, chief executive officer of Sandhills, and Casto begged to differ. Loss of local input is a big red flag.

“Bigger gets away from local management and makes it harder to keep management in the community,” Whitt said.

The major problem is that many people are not well-informed on this issue and, as a result, it’s happening quietly, relentlessly and without public approval.

Cathie Witty, counselor for the center for continuing education, expects it will keep happening unless we, as a community, speak up.

“It’s the state legislature strangle-holding part of the budget they think they can get away with,” said Witty. “Which they can if Guilford’s not going to take a stand and fight back.”