Following John Hood’s latest dispatch from the Gov. Trail comes an interesting AP article on gubernatorial candidates’ views on mental health reform.

Details are sketchy on both sides, though Republican Bob Orr admitted that a return to a government-based system in low-income areas “where the ability to make a profit is probably pretty limited” is necessary. Professionalism among mental-health care workers under the reformed system has been a problem, and Democrat Richard Moore has some ideas about how to solve it:

Moore wants to give higher salaries to mental hospital workers if they earn professional certification in their field, an education program he envisions could be created by the state’s community college or university systems. The financial incentives will provide continuity of care for long-term patients.

“If we don’t face the reality that the person, the caregiver, the technician, the person that’s going to see that same patient everyday, if we don’t have some stability in that piece of the puzzle, none of the rest of this stuff is going to work,” Moore said.

Of course, that solution is more than likely part of Moore’s plan to offer free community college to North Carolina residents. (Note in yesterday’s N&R article that both Moore and Bev Perdue say they have plans for free community college, the in the next paragraph say the state needs to reign in spending — mutally exclusive, right?)

With sketchy details, it’s safe to assume that Moore and Perdue will push for a return to a bigger government role in mental health care. But which way will free-market Republicans go? Will they advocate pushing on with a more privatized system using government money to patch holes? The view seems to be that shifting mental health care to private providers was a bad idea in and of itself. But it’s not as if the money wasn’t there to pull it off:

The idea behind the 2001 reform was to shift the state’s mental health programs away from institutional care to community-based treatment offered by private providers. The General Assembly set aside money to help local agencies that manage patient services to build up their treatment capacity by adding short-term hospital beds and crisis services.

The intention was to keep patients from ending up in jails or emergency rooms following a breakdown.

Instead, the state’s institutions are used more than ever. Replacing government-run psychiatric services at the county level led to no care in some rural areas because private or nonprofit providers either couldn’t survive financially or simply left the area. Easley also intercepted tens of millions of dollars earmarked for mental health to plug a budget shortfall.

This is a tough issue, and it will be interesting to see how the respective nominees address it.