DHHS Secretary Aldona Wos announced Nov. 7 the McCrory Administration’s Crisis Solutions Initiative, a new statewide effort to improve mental health and substance abuse crisis services in North Carolina. This initiative will bring healthcare, government, law enforcement, and community leaders together to identify help for individuals experiencing a mental health or substance abuse crisis so they receive the most effective care.
"Improving mental health and substance abuse services is a top priority of our administration," said Governor Pat McCrory. "By bringing people together to implement strategies that work, we can better serve the thousands of North Carolinans who struggle with mental illness and substance abuse."
Secretary Wos was joined by Dave Richard, director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, as well as Dr. Brent Myers, director and medical director of the Wake County EMS System, and Dr. Bill Roper, CEO of UNC Health Care, at the announcement event at the WakeBrook Crisis Center in Raleigh.
"With today’s announcement, we begin a focused, long-term effort to ensure that individuals and families who are experiencing a mental health or substance abuse crisis know where to turn for the help they need," said Secretary Wos. "In turn, we can begin to reduce the tremendous burden that these issues place on hospital emergency departments and law enforcement."
Each year, there are an estimated 150,000 visits to emergency departments in North Carolina related to an acute psychiatric or addictive disorder crisis. 13 percent of patients with a mental health crisis who are treated in an emergency department will return within 30 days. In addition, national studies indicate that about 17 percent of people in jail have a serious mental illness.
As a part of this initiative, a Crisis Solutions Coalition will be created to address the inefficiencies that currently exist surrounding crisis services in the state. Secretary Wos has charged Dave Richard, director of the DHHS Division of Mental Health, Developmental Disability and Substance Abuse Services, with leading this coalition. Patient advocates, along with leaders from healthcare, government, and law enforcement communities will be invited to join the coalition to help:
- Recommend and establish community partnerships to strengthen the continuum of care for mental health and substance abuse services.
- Promote education and awareness of alternative community resources to the use of emergency departments.
- Make recommendations related to data sharing to help identify who, when and where people in crisis are served, and what the results of those services are.
- Create a repository of evidence-based practices and provide technical assistance to Local Management Entities/Managed Care Organizations (LME/MCOs), law enforcement and providers on how to respond to crisis scenarios.
- Recommend legislative, policy and funding changes to help break down barriers associated with accessing care.
- Assist with the creation of LME-MCO Local Business Plans to provide a roadmap for mental health investments in the community.
"By bringing all stakeholders together, we can begin to focus our resources and energy on solutions that already are working in some of our local communities," said Dave Richard. "This effort is about finding practical solutions that will allow us to move away from a crisis-based system to one that is truly focused on patient outcomes."
A primary goal of the Crisis Solutions Initiative is to ensure that individuals experiencing an acute mental health or substance abuse crisis receive timely specialized psychiatric treatment in coordination with available and appropriate community resources. The initiative seeks to identify ways to expand existing best practices that have been proven to work on the local level, such as:
- Walk-In Crisis Centers and Short-Term Residential Treatment Options
- Youth Mental Health First Aid
- Person-Centered Crisis Prevention Plans
- EMS Pilot Programs
- Crisis Intervention Teams
"It is tremendously important to Wake County that we find ways to help people in crisis receive the treatment they need, in the right place, from the right provider, the first time," said Dr. Brent Myers. "Our comprehensive, community-wide approach includes partnerships with hospitals, mental health facilities, detox facilities, and the Capital Care Collaborative so that patient’s encountered by EMS may choose from a menu of services rather than be transported only to an emergency department that may not have the resources to address the cause of their crisis. This concept, referred to as Mobile Integrated Healthcare, is receiving national attention and can be replicated in other communities."
At the center of this initiative is a new scorecard system to help track the progress and success of these initiatives in three key areas over time:
- Percentage of emergency department visits for primary diagnoses related to mental health or substance abuse issues;
- Wait times in emergency departments for inpatient psychiatric and substance abuse placement;
- Number of individuals with mental health crises, who have been admitted to emergency departments that are readmitted within 30 days.
"I want to thank Governor McCrory, Secretary Wos and the Department of Health and Human Services for their commitment to this issue," said Dr. Bill Roper, CEO of UNC Health Care. "We look forward to partnering with you and the community to solve the mental health problems facing our state."
North Carolina Hospital Association President Bill Pully added: “NC hospitals support the renewed efforts of Secretary Wos and the Department of Health and Human Services to reduce the amount of time behavioral health patients spend in emergency departments. Hospitals know first-hand that the current system of care for North Carolinians with behavioral health needs is dysfunctional and unsustainable. We look forward to working with the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the Local Management Entities and Managed Care Organizations and other stakeholders to develop and implement concrete, cost-effective, and evidence based, steps to improving the behavioral health service delivery system in NC for all North Carolinians.”
- Click here for a fact sheet about North Carolina’s mental health and substance abuse challenges.
- Click here to download an in-depth overview of the new Crisis Solutions Initiative.