By Taylor Sisk
“I don’t know if I was ready for help, but my husband was ready for me to get it,” said Rebekah McCloy, recalling her behavioral health crisis. “But we didn’t know who to call, we didn’t know where to go.”
McCloy made her comment at the Tuesday groundbreaking of the CaldwellC3 Comprehensive Care Center, a full-service behavioral health care center in Lenoir, county seat of Caldwell County, 70 miles north east of Asheville.
The center will be operated by RHA Health Services and will serve rural Caldwell, Alexander and McDowell counties. It will offer 24-hour mental health and addiction urgent care, outpatient behavioral health treatment and 12 beds for people in crisis, regardless of insurance status.
It’s the kind of place McCloy needed once upon a time.
Born and raised in Lenoir, she now works for Smoky Mountain LME/MCO as a peer support specialist, helping people transition from assisted-living facilities into housing within their communities.
But six years ago, McCloy was in crisis. “I went through the gambit, honestly,” she said of her substance abuse, “more than I could handle.”
She eventually found her way to a nine-week intensive outpatient program. But first she required detox, and before a bed could be found at a facility in nearby Wilkesboro she had to bide her time in an emergency room.
Scariest of all though was her wait for a slot in the treatment center.
“I was afraid I would use,” McCloy said. “I had a week clean, and I hadn’t had that in a long time. I didn’t know if I was going to make it to treatment.”
Had the CaldwellC3 Comprehensive Care Center been in her community then, she could have received immediate around-the-clock care.
‘Pebble into a pond’
The new facility will be adjacent to RHA’s current outpatient services clinic. The project will entail a $1.2 million renovation and expansion, funded through an interest-free N.C. Housing Finance Agency loan to Caldwell County and assistance from Foothills Services and Smoky Mountain.
Crystal Farrow, who runs the state Division of Mental Health, Developmental Disabilities and Substance Abuse Services’ Crisis Solutions Initiative, spoke at Tuesday’s event, calling the launch a “pebble into a pond,” generating ripples throughout the region.
Somewhere between 10 and 12 percent of North Carolinians in need of inpatient treatment must travel more than 100 miles to receive that treatment, Farrow said. The percentage is higher still for youth, who have few options.
That travel, she said, “is generally in the back of a law enforcement car and often in handcuffs.”
Farrow said that last year emergency departments throughout the state received 153,000 people with a behavioral health care need as their primary problem, and that the vast majority would have been better served elsewhere.
Six counties in the state, she said, have 24-hour, seven-day-a-week centers such as the one to open in Caldwell County and those communities have experienced 25 percent reductions in ED visits.
“This model does work,” Farrow said.
Enhanced collaboration
Becky Garnett, director of RHA’s mobile crisis services in Caldwell County, said her department attends to about 50 to 60 people a month.
“This is going to be phenomenal,” she said of the new center, “because oftentimes when an individual is assessed and needs inpatient treatment, we have very limited options.”
Garnett said inpatient facilities other than these types of crisis centers require medical clearance prior to admission, often slowing the process to a crawl. Caldwell C3 will allow for much more immediate care.
It will also smooth information exchange among providers, she said, improving the continuity of care.
“If someone receives treatment here and also has an outpatient therapist, there’s no gap in communication,” as often happens after discharge from an ED, Garnett said. “The therapist is going to get the discharge plan; they’re going to be part of that process.”
The bottom line, she said, will be the ability to more immediately “get people through those doors, get them assessed and get them the treatment that they need.”
“We’ve seen it working with our C3 in Asheville,” Garnett said. “We’ve seen that just beautiful transition so that people aren’t falling through any gaps.”
Spreading the word
According to Smoky Mountain CEO Brian Ingraham, in 2010 Alexander and Caldwell county law enforcement agencies spent more than 4,000 man-hours transporting people in crisis to emergency departments.
“Lack of crisis services for those in need has put unacceptable burdens on our law enforcement,” Caldwell County Commissioner Mike LaBrose told those assembled for the groundbreaking. “With the addition of 24/7 crisis services, we are finally moving toward lessening the burden on these agencies.
“This is greatly needed.”
“It’ll be really important that we get the word out to the whole community, ‘Come here first. Don’t go to the hospital; come here first.,’” said Sandy Feutz, RHA’s vice president of operations.
Rebekah McCloy will be among those spreading the word.
“I was in tears thinking about what this would have meant to me,” she said.
[box style=”2″]This story was made possible by a grant from the Winston-Salem Foundation to examine issues in rural health in North Carolina. [/box]
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