By Taylor Knopf
When a child is struggling with a behavioral health crisis, family members often call 911 or take the child to a hospital emergency room for help. But medical providers say that a busy, sometimes chaotic emergency department is not the best place to tackle behavioral health issues.
Some young patients in these circumstances can linger in the hospital for weeks because they don’t meet criteria for admission to an inpatient psychiatric facility, even as the family insists they will not go home without help.
Now, there’s a service available in 20 North Carolina counties to meet these families at their homes with a goal of preventing emergency room visits.
Started in 2023, the MORES program — mobile outreach, response, engagement and stabilization — is a special mobile crisis unit for children and young people ages 3 to 21 who are experiencing heightened emotional or behavioral health needs. A MORES team responds to non-life-threatening crises within an hour of receiving a call. A team includes a licensed clinician trained in adolescent care and a family peer support specialist — someone who has experienced caring for a child with behavioral health issues and can walk alongside the caregivers.
What sets the MORES program apart from other mobile crisis teams is that the team follows up with the family in their home as often as needed for up to eight weeks after the initial visit.
How to contact a MORES team
MORES teams are operating in the following counties: Buncombe, Cabarrus, Chatham, Cumberland, Davidson, Durham, Harnett, Haywood, Henderson, Jackson, Johnston, Lenoir, Macon, Mecklenburg, Orange, Pitt, Swain, Wake, Wayne and Wilson. The Department of Health and Human Services plans to expand this service to more counties in the coming years.
The simplest way to connect to any crisis service in North Carolina is by texting or calling 988.
The state’s behavioral health management companies (LME-MCOs) are responsible for the MORES teams. You can also connect with a MORES team by calling the crisis line for the LME-MCO that covers your county.
How MORES teams work
Similar to other mobile crisis units, a MORES team meets a family wherever they are in the community within about an hour of receiving a call for help. It’s a publicly funded service available 24/7.
“It is a mobile crisis response specifically designed for children and families, where they define what that crisis is — big crisis, little crisis, something in the middle. They are able to say, ‘I am not having my very best day, and I would like some help,’” said Teri Herrmann with SPARC Services and Programs, an operator of a MORES team in the Mecklenburg area, during a i2i Center for Integrative Health conference in January.
Herrmann said that the first 72 hours are really intense. The local team shows up to de-escalate the situation and talk with the child and their family. Team members perform a risk assessment and put safety plans in place. The MORES teams also have access to psychiatric consultations.
“Then we start to move into that stabilization phase where we’re giving them more skills,” she said. “We’re giving them a little bit more therapy. We’re giving them referrals and linkages to those resources and those supports. We’re setting up those school meetings, because sometimes it might be the suspension from school is the crisis that started all of this.
”The team is able to stay in place for up to eight weeks post that initial crisis to help continue to do that stabilization.”
The goal is to provide services at home and in the community, so the child can stay with their family and avoid a trip to the hospital or a psychiatric institution. Part of that is equipping the caregivers and other family members for future success.
“Involving that entire family system is critical,” Herrmann said. She explained that treating a child in an institution — away from their family — and then returning them to the same environment without providing support and skills to their caregivers will often result in the child cycling back to the emergency room.
DHHS reports that engagement with a MORES team has led to fewer hospitalizations and residential treatment placements for children. The majority of people find this service helpful: 96 percent of caregivers and 94 percent of adolescents reported that MORES was right for them, according to data DHHS provided to NC Health News.
DHHS data shows that MORES teams engaged with 645 children and their families between June 2023 and Dec. 31, 2025. On average, the MORES teams followed up with face to face or telehealth meetings 1.6 times per week during the ensuing eight weeks, according to the department. Most interactions with the MORES team — 80 percent — were the direct result of calls to a mobile crisis line, the data show.
Additionally, DHHS reports that other agencies, including behavioral health urgent cares, LME-MCOs, schools and DSS offices, have put in referrals for MORES services.
Relieving emergency departments
Courtney Cortes, director of nursing for emergency services at Novant Health Presbyterian Medical Center, described a scenario she has seen regularly. A parent brings in a teenager and says they can’t manage their behavior at home. The child has been destructive and physically aggressive with family members. And this isn’t the first time it’s happened.
Sometimes kids are brought to the ER by law enforcement as the result of a 911 call — for the child, that can be a traumatic experience in itself.
In many of these cases, though, there is nothing wrong with the child from a medical or psychiatric standpoint that would justify an admission to inpatient care, Cortes said.
“It’s truly behavioral stuff,” she explained to an audience gathered at the i2i health conference in January. But the family is at a breaking point and refuses to leave without help.
In the past, that could result in the child lingering in the emergency department for weeks, sometimes even months. Before the MORES program came to Mecklenburg County, Cortes said, 50 percent to 70 percent of the rooms in her emergency department’s pediatric unit were filled with behavioral health patients, and at least half of those were what she calls “unpreventable social holds” — children with no acute medical need but a behavioral issue that prevented them from leaving.
The average stay for these patients was four to six weeks, she said, with some young patients living there for up to nine months.
Now, when a family like that comes in, Cortes said her behavioral health therapist calls the MORES team. MORES then sends someone directly to the emergency department to meet with the child and family, connecting with them face to face. This is where a family peer support person can make a big difference, as someone who has sat in an emergency department before with their own child. That support can help the parent or guardian feel they are not alone, assuring them that they will be accompanying them home to help them through this event.
Cortes said she feels much better about sending parents and children home from her ER with real support.
“I’m actually going to have someone who’s going to be there for you. And if anytime you’re in crisis, you call this number,” she tells families. “That’s so empowering for these families who the whole time they’ve been telling us that ‘I don’t have any help.’”
Since working with the MORES team, the number of Novant Health Presbyterian’s pediatric rooms that are occupied by these unpreventable social holds on any given day has dropped to fewer than 10 percent. Some days there’s only one or none at all, Cortes said. The average length of stay for that patient population has dropped to 2.11 days with the exception of four outliers, she said.
“That’s just incredible, that we did that in a year,” Cortes said.
Meeting needs and staying connected
The creation of the MORES teams originated from the question: What happens after the crisis?
Allison Gosda, chief clinical officer with Partners Health Management, the LME-MCO that coordinates behavioral health services for counties in the middle of the state, said that people will often reach out for help in a moment of crisis, but then not again until the next crisis.
“The initial reason they were calling was addressed,” she told NC Health News. “Then, the next thing you know, they end up in an emergency room the next time they have a crisis, or in a residential facility … and we don’t want that to happen.”
When patients are discharged from these facilities, they’ll get lists of resources or a referral to an appointment.
Too often “they don’t follow through on anything,” Gosda said. “Starting with the crisis […] we decided we needed to do a little bit more. So we’ve created this service.”
The goal is that after eight weeks of going into a family’s home, visiting the child’s school and intermittently following up with phone calls, the team has stabilized the situation and ensured connection to other outpatient services.
In addition to providing counseling, teaching skills and connecting to services, the MORES teams address the social factors that keep people safe and healthy — having a place to sleep, enough food and transportation for health appointments.
Gosda gave the example of a MORES team in Catawba County who responded to a home where the children continually struggled with “escalated” behaviors.
“What they found out was they have three young children sleeping in one bed, and so they said, ‘We can help get three beds and set up three distinct spaces for these young children,’” she said. “They did, and the anxiety and the fighting all kind of dissipated.”
Other LME-MCO leaders have called this new service a “game changer” because it’s one of the few real-time services that offers long-term support. The MORES team is only operating in 20 counties, but DHHS’ long-term strategic plan includes expanding these services to the entire state.
KEEP UP WITH THE LATEST
Republish our articles for free, online or in print, under a Creative Commons license.
