Alamance County Commissioners move ahead with mental health crisis center

Demand on emergency rooms has grown steadily in the 21st Century, including from patients having mental health crises. Alamance County is taking steps to relieve some of that pressure in the next year and a half.

The effort to get a full-time mental health crisis center in Alamance County goes back the better part of a decade. There still isn't one, but for the first time there is a plan and a deadline to at least get started.

In mid-April, the Alamance County Board of Commissioners expects to see bids on building a roughly 28,000-square foot facility by Alamance Regional Medical Center in the next year to 18 months where mental-health professionals can figure out what people need and get them help without them getting arrested or necessarily getting admitted to the hospital.

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The county is getting some financial help to get this done. The state provided a $500,000 grant to start the center, and the agency that runs county mental health services, Vaya Health, will pay start-up costs once the center is built to get operations to the point where providers can start billing Medicaid and other programs and insurers.

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Jails, including the Alamance County Detention Center, also end up holding many people who probably wouldn't be there if they had gotten treatment. Last spring, 37%, or about 100 people, held in the county jail on an average day had mental-health issues, according to sheriff's office statistics.

There is nobody, least of all Sheriff Terry Johnson, saying that's where they should be. Not only do these people not get treatment, but it also crowds the jail, the cost of which falls on the county instead of Medicaid or other insurance.

The emergency room isn't much better. It can be hours or even days before people get psychiatric help. All that time, law enforcement has to watch over them, and still assaults on emergency department staff is not uncommon, ARMC President Mark Gordon told the county commissioners this week.

There has been a diversion center near Holly Hill Mall and Business Center for years, but it has never been 24-hour and doesn't have the capacity the county is looking at now. When RHA Health Services, which operates the current center, expanded its hours in 2020, it went from helping 379 clients in one year to 500 showing there is probably plenty of unmet demand.

Advocates say a 24-hour center would make a big difference. For one, there would be beds there for anyone who could not be placed in treatment immediately. The center would also be a place where other providers could set up shop, making it easier for clients to find things like addiction treatment, Alcoholics Anonymous meetings, jobs programs and help adjusting after a stay in the jail.

Every complication or step, Donald Reuss told commissioners this week, is a chance for a troubled person to get derailed. Reuss is a vice president with Vaya Health, the county's LME/MCO. That's a local management entity/managed care organization, which is a state government organization that looks a lot like a private company. It even competes with other LMEs to serve North Carolina counties. Vaya is responsible for managing care for those with Medicaid, no insurance, the underinsured, people with mental illness, addiction, or intellectual and developmental disabilities.

Since coming to work with Alamance County last year, Vaya has been very active in getting a viable plan for a diversion center in Alamance County. It worked on a similar plan in Greensboro, Reuss said, giving it some good background for this project.

These kinds of diversion center are starting all over the state and country and fill a gap in our complicated healthcare system and mental healthcare in particular. Instead of the big state hospitals of the 20th Century, much mental health care comes through private mostly nonprofit providers from psychiatric practices to rehab centers.

Isaac Groves is an Alamance County watchdog reporter for the Times-News and the USA Today Network. Call or text 919-998-8039 with tips and comments or follow him on Twitter @TNIGroves.