By Taylor Knopf
Later this month, a new 54-bed youth psychiatric hospital in Butner will open its doors to help North Carolina’s children and teens struggling with mental health issues.
The UNC Hospitals Youth Behavioral Health facility will include specialized units for patients with co-occurring mental health and substance use disorders, as well as a unit dedicated to serving children with intellectual and developmental disabilities with mental health needs.
Additionally, hospital leadership say they intend to take a whole-family approach to treatment and will offer family therapy services.
Over the past year, UNC Health and the N.C. Department of Health and Human Services has repurposed and renovated a former state-run substance use treatment facility to serve the growing number of adolescents showing up at emergency rooms across the state in mental distress.
“It was just in December, when we announced this opportunity. And here we are less than a year later about to cut a ribbon. … That is wild fast,” DHHS Secretary Kody Kinsley said. “It is also in recognition of the great need that our state has.”
During the pandemic, hospital emergency staff across the state reported record numbers of children in need of mental health support, at times tripling pre-pandemic levels.
“Truly, the mental health of our children and adolescents is the most pressing issue for our state and its future health,” said Wesley Burks, CEO of UNC Health and dean of UNC School of Medicine, at a ribbon cutting ceremony for the new facility on Tuesday.
“It was a problem way before the pandemic started. But during the pandemic and now, it really has reached dire levels,” he said. “Today is only a first step in what we need to do to address these issues.”
While health experts and families agree that the E.R. isn’t the safest or best place for kids in need of psychiatric care, it’s where many parents — often as a last resort — bring their children. And sometimes the wait for an inpatient bed can end up being weeks, particularly if a child has more complex needs, such as a disability or co-occurring substance use disorder.
The new youth psychiatric hospital hopes to offer a space designed to treat those patients.
The facility will consist of four units: a general child and adolescent unit; one for patients with more severe mental health issues; a unit for patients with co-occurring substance use and mental illness; and a unit for patients with intellectual and developmental disabilities.
There are also therapists from several disciplines working at the hospital, including music therapy, art therapy, yoga movement therapy, activities therapy, occupational therapy and child-life therapy.
“With novel approaches, integrating cutting-edge research that will have recreational therapy, art therapy, music therapy, family therapy, we will be one of the only units in North Carolina — and very few in the country — that will have a dedicated unit for children and adolescents with neuro-behavioral psychiatric issues,” said Samantha Meltzer-Brody, UNC Department of Psychiatry chair.
Music therapist Ashley Taul said because music can be a huge part of kids’ identities, it is often a great way to connect with them.
“They get their phones taken away and their music taken away, so to be able to offer some sort of normalcy to these kids is really important,” Taul said, a guitar slung over her shoulder. “So I do a lot of music listening interventions. We’ll play some drums. We’ll do songwriting. We’ll do music listening. I love doing a good lyric discussion. All these different kinds of things you can work on through music.”
Occupational therapy is also part of every unit, with one-to-one and group sessions. The units have a “quiet room” filled with tools like fidget devices, rocking chairs, weighted blankets and noise canceling headphones. If a patient is feeling overwhelmed or struggling to regulate their body and emotions, the tools in these rooms are designed to help them cope.
Tyler Harrell, an occupational therapist and therapy supervisor at the hospital, said ideally patients will learn to recognize when they need these interventions and request them. Harrell came to the new facility from the state-run psychiatric hospital across the street, Central Regional. Before that he worked with children with autism in Wake County public schools.
He said he’s looking forward to the opening of the unit for kids with intellectual and developmental disabilities, adding that it will be the last to open due to the increased training those staff will receive and some of the unique sensory equipment the hospital plans to install on the unit. These are the patients who tend to wait in emergency departments the longest for inpatient psychiatric beds because health professionals in many facilities don’t have the skills or training to help them, he added.
“I’m really happy that we’re filling a gap and kind of filling the need,” Harrell said.
The family-integration piece will also be huge for this population, he said. He added that the child-life specialists will be working with parents and siblings to ensure that each child has the best possible transition home after hospitalization.
A promise to families
Over years of reporting on mental health issues, NC Health News reporters have often heard from families of children in crisis who feel as though they’re cut out of the treatment process.
Parents of children in inpatient psychiatric facilities have often said they want to be more involved and know what’s going on with their child’s care. Many have said they don’t feel as though they have a good plan for support and continued recovery when their child comes home from the hospital.
Leaders of the new youth psychiatric hospital promise to instead take a whole-family approach to treatment.
“It’s the individual and the parents that suffer terribly when they can’t get care. And that weighs very heavily on all of us,” Meltzer-Brody said. “We have taken great strides here to ensure family members will play a vital role in the treatment.”
The new facility will also include virtual and in-person family therapy, she said.
“So that every child has the best opportunity to return home safely, that their family is part of the treatment plan and that they can get better as quickly as possible,” Meltzer-Brody added. “To our families — we want you to be able to trust us that we will care deeply and safely for your child so they can learn critical coping skills and recover in a sustained way so they can return home to you and move forward for a bright future.”
UNC child psychiatrist Jim Bedford said family involvement during treatment and during the hospital discharge process is vital for a child’s mental health recovery.
“One of the things that can make an inpatient stay the most meaningful is if the rest of the community-based [mental health] system rallies around the child and says, ‘This child has tremendous support needs and and we need to reach out to the child and family and offer more resources when they come out of the hospital,’” he said.
“That helps to make it the forward path toward a sustained recovery and prevent rehospitalization.”
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