As more mental health crisis centers open across the state, here’s what you need to know
By Taylor Knopf
Last month, the state health department announced $13 million in funding to open four new community mental health crisis facilities in Lenoir, New Hanover and Pitt counties by the end of the year.
This is one of a flurry of new mental health initiative announcements from the state Department of Health and Human Services that have come as a result of a $835 million investment for behavioral health needs included in the 2023 state budget. This massive influx of cash was made possible due to a $1.4 billion sign-on bonus delivered by the federal government after North Carolina expanded Medicaid.
Of this historic investment, state lawmakers allocated $80 million over two years to bolster the state’s mental health crisis services. Those services include new mobile crisis teams that travel to people in acute need, as well as fixed sites where people can go when they need mental health evaluations and support. These are alternatives to emergency departments, where people have historically gone when experiencing mental distress.
As more mental health crisis services become available, Kelly Crosbie, director of the DHHS Division of Mental Health, Developmental Disabilities and Substance Use Services, recently held a live tele-town hall to explain who these services are for and how to access them.
“Everybody needs access to mental health support and services, and everybody deserves that access, but we know it can be a challenge for many,” Crosbie said. “For reasons [such as] stigma, because of anxiety about reaching out, and sometimes our system is really confusing and you don’t really know where to go.”
What’s a mental health crisis?
A mental health crisis can look many different ways, and Crosbie encouraged town hall listeners by saying “there is no wrong reason to reach out.”
“Crisis means different things to different people,” she said. “So when we say crisis services, we’re talking about something that is private and compassionate. It’s support for people who may feel like life is out of control or overwhelming or you’re hitting your breaking point.
“It’s very personal, and I want you to know that help is here.”
There’s an array of signs leading up to a mental health crisis that may signal it’s time to reach out for support, explained Joy Brunson-Nsubuga, chief operating officer with crisis services provider Recovery Innovations.
“So some of those could be feeling lower than we have felt before. Having lower energy. Not being able to get up and move around and really engage as we have typically engaged before: socially, at work or with our families,” she said during the town hall meeting. “Another sign can be a negative self-talk, talking down about ourselves, feeling kind of low about ourselves.”
An increased use of substances such as drugs or alcohol, or starting to use a substance to cope with something in someone’s life, could be a sign to reach out to crisis support, Brunson-Nsubuga said.
“It could be stepping away from family and friends. It could be doing more kinds of risky behaviors,” she added. “It could even be just feeling tired and having more sleep or having trouble sleeping. Everyone’s situation is really unique and different.”
What crisis services are available in North Carolina
Someone to call
For those seeking help, a simple first step is to call or text or chat with a crisis counselor through the 988 suicide and crisis lifeline. The line is available 24/7 anywhere in the United States, and a trained counselor can connect callers to resources or just listen and provide emotional support. 988 has options for Spanish-speaking callers or those who are deaf or hard of hearing. The crisis line has additional support for young people, military members and veterans as well as those in the LGBTQ+ community.
“There’s no wrong reason to call,” Crosbie said. “A lot of our callers are just seeking help or have questions about their families, and that’s OK.”
North Carolina also has a Peer Warmline, a noncrisis mental health support line staffed by peer support specialists — people living in recovery from mental health problems who may have also experienced substance use, psychiatric hospitalization, homelessness, incarceration or a combination of those factors. People with a history of mental illness sometimes prefer talking with people they feel they can relate to, who may have had similar experiences.
Callers can reach North Carolina’s 24/7 Peer Warmline at 1-855-PEERS-NC (1-855-733-7762). The 988 call center also connects callers to the Warmline by request.
Somewhere to go
There are two types of places you can go if you or a loved one is experiencing a mental health crisis: behavioral health urgent care or a facility-based crisis center.
A behavioral health urgent care is similar to the way one might think of a medical urgent care, Crosbie explained. If someone is having mental health or substance use concerns, a behavioral health urgent care is a place where someone can walk in and receive an evaluation. The behavioral health urgent care is designed for stays no longer than 24 hours. If a patient needs support beyond that, the urgent care workers can help with next steps.
A facility-based crisis center is a place for patients who may need to stay for up to seven days.
“These are places where if you don’t feel well or you feel out of control, you can actually stay for longer,” Crosbie explained. “They’re somewhat like a little mini-hospital. There are places where there’s going to be a doctor, a nurse, mental health clinicians, peers — and you might need to stay there for two days, sometimes seven days. […] It’s a good place to go so you’re not going to the emergency room or to the hospital.”
To find a mental health urgent care or crisis center near you, the N.C. Department of Health and Human Services website has a search tool [linked here].
North Carolina has also started investing in a unique mental health support model called peer-run respite centers. These home-like facilities give people who are having emotional issues the opportunity to spend time in a nonclinical therapeutic environment while receiving support from peer support specialists.
“If you were to go by any of our peer-run respites, you wouldn’t know that it’s a crisis environment, because it’s literally a house in a neighborhood,” said Cherene Caraco, director of Promise Resource Network, a mental health nonprofit based in Charlotte. Her organization started and runs peer respite houses in Charlotte and in Raleigh, as well as the Peer Warmline. With state funding, Promise Resource Network will open its third peer respite center in Cabarrus County later this year. There is a fourth peer respite in Asheville operated by Sunrise.
Caraco explained to the town hall audience that a respite house is an alternative for those who just want a connection to somebody who shares their experience without the fear of losing their autonomy and rights during an involuntary hospitalization. “We feel that a lot of what lands us in mental health crises are actually a lot of traumas that we’re experiencing in our lives,” she said.
“We are there to support people, to kind of explore what is going on and what the meaning of that crisis is,” Caraco said. “We center everything on healing and connection.”
Someone to come to you
North Carolina also has mobile crisis units across the state that can meet someone wherever they are. The mobile crisis units consist of specialized teams of licensed behavioral health providers. Crosbie said the state is also working toward including peer support specialists on these teams.
“So they can come to your home. It is private. It’s not an ambulance. It’s not law enforcement. They can quietly come to you in their own vehicle or their agency vehicle,” Crosbie said. “Their job is to help you manage the crisis, to help your family, to provide education, to make sure you get connected to services and supports. And even if you need to go to a behavioral health urgent care, they’ll help you get to one.
“It’s good to have someone come to you.”
To find your local mobile crisis team, the N.C. Department of Health and Human Services website has a search tool [linked here], or search in the box below. You can also call 988 and ask for a mobile crisis team to be sent to you.
How much do crisis services cost?
All of these mental health crisis services are free to North Carolinians, even for people without insurance.
In 2023, state lawmakers allocated $835 million to expand behavioral health services in the state. There are other county and state dollars to support these as well.
“If you happen to have Medicaid, Medicaid does reimburse for these services,” Crosbie said, “which is really exciting.”
“We all worry about the cost of health care,” she added. “We never want folks to hold back or not go seek help for a mental health crisis because they’re worried about cost. So our crisis services in North Carolina — they are free.”
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