Mental health service providers face challenges

Article printed in the Jacksonville Daily News
By Amanda Thames
Posted: Jan 23, 2017 at 12:01 AM

Getting help for a mental illness means knowing where to go — and having the courage to do so.

RHA Health Services, Le’Chris, Integrated Family Services, and Onslow Memorial Hospital offer mental health services in Onslow County, but none of them are long-term treatment facilities. For that, these agencies have to send people outside of the county.

Unlike with other health problems, those with a mental illness tend to shy away from treatment, RHA Regional Director Molly Daughtry said.

“A lot of people think that having a mental health illness is a weakness,” she said.

There’s a stigma, she continued, as if mental health is looked at as not being “normal.” RHA Program Manager Tee West agreed and said many believe there’s something wrong with them if they seek help.

“I think there’s a little bit of fear, too,” West said.

Provider challenges

But for those who do seek assistance, a lack of resources makes it difficult to provide long-term care for some patients, Clinical Neuropsychologist Tobi Gilbert said.

Gilbert, behavioral health consultant for Onslow Memorial Hospital, said often due to the limited amount of beds available, psychiatric hospitals will only take in individuals who are involuntarily committed because they’re seen as having the higher need.

In-patient psychological help is not what it used to be, Gilbert continued. Insurance companies used to cover a lot of mental health treatment, but with changes in mental health in recent years Gilbert said it “puts a damper” on getting treatment.

“Insurance companies might only pay for a certain length of time,” she said.

Her Onslow Memorial Hospital team also has challenges with people who have both a mental illness and substance abuse problem, she said.

Someone who is admitted to the Emergency Department while intoxicated may be unable to control their emotions under the influence, but they sober up the next day and deny having any problems, Gilbert said. At that point, the hospital has no choice but to discharge them. If it’s a patient they see often, Gilbert said the hospital tries to intervene but there’s only so much they can do.

Families also bring their loved ones in for treatment for mental illness, but Gilbert said psychiatric hospitals require the patient to go to a treatment center if there’s a substance abuse problem and detox before they’re allowed to be admitted. The substance abuse treatment centers want to do interviews, and the patient may refuse treatment. There is no involuntary commitment at substance abuse treatment centers, she added.

“Our hands are tied,” Gilbert said. “It’s incredibly frustrating for the families and for us.”

Onslow Memorial Hospital

Not knowing where else to turn, many people find themselves in the Emergency Department at Onslow Memorial Hospital, Gilbert said.

The hospital, located at 317 Western Blvd. in Jacksonville, needs an ID and insurance card, if the patient has insurance, and they can be seen, Gilbert said. The list of the medications they take is helpful as well, but they can be looked up if forgotten.

If the patient has a provider already, that’s also helpful to note, Gilbert added.

Patients without a provider may find one after they visit the Emergency Department, she continued. One of the goals at OMH, like with RHA, is referrals. They find providers who take the patient’s insurance or who offer assistance without insurance and refer them there.

For those who need long-term services, they’re often sent out of the county. Some people are referred to Brynn Marr, but because it is a privately-owned facility, patients needs insurance, children’s Medicaid or the money to pay for their care, Gilbert said.

Brynn Marr offers services to children and adolescents with severe emotional, mental, and substance abuse problems as well as developmental disabilities, according to their website. The hospital also offers help to adults struggling with severe depression, chronic mental illness, and suicidal or homicidal thoughts.

They accept referrals from mental health providers, families, physicians, hospitals, and managed care providers, according to their website, and accept most major insurance and managed care plans, Tricare, Medicare, and Medicaid for people under the age of 21.

Brynn Marr representatives did not return calls for more information.

RHA Health Services

From inside their offices located at 215-A Memorial Drive in Jacksonville and 3820 Suite B. Bridges St. in Morehead City; outpatient; or mobile crisis unit, RHA offers a wide array of services.

“We’ve been around for over 25 years,” Daughtry said, adding that RHA is committed to the community and proud to be part of it.

To be seen, Daughtry said patients can walk into the clinic with their ID and basic information to get an assessment or call 910-353-5118 to make an appointment. Someone 18 and older who does not consent can’t get treatment at RHA, Daughtry said.

“We can’t force them,” she added.

However, RHA will help coordinate an involuntary commitment if the person is a danger to themselves or others and do their best to persuade the person in need to let them help.

RHA then uses its assessment to determine the best course of action for the patient.

That treatment could mean medication, therapy, or a higher, more intense, level of service at an in-patient facility outside the county, Daughtry said.

The goal of RHA is to de-escalate a situation to avoid using the emergency room at the hospital.

Their out-patient services include group therapies with individual assessments and Peer Support Specialist Interventions, which are individuals who have been diagnosed with a mental illness and gone through training to help others, according to the RHA brochure.

For someone who needs immediate help in a crisis, RHA has offered a mobile crisis unit for about eight years, Daughtry said. The unit is called to action in Onslow County four-to-six times a day on average.

There are no barriers with money or insurance for the unit, she said — they just want to help.

Once the crisis has been contained, the unit staff will either make an appointment for the individual at RHA or to another agency for continued care, West said.

The only information necessary for treatment with the mobile unit is the name, address, age, and phone number. Although guardianship information is necessary for an appointment or walk-in, if a patient is under 18 and needs immediate assistance a verbal authorization will work during a crisis, Daughtry said, and they’ll follow up later.

The mobile unit is available all day every day by calling 844-709-4097.

In-home services are also offered and include therapy, caregivers working on problem-solving and crisis management skills, individual and family counseling, and strategies to help prevent a future crisis, according to their brochure.

With RHA, payment options include private insurance, Medicaid, Medicare, and state funding for those eligible.

Le’Chris Counseling Services

There’s been a downsizing recently at Le’Chris Counseling Services, said Therapist Elizabeth Negron.

A lot of people thought they didn’t exist anymore, she said. She didn’t know exactly why Le’Chris downsized but thought it may have something to do with getting a smaller building or finances.

The agency used to have a program tailored to adults with mental illnesses but the Jacksonville building became a satellite office of sorts for the Morehead City location after downsizing, she said.

Now, they only offer assessments and intensive in-home treatments for children and teenagers with mental illnesses.

“We really try to teach (kids) the skills they need … to regulate their own emotions,” Negron said.

Adults can be transported to the Morehead City location from the Jacksonville Le’Chris building at 2444 Commerce Road, she said.

Parents will need a copy of their child’s insurance card and a list of current medications taken when they come to Le’Chris, Negron said. It’s also helpful to bring any information that would be helpful to an assessment, like past evaluations and Individualized Education Plans (IEPs) from school.

Their Intensive In-Home team accepts Medicaid patients and provides 24/7 crisis intervention services to active clients, Negron said.

The in-home service usually lasts about six-to-nine months and includes a three-person team coming into the patient’s home up to five times per week to work with them and their parents, according to a brochure from Negron.

The goal, according to the brochure, is to help with crisis response, parenting skills, reduce mental health symptoms, anger management, and more.

The other Le’Chris offices offer intensive in-home services, as well as other services such as outpatient therapy and community based support team services, medication management, psychosocial rehabilitation services, and day treatment programs, she added.

Negron directed callers to the Le’Chris 24/7 crisis line at 1-866-321-8452.

Integrated Family Services

RHA doesn’t provide the only mobile crisis units in Onslow County.

Integrated Family Services, or IFS, began offering a mobile crisis team in Onslow County on Aug. 1, said Supervisor Tracy Hyde.

The team had already assisted 128 people by mid-December, Hyde added.

When a call comes in, a person screens the call and, if appropriate, sends the team out to assist, Hyde said. The team goes to wherever the client is and helps with mental health issues, developmental disabilities, and drug abuse.

It’s immediate face-to-face help.

An assessment is made, including determining if a risk of suicide or homicide is evident, and the unit attempts to de-escalate the situation before creating a long-term plan and linking the patient with the best resources to help, Hyde said.

“We’re here,” Hyde said. “We’re more than willing to help.”

IFS stays involved with the client until a resource is located, she said. In-patient treatment is avoided unless necessary. The focus is on keeping them safe at home.

“That’s definitely our goal,” Hyde said.

If in-patient treatment is needed, IFS creates a direct admission referral for a hospital, like Brynn Marr or Onslow Memorial. Most often, Hyde said, people are taken to the Emergency Department at OMH.

After a person is safe and has a treatment plan in place, they don’t need to worry about money.

“We do not ever send our clients a bill,” Hyde said.

The state-paid agency doesn’t turn people away for lack of insurance or an insurance that doesn’t cover the services they offer, Hyde said.

Hyde encouraged anyone experiencing a crisis to call the hotline at 1-866-437-1821 for help.

IFS has been able to divert quite a few people from the hospital with their services, Hyde said. Many times just knowing a plan has been created and help is coming relieves the anxiety and stress that caused the crisis in the first place.

“We hope we can continue to reach out to the community to let them know we’re here,” she said.

Why it matters

When it comes to long-term mental health treatment in Onslow County there aren’t a lot of options – but there is a significant need.

Officials in law enforcement and medical fields note that most of the places available locally to address mental health are only able to refer patients in need of more intensive care elsewhere.

A level of access that isn’t always enough .

The number of people in Onslow County who died from mental and behavioral disorders had been above 40 since 2012, but 2015 marks the year with the lowest number of deaths – 32 – from mental and behavioral disorders since 2007. That’s still 32 too many.

Immediate help available locally for mental health concerns

Although Onslow County does not offer intensive mental health services, local agencies are able to refer patients elsewhere. To find out more about getting mental health help, visit or call the following Onslow County locations:

– RHA Health Services, located at 215 Memorial Drive in Jacksonville, can be reached at 910-353-5118. Their mobile crisis unit is available 24/7 for emergencies and can be reached by calling 1-844-709-4097. Patients can walk in to the clinic with their ID and basic information to get an assessment or make an appointment beforehand. Someone 18 and older who does not consent can’t get treatment at RHA, but providers there will work with the patient to convince them to be seen or help the families have an individual involuntarily committed if needed.

– The Emergency Room at Onslow Memorial Hospital, located at 317 Western Blvd. in Jacksonville, can be reached at 910-577-2240 and is open 24/7. To be seen patients need to bring an ID and insurance card, if they have it. The list of the medications they take and any provider if they have one is helpful as well, but can be looked up if forgotten.

– Brynn Marr Hospital, located at 192 Village Drive in Jacksonville, can be reached at 910-577-1900. Their admissions staff is available at this number 24/7. For an in-patient stay, their website suggests bringing up to three changes of comfortable clothing. Patients are not allowed to bring in clothing with straps, drawstrings, pull strings, or studs; belts; scarves; ties; clothing with drugs, alcohol, sex, or violence printed on it; tank tops; undershirts; any product with staples; sagging or transparent clothing; jewelry except wedding rings; makeup or other cosmetics; sunglasses; hats; or any hygiene or aerosol products. The website states they will provide for patients’ hygeine needs.

– Le’Chris Counseling Services, located at 2444 Commerce Road in Jacksonville, can be reached at 910-577-8200, or at their after-hours crisis line, 1-866-321-8452. To receive the in-home care, a patient must be under 21, have Medicaid or N.C. Health Choice, meet Axis I psychiatric (Diagnostic and Statistical Manual of Mental Disorders, or DSM, level meaning clinical disorders) or substance related disorder or Axis II psychiatric disorder criteria (DSM level for personality disorders and intellectual disabilities), be unable to benefit from outpatient therapy, be at risk of out-of-home placement, meet a CALOCUS level 3 (the Child and Adolescent Level of Care Utilization System level that requires more frequent contact between providers and youth, according to the American Academy of Child and Adolescent Psychiatry) or LOCUS level 3 (the Level of Care Utilization System level that requires high intensity community-based services, according to the American Association of Community Psychiatrists) or ASAM level II (the American Society of Addiction Medicine level for intensive outpatient services), and have demonstrated the need for a crisis intervention with the last 30 days, according to the brochure.

– Integrated Family Services offers a mobile crisis unit 24/7 that can be reached by calling 1-866-437-1821. Calls are screened and, when help is needed for mental health issues, developmental disabilities, or drug abuse, aid from IFS is sent immediately to address the crisis and work on referring the patient somewhere they can be helped.

Posted in Community, Mental Health, Services