
{"id":4400,"date":"2008-12-31T14:19:34","date_gmt":"2008-12-31T22:19:34","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=4400"},"modified":"2011-12-15T13:05:55","modified_gmt":"2011-12-15T18:05:55","slug":"breakdown-amid-the-doom-and-gloom-positive-developments-in-orange-county","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2008\/12\/31\/breakdown-amid-the-doom-and-gloom-positive-developments-in-orange-county\/","title":{"rendered":"Breakdown: Amid the doom and gloom, positive developments in Orange County"},"content":{"rendered":"<p><em>Following is the final story in our <a href=\"http:\/\/www.carrborocitizen.com\/main\/2008\/10\/04\/breakdown-series\/\">Breakdown series<\/a> on mental health care in North Carolina.<\/em><\/p>\n<p><strong>by Taylor Sisk<\/strong><br \/>\n<em>Staff Writer<\/em><\/p>\n<p>Buried in the deluge of news about our state\u00e2\u20ac\u2122s collapsing mental health care system are reports of at least two encouraging developments in Orange County, each the sort of community-based response that local advocates say is the only way out of the crisis.<\/p>\n<p>The first is at Carrboro\u00e2\u20ac\u2122s Carr Mill Mall, where the UNC Department of Psychiatry has opened a community mental health clinic to house its Schizophrenia Treatment and Evaluation Program (STEP) Clinic and the clinic\u00e2\u20ac\u2122s Outreach and Support Intervention Services (OASIS) program. OASIS provides help to adolescents and young adults who are experiencing, or are at risk of experiencing, early psychosis. <\/p>\n<p>The second comes from the Town of Chapel Hill, where Mayor Kevin Foy has convened a Mental Health Task Force, comprised of advocates from the community, local government and UNC. <!--more--><\/p>\n<p><strong><br \/>\nCommunity based<\/strong><\/p>\n<p>John Gilmore, vice chair of the UNC Department of Psychiatry, envisioned a community clinic that would provide services for people with severe and persistent mental illness. Thanks to $100,000 from the state\u00e2\u20ac\u2122s Mental Health Trust Fund, $400,000 from the state Legislature and, most recently, a $900,000 grant from the Duke Endowment, that vision has now become a reality. <\/p>\n<p>The clinic is located on the second floor of Carr Mill Mall and will be called the UNC Center of Excellence for Community Mental Health. Gilmore\u00e2\u20ac\u2122s long-term goal is to provide comprehensive services to the community, utilizing university resources from the departments of psychiatry and psychology, the schools of social work and nursing and the rehabilitation counseling program.<\/p>\n<p>The clinic will initially be staffed by two full-time social workers and a part-time psychiatrist and psychologist from the university. Students will also work in the program, thereby gaining real-world experience. <\/p>\n<p>\u00e2\u20ac\u0153One of the main goals,\u00e2\u20ac\u009d says Gilmore, \u00e2\u20ac\u0153is to develop an interdisciplinary training program in community mental health. We hope to develop evidence-based practices and then go out across the state to train practitioners.\u00e2\u20ac\u009d<\/p>\n<p>While initially focusing on schizophrenia and psychotic disorders, Gilmore says, \u00e2\u20ac\u0153We\u00e2\u20ac\u2122re going to do the best that we can to see as many people as we can. We\u00e2\u20ac\u2122ll take all comers at this point.\u00e2\u20ac\u009d<\/p>\n<p>The OASIS program has moved from offices near University Mall to Carr Mill Mall and has been offering services at Carr Mill for about a month. The STEP Clinic is due to open soon after the first of the year.<\/p>\n<p><strong>Nowhere to go <\/strong><\/p>\n<p>Gilmore is also serving on Chapel Hill Mayor Foy\u00e2\u20ac\u2122s Mental Health Task Force.<\/p>\n<p>\u00e2\u20ac\u0153I think it\u00e2\u20ac\u2122s a good group,\u00e2\u20ac\u009d Gilmore says. \u00e2\u20ac\u0153Many of the important players in the community are there. The charge is a good one.\u00e2\u20ac\u009d<\/p>\n<p>That charge is to identify the impact on the community of \u00e2\u20ac\u0153changes in the mental health service delivery system \u00e2\u20ac\u00a6 create awareness and generate discussion about the mental health service system\u00e2\u20ac\u009d and then \u00e2\u20ac\u0153make recommendations for the future.\u00e2\u20ac\u009d<\/p>\n<p>The task force is chaired by Dr. Natalie Ammarell, a longtime consultant in the delivery of human services and former president of the Inter-Faith Council. While at IFC, Ammarell began discussions with Foy about the way mental illness affects the entire community, in particular with regard to homelessness.<\/p>\n<p>Former county Commissioner Margaret Brown has also shared her concerns about the relationship between mental illness and homelessness with Foy, and encouraged him to form a task force. <\/p>\n<p>Mental health reform in North Carolina was initiated in 2001, with a mandate to move the mentally ill out of state institutions and into community-based services delivered by private providers. But community-based services were never sufficiently funded. Without adequate community services, state institutions have become so overcrowded that stays are generally limited to a few days, regardless of a patient\u00e2\u20ac\u2122s needs. <\/p>\n<p>Brown recognized early on that the premature release of mental patients from UNC Hospitals into a community with very limited options for care was bound to exacerbate the county\u00e2\u20ac\u2122s homeless problem. <\/p>\n<p>\u00e2\u20ac\u0153When you start ending these programs and dumping all these people out, where are they going to go?\u00e2\u20ac\u009d Brown asks. \u00e2\u20ac\u0153The only places to go are to the emergency room [or] on the street. <\/p>\n<p>\u00e2\u20ac\u0153So I went to Kevin Foy and said, \u00e2\u20ac\u02dcKevin, why don\u00e2\u20ac\u2122t you pull together a  meeting of the head of psychiatry and the chancellor and some other people, and let\u00e2\u20ac\u2122s sit down and talk about mental health reform and the impact it\u00e2\u20ac\u2122s going to have on the town of Chapel Hill.<\/p>\n<p>\u00e2\u20ac\u0153Let\u00e2\u20ac\u2122s anticipate the impact and see if we can\u00e2\u20ac\u2122t brainstorm.\u00e2\u20ac\u009d<\/p>\n<p>Ammarell agrees with Gilmore that Foy\u00e2\u20ac\u2122s task force represents diverse perspectives on mental health issues in Orange County, but stresses the importance of continually hearing from other voices, particularly of the consumers of mental health care services. <\/p>\n<p>\u00e2\u20ac\u0153My goal is to get lots of perspectives at the table,\u00e2\u20ac\u009d says Ammarell, \u00e2\u20ac\u0153but to keep it a manageable size.\u00e2\u20ac\u009d<\/p>\n<p>She also stresses that while the task force has been formed in Chapel Hill, its mandate is to address the needs of the entire county, \u00e2\u20ac\u0153because everyone is affected.\u00e2\u20ac\u009d In recognition of that mandate, the task force includes Gwen Harvey, Orange County\u00e2\u20ac\u2122s assistant county manager.<\/p>\n<p>Ultimately, Ammarell says, \u00e2\u20ac\u0153The goal is to look at how our work can reach beyond Orange County. The mayor is already looking into that.\u00e2\u20ac\u009d <\/p>\n<p>\u00e2\u20ac\u0153The fact that all of these key stakeholders are coming together to dialogue and strategize is positive,\u00e2\u20ac\u009d Mark Sullivan, task force member and executive director of the Orange County Mental Health Association, writes in an email reply. <\/p>\n<p>\u00e2\u20ac\u0153The issues that we are facing are the results of state policy that we do not have much influence over, and the economic landscape makes things more challenging. <\/p>\n<p>\u00e2\u20ac\u0153However, I am hopeful that we can overcome some of the turf issues that are problematic and that we can begin to take responsibility for our community as a community.\u00e2\u20ac\u009d<\/p>\n<p><strong>\u00e2\u20ac\u02dcDown and dirty\u00e2\u20ac\u2122 <\/strong><\/p>\n<p>Chapel Hill psychiatrist Clay Whitehead was another early task force advocate, and is now one of the 15 members. <\/p>\n<p>\u00e2\u20ac\u0153The number-one objective I have is trying to get people aware of the problem,\u00e2\u20ac\u009d says Whitehead.<\/p>\n<p>His second objective is to \u00e2\u20ac\u0153open the possibility of a community renewal\u00e2\u20ac\u009d built on an understanding of the depths of the problem, and to \u00e2\u20ac\u0153do something creative and benevolent\u00e2\u20ac\u009d to address that problem. <\/p>\n<p>It just makes sense to use local talent and resources, and locally generated funds, to solve a local problem, Whitehead says. Stressing the importance of the university\u00e2\u20ac\u2122s involvement, he sees the opening of the UNC Center of Excellence for Community Mental Health as exactly the sort of initiative that can begin to address this crisis. <\/p>\n<p>Whitehead says we could create a model program, but it should not be approached as \u00e2\u20ac\u0153some rarified research kind of enterprise.\u00e2\u20ac\u009d <\/p>\n<p>While \u00e2\u20ac\u0153the \u00e2\u20ac\u02dcgreat institution on the hill\u00e2\u20ac\u2122 can offer a great deal\u00e2\u20ac\u009d in terms of best-practice and administrative models, he says, \u00e2\u20ac\u0153We\u00e2\u20ac\u2122re talking down and dirty here. We\u00e2\u20ac\u2122ve got to get out there and take care of people.\u00e2\u20ac\u009d<\/p>\n<p><strong>Beginning anew<\/strong><\/p>\n<p>Newspaper accounts depict a broken mental health care system in North Carolina. But for many advocates, including Margaret Brown and Clay Whitehead, there is no \u00e2\u20ac\u0153system\u00e2\u20ac\u009d at all. Reassembling a network that worked relatively well four decades ago isn\u00e2\u20ac\u2122t an option.<\/p>\n<p>\u00e2\u20ac\u0153There\u00e2\u20ac\u2122s nothing to knit back together,\u00e2\u20ac\u009d says Brown. Building anew, she urges, must begin at the community level, and the university\u00e2\u20ac\u2122s involvement is critical.<\/p>\n<p>She stresses that the town must show leadership, and says she has faith in Foy.<\/p>\n<p>\u00e2\u20ac\u0153Kevin is the only person of leadership in this community that I can see that could pull this together,\u00e2\u20ac\u009d she says. <\/p>\n<p>She believes Foy understands the issues and potential repercussions, and is uniquely positioned, as mayor of Chapel Hill, to urge the university to commit its considerable resources. <\/p>\n<p>Ignoring this crisis, says Whitehead, is clearly no longer an option. He believes spreading awareness should be the first objective of any local initiative.<\/p>\n<p>\u00e2\u20ac\u0153Everyday you see something in the paper about how another clinic is closing up,\u00e2\u20ac\u009d he says, while yet another state official urges us to be patient with reform.<\/p>\n<p>\u00e2\u20ac\u0153What excites me,\u00e2\u20ac\u009d Whitehead says, \u00e2\u20ac\u0153is that a few people here have perceived that this is not such a great situation, and are trying to figure out what can be done.\u00e2\u20ac\u009d <\/p>\n<p>Are we as a nation any closer to recognizing that we have a mental health care crisis, and that mental illness is as critical as any other serious illness?<\/p>\n<p>\u00e2\u20ac\u0153I think there are more people that know this,\u00e2\u20ac\u009d Whitehead says. \u00e2\u20ac\u0153But it\u00e2\u20ac\u2122s still very much stigmatized. We\u00e2\u20ac\u2122re in denial.\u00e2\u20ac\u009d<\/p>\n<p>He believes though that with a creative approach here in Orange County, \u00e2\u20ac\u0153We might be able to illustrate how a local community can tackle and resolve this problem.\u00e2\u20ac\u009d<\/p>\n<p>Whitehead acknowledges that the task ahead is daunting, particularly within the current economic climate. <\/p>\n<p>But, he says, \u00e2\u20ac\u0153When people start to think \u00e2\u20ac\u201c and they are now starting to think \u00e2\u20ac\u201c they\u00e2\u20ac\u2122re going to realize that we\u00e2\u20ac\u2122ve got a serious problem in this country,\u00e2\u20ac\u009d and that we must chart a path for providing \u00e2\u20ac\u0153the greatest good for the greatest number.\u00e2\u20ac\u009d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Following is the final story in our Breakdown series on mental health care in North Carolina. by Taylor Sisk Staff Writer Buried in the deluge of news about our state\u00e2\u20ac\u2122s collapsing mental health care system are reports of at least two encouraging developments in Orange County, each the sort of community-based response that local advocates&#8230;<\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4400","post","type-post","status-publish","format-standard","hentry","category-miscellany"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/4400","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=4400"}],"version-history":[{"count":6,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/4400\/revisions"}],"predecessor-version":[{"id":22464,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/4400\/revisions\/22464"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=4400"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=4400"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=4400"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}