Curious Chatham: For mental illness help, does Chatham – or the state – provide enough?


Last week, I spoke with Chatham County resident Ken Howard. He told me he was at a loss: his 18-year-old son Jack, whose name – like his father’s – has been changed for privacy, was soon be released from his third stint at a psychiatric facility.

The challenges Jack faces – depression, social anxiety and bipolar behavior – leave his family feeling unsafe allowing him in their home.

So, Howard has embarked on a intensive one-man research project to help his son: he estimates that he’s called 50 local resources looking for group homes, and he sent me some meticulous notes of his contacts. 

His list includes phone numbers for health insurance attorneys, faith-based housing resources, at least one outpatient facility. But it was strikeout after strikeout: 

“Wait of weeks or months.”

“No openings”

“Left message, have not heard back.”

“Never returned calls or emails”

Hopeway Residential Mental Health Service, a Charlotte-based group home in Howard’s notes, had a price tag that took my breath away: an “upfront cost base” of $26,000 for a 30 day stay in the facility.

Howard’s goal seems straightforward. He wants Jack to “learn more responsibility, accountability; be in a situation where he could grow up.” 

But the family has private health insurance through Howard’s wife’s employer, which leaves Jack ineligible for inclusion at Medicaid-only facilities. Howard is looking into government insurance solutions like Medicaid and Social Security, though he hasn’t had luck yet. 

“If you don’t have social security, Supplemental Security Income, Social Security Disability Insurance, it seems like there’s a huge hole and there’s really no options there,” he said. 

Statewide plans to expand Medicaid have been stalled over the years at the U.S. federal court, North Carolina governor’s office and the state General Assembly. 

Julie Bailey, the cofounder of a nonprofit called Josh’s Hope, says that situation blocked many young people from coverage unless they were in an emergency. 

Bailey and her husband started Josh’s Hope, a vocational skills program for young adults with mental illnesses and substance abuse, after their oldest son Josh was murdered in 2008. She believes his “lifelong mental health issues” led him into a situation of victimization and violence. 

“We always felt that Josh was in the wrong place at the wrong time, because there were not programs to support his needs,” Bailey said.

Through her work, she often hears of individuals being released from the county jail, hospitals, and residential psychiatric facilities. She says those people are united by “the need to have something to fill their days or to go into some sort of supervised living.”

But Bailey has noticed a lack of “psychiatric beds” across the state for those suffering with mental illnesses. She says the problem is related to hospital closures and changing standards for group licenses. 

Debra Henzey is Chatham County’s director of community relations. She says that North Carolina’s “mental health reform” process, which has taken shape over the last 20 years, has reduced funding and availability of treatment facilities and housing for the mentally ill and developmentally disabled. 

Chatham County’s primary walk-in mental health treatment clinic, Daymark Recovery Services, is located in Siler City. Though it receives some funding directly from the county, Henzey says the center has had difficulty surviving because Medicaid patients often choose other facilities further from Chatham County.

“Your Medicaid patients have more choices,” she said. “They can go to any provider that takes Medicaid. The people that are caught in this situation of having trouble finding facilities and services are the ones who are under-insured and uninsured.”

She called the situation “very distressing” and suggested that North Carolina’s General Assembly “provide more funding instead of cutting, cutting, cutting every year.”

According to Indy Week, the federal government would pour over $10 billion into the state if Medicaid expansion is passed.

Howard is all too familiar with the lack of resources. 

“I have had two social workers basically just tell me, “homeless shelter is the answer,” he said.

I asked him how he felt about that option. 

“That’s what it might come down to,” Howard said. “We’re in that far. And I’ve actually had a therapist tell me that the best thing – he’s actually been in jail – and that might be a better solution as well. To be back in jail.”

2 thoughts on “Curious Chatham: For mental illness help, does Chatham – or the state – provide enough?

  1. Interesting article.
    I have additional data I have obtained while trying to find a place for my brother-in-law after his current apartment in raleigh decided they will not renew his lease.

    1. He was fired from his job of 23 years (10/2018)
    2. He apartment manager decided they will not renew his lease. (May 2019)
    3. He was diagnosed with Huntingtons Disease. (June 2019)
    4. Applied for SSDI and Medicaid. (July 2019)

    Because he has no private insurance and has not been approved for Medicaid or SSDI yet, he does not qualify to rent anything anywhere. I don’t expect SSDI or Medicaid decision for several month. Once he is in the system he will qualify for a rental but the waiting list is more than a year for a decent place.

  2. I am a clinical case manager for psychiatry/mental health services, and it has been nearly impossible to locate mental health services in rural counties. In the 1980’s, I worked in an area mental health center where we provided day hospital/partial hospitalization services, giving clients day time structure and treatment, then they could return home in the evening. This provided a great stabilizing service for the clients and respite for family so family members could continue their own employment or school schedules. These day hospital programs also worked in conjunction with vocational rehabilitation services to help clients gain some basic job and employment skills. These services were great for those stabilized from an inpatient hospitalization, but not stable enough for a traditional weekly outpatient therapy session. The services addressed the needs for those with chronic mental illness, needing such support for months/years. These community-based services were developed in the era of deinstitutionalization, to release patients from long term state hospitals to their community and family, but clearly they would need ongoing daily oversight, support and treatment. It was not a perfect system, but I think a lot better then what we have now.

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