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Wake County is experiencing another crisis in the midst of the pandemic – escalating numbers of adults and children in need of urgent care for mental health and substance use issues. As COVID continues to fuel this mounting mental health crisis, the Network for Advancing Behavioral Health (NABH) has expanded its network of clinical providers and community services to meet these growing needs and ensure access to appropriate care. 

The NABH formed in 2018 to better serve individuals with behavioral health and substance use issues. The network connects adult and pediatric patients with outpatient behavioral health and substance use providers. 

The expansion comes at a critical time, as WakeMed Emergency Departments have seen a 33 percent increase in behavioral health cases presenting with higher acuity, a 26 percent increase in patients with suicidal ideation (suicidal thoughts/ideas), and a 68 percent increase in overdose cases.     

“Most people who are experiencing a mental health or substance use crisis go to their local emergency room for help because they simply do not know where to go,” explains Tom Klatt, executive director, WakeMed Behavioral Health Network. “Our hospitals, which are acute, medical facilities, are not staffed and equipped to provide the right care for these patients,” adds Klatt. “In many cases, people can find the timely, specialty mental health crisis services they need without a trip to the hospital.”

The NABH member organizations ARE equipped and staffed to provide timely, appropriate care for people experiencing a non-life-threatening behavioral health or substance use crisis – and prevent future issues in the face of the pandemic and beyond.  

The newest members of the NABH – Hope Services, Easter Seals, Fernandez Community Center, Fellowship Health, Daymark Recovery Services, Sigma Health Services, Eleanor Health, Morse Clinic, Carter Clinic, Triangle Springs IOP/PHP and Holly Hill’s Pines Outpatient Program – join current members – Carolina Outreach, MindPath Care Centers, Monarch, RHA Health Services, SouthLight and Yelverton’s Enrichment Services. The network works brings together urgent care and ongoing services to help people navigate behavioral health and substance use crises. 

“Based upon need, behavioral health and crisis services can be provided in a variety of settings to include home, office, mobile/community, or residential settings. This flexibility, along with the expanded network of practitioners to address the growing behavioral health needs and the pandemic-induced demand for workers, will enhance our ability to provide rapid services and quality care to individuals and families in the Triangle area,” says Sean Blair, chair, NABH Board of Managers.

Patients in the midst of a behavioral health or substance use crisis who come to a WakeMed Emergency Department will be evaluated and receive any needed medical treatment. Members of the WakeMed Behavioral Services team can then connect qualifying patients with the right community behavioral health provider (the NABH network). WakeMed Transitional Care team members then support the patient through their first and second outpatient appointments as they become established with their provider.

“From a clinical efficiency standpoint, connecting individuals to the right behavioral health services in a timely manner can help lower medical costs and free up limited resources at a time when hospitals are busier than ever,” says WakeMed’s Tom Klatt. “More importantly, it’s the right thing to do for people who desperately need a type of specialty care that is not available in the acute care setting.” 

Studies indicate that people use medical services 90 percent less frequently after receiving and connecting to appropriate mental health care.

Network for Advancing Behavioral Health (NABH) 

The NABH is a wholly owned behavioral health network that employs a shared governance model with its participating members. The NABH is considered a ONEcare model, as developed by Blaze Advisors. It is an integrated model of care deployed by a network of primary care, hospital and behavioral health providers that coordinates early disease identification, communication, priority access to care and build the all-important trust between patients and their care team.  

About WakeMed Health & Hospitals 

Serving the community since 1961, WakeMed is a not-for-profit health care system founded and based in Raleigh, N.C. WakeMed exists to improve the health and well-being of our community by providing outstanding and compassionate care to all. WakeMed’s 976-bed system comprises a network of facilities throughout the Triangle area, including three full-service hospitals, seven emergency departments, a dedicated Children’s Hospital and Rehabilitation Hospital, more than 80 physician offices and Wake County’s only Level I Trauma Center. WakeMed’s mission-driven team includes more than 10,000 employees, 1,500 volunteers and 1,300 affiliated physicians, along with the more than 580 physicians and providers with WakeMed Physician Practices – all representing the best minds and the biggest hearts and the finest quality in health care and community health. For more information, visit www.wakemed.org or follow WakeMed on Facebook, Twitter and Instagram.

Community partnerships could address mental health care lack-of-access issues, writes Sean Blair, Chief Growth Officer of ncgCARE, a behavioral health care organization with provider agencies in North Carolina, Virginia, Georgia, and West Virginia.

According to the America’s Mental Health 2018 report and overview, “Lack of access is the root cause for the mental health crisis in America.” What could be a key to unlocking this access issue and, in turn, impact the behavioral health of the country? In short: partnerships between hospitals and the communities they serve.

WakeMed Health and Hospitals, with the consultative assistance of Blaze Advisors, has addressed the issue by formulating the WakeMed Behavioral Health Network (WMBHN). The group, consisting of over 30 high-quality behavioral health care organizations in the Raleigh, NC, area, provides an array of inpatient, outpatient, community-based, and social determinants of health services.

Over the four years of the WMBHN’s existence, these community partnerships have greatly enhanced behavioral health access. Patients that go through the WakeMed health system now receive needed mental health and/or substance abuse disorder services quickly and easily due to the close network of providers. As a result, individuals’ overall health has improved faster, more significantly, and more sustainably, leading to a decrease in hospital readmissions and an increase in quality of life.

Why do community partnerships such as these work? From the behavioral health provider perspective of ncgCARE, the parent organization for a network of eight behavioral health care providers, we know clients are most likely to seek services if the following is true:

• They know where to go for help.
• Services are convenient.
• Services are confidential and of high quality.
• Treatment can start quickly.
• Services are not costly.
• The client trusts the professional who refers them.

So what are the steps to meeting the needs of these “ifs”? We’ve found the following formula to work:

• Hospital and community partnerships help overcome those “ifs” by establishing a solid referral structure. A partnership could easily satisfy the first three “ifs” above because the network’s construction would include quality agencies that provide a variety of services in a geographically appropriate area.
• Once the structure is in place, the network needs an understanding around metrics and accountability measures to assure that referrals are handled in an expedited manner so that services start quickly. A good use of technology aids in the critical component of communication, which keeps the process running smoothly.
• The final “if” relies on physicians. Trust is a fundamental aspect of the patient-physician relationship. Most individuals trust their doctors’ advice and are more likely to follow through with recommended behavioral health appointments. WakeMed did indeed experience an increase in patient show-up rates, as well as a 64% reduction of ‘days in waiting’ for patients to get the care they need.