Working together to improve mental health services in Macon County

Macon County’s mental health and addiction providers are working together to better coordinate their services and strategies.

At a meeting of the county’s Mental Health Task Force, June 9 in the Robert C. Carpenter Building, representatives from roughly a dozen local organizations met to compare notes and discuss strategies on caring for Maconians’ mental health. Presided over by County Commissioner Ronnie Beale, groups ranging from healthcare providers to the county jail shared their list of services.

Following brief introductions from meeting attendees, Beale shared a list of concerns pertaining to the county’s mental healthcare infrastructure. In his time leading the task force since early 2008, Beale has identified a lack of healthcare personnel and beds as major concerns. He opened the floor to attendees to talk about the day-to-day issues they face.

Vaya Health

Vaya Health regional community relations director Shelly Foreman discussed what’s called Medicaid Transformation, a program enacted last year by the state government to consolidate patients’ mental and physical care under the same plan. Foreman said that while the consolidation means less of a hassle for patients, it also shifts responsibility for patients’ physical healthcare and pharmacy needs onto providers, which has required local providers to expand their services. She also mentioned that most of the county’s providers are in and around Franklin and Otto, leaving other areas of the county like Highlands with comparatively less.

Appalachian Regional Healthcare

After Foreman, the group heard from John Pruett, the Macon County site director for Appalachian Regional Healthcare services. Although Appalachian, like many other providers, has seen high rates of staff turnover in recent years, Pruett said he recently hired two additional therapists to bring their total to three. He also reported positive results from the company’s substance Abuse Intensive Outpatient Program.

Macon County Schools

Next, Beale turned the discussion to Macon County Schools, where Exceptional Children program specialist Cristy Passmore gave an update on the system’s in-house clinicians. While the system has been able to hire three specialists with federal Elementary and Secondary School Emergency Relief (ESSER) funding, Passmore said they have seen an increase in anxiety, suicidal ideations and struggling family systems in recent years, as well as younger and younger students being identified with mental health needs. Passmore said the expiration of ESSER funding contracts June 30 has created a significant obstacle in retaining the system’s clinicians.

WNCAP

Western North Carolina AIDS Project (WNCAP) lead harm reduction specialist Claudia Mattheiss shared their observations from recent months. They reported that the group’s Franklin office has held 4,585 patient visits through the past fiscal year including 755 unique individuals over the most recent six-month period and has successfully reversed 1,183 drug overdoses through the use of “Reversal Drugs.” WNCAP also tests patients for Hepatitis C and HIV, which can spread through used syringes, and arranges for transportation and food support for many of its clients who would otherwise lack such resources. Mattheiss said they have seen a large uptick in demand over the past three months, possibly due to the spread of fentanyl as a replacement for heroin. She also mentioned that roughly 80% of drug users show little to no physical signs of addiction, and that the majority have families, businesses, etc.

Social Services

Department of Social Services representative Lisa Hilliard, who is retiring after 33 years of service, said the department’s rate of protective services referrals has been holding steady/trending upward for both children and adults, with roughly 80 children currently in protective custody. Retaining social workers remains a big problem for the department, as demand has remained steady in recent years while the number of college graduates interested in the field has dwindled.

HIGHTS

Greta Metcalf, clinical operations director for HIGHTS (Helping Inspire Gifts of Hope, Trust and Service), informed attendees about her organization’s restorative justice work in the county. HIGHTS provides counseling, transportation, workforce development and job opportunities to some 72 county residents aged 16-24 who had previously dropped out of school and are now seeking their high school equivalency. The group also provides mental health services, (particularly in the area of addiction counseling), mentor programs and therapy for young expecting mothers and others through the Medicaid Standard Plan.

Public Health

Public Health Director Kathy McGaha gave a brief report on the department’s recent Community Health Assessment, wherein substance abuse and access to mental healthcare were identified as top priorities. She said that while her department does provide a case manager for children and pregnant women, she hopes to one day provide a case manager for every resident who receives services. Regarding the department’s role in providing autopsies to county residents, McGaha said it has had financial difficulties due to a large recent uptick in autopsy requests to examine things like blood toxicity and gunshot wounds. Beale mentioned that Macon – which contains a very high number of veterans at roughly 1 in 9 residents – was also recently named one of just five counties nationwide at the highest risk for veteran suicide by the Veterans’ Administration, and said he’d like to secure more funds to combat the issue. Attendees heard from the department’s newly hired health educator Jennifer Germain, who specializes in using physical exercise as a supplement to therapy for sufferers of chronic pain, PTSD, anxiety and depression.

Hazelwood Healthcare

Dr. Matt Holmes of Hazelwood Healthcare, who specializes in psychiatry and addiction medicine, gave a report on the effects of fentanyl, an ultra-dangerous opioid whose addiction is harder to treat than prescription drugs. Holmes said his office has seen more than 300 patients since opening two years ago but has had success treating addictions with methadone and buprenorphine.

Safety net

Local safety net provider Stephanie Almeda gave a report on her harm reduction efforts for clients who seek help from her group. For the past 15 years, Almeda has leveraged a variety of local partners to provide a wide range of services, from food and winter survival kits to HIV/Hepatitis C/Syphilis testing to harm reduction to preventative care. The group is also working with nine local families who lack access to adequate housing, and recently helped place a man in an apartment after he had been living in his car for three years.

EMS

County EMS Director Warren Cabe said his department has received roughly double the number of 911 calls so far this year compared to years past including for drug overdoses and 86 suicide attempts in 2021. The rate of naloxone use – a drug used for on-scene rapid overdose reversal – has risen significantly as well. Cabe also mentioned staff retention as a huge problem for the department due to employee burnout, saying it simply does not have enough staff to meet the demand.

The next Mental Health Task Force meeting will be Aug. 10 from 10 a.m. – 12 p.m. at the Robert C. Carpenter Community Building.

- By Will Woolever/The Franklin Press