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[Ed Ergenzinger J.D., Ph.D.+]

Ed Ergenzinger J.D., Ph.D.

Night Sweats and Delusions of Grandeur

Psychiatry

The State of Mental Healthcare in North Carolina

From crisis to hope by way of Medicaid expansion.

Updated May 5, 2024 | Reviewed by Monica Vilhauer

THE BASICS

Key points

[Source: Mohammed Hassan / Pixabay+]

Source: Mohammed Hassan / Pixabay

I recently presented a talk at a conference for North Carolina behavioral healthcare professionals about how North Carolina, like many states, is in the midst of a crisis in its mental healthcare system. The state ranks last in the nation for access to quality behavioral health care, with about two out of five North Carolinians living in an area with no access to mental health professionals. The number of mental health emergency room visits has been rising in recent years, straining a system already relying heavily on emergency services before the pandemic.

But, I was also able to discuss how, in December, North Carolina’s expanded access to Medicaid under the Affordable Care Act was tied to a $30 billion spending plan with substantial investments in mental health services. According to North Carolina Senator Jim Burgin, “[O]ne of the attractions to Medicaid expansion for all of us was this once in a generation or maybe even once in a lifetime opportunity to say, ‘Mental health is a big deal.’”

A few of the areas impacted by the spending plan are described below.

Alternatives to the Emergency Room

A visit to the emergency room (ER) for a mental health crisis is a traumatic experience for many, in large part because ERs are not set up to treat mental health crises. ERs across th

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