CLAYTON — Mental health care reforms in North Carolina have rippled out to Johnston County, and now the the Johnston County Health Department has taken over the job of providing behavioral health services in the county. The services were previously provided by the Johnston County Mental Health Center.
Existing patients will still be seen at the same location in Smithfield, and will continue to have the same care providers.
The mental health center became part of Alliance Behavioral Health Care, a managed care organization, in February. Because the agency will be managing the services, they are not allowed to provide direct services because it’s considered a conflict of interest.
The change was inevitable. In 2011, the legislature passed a law requiring all local management entities, including Johnston County Mental Health Center, to transition to managed care organizations by July 1, 2013.
Johnston County joined with three other counties, Wake, Durham, and Cumberland, to become part of a managed care organization Alliance Behavioral Healthcare.
Dr. Janis Nutt, Mental Health Director for Johnston County said the transition is a positive thing.“We can identify gaps in the county where services are needed and make sure people who were being helped before can be helped in more ways,” said Dr. Nutt.
The Mental Health Center, which previously provided direct services, such as psychiatric care, to mental health patients, will now oversee the business aspect of patient care, which includes focusing on the community’s needs. The center will be responsible for managing community needs related to mental health including housing, system of care, the court system, jail and detention center, the geriatric team, and a hospital liason.
Last year, the mental health center saw about 4,000 people, and the Health Department will still be able to see those same patients.
A staff of 21 mental health professionals, including psychiatrists, nurses, and therapists who worked at the mental health center will now work for the health department so that established mental health patients can continue care with the same people.
The longterm goal of the managed care is to appropriately manage the money so that the resources are best used.
The health department is a “safety net provider,” meaning that it is charged with serving low income, underinsured, and uninsured clients in Johnston County.
Health care streamlined
The change means that mental health services and physical health services will not be as separate as they were before. The health department, which sees people for a variety of health needs, will now have the records of a patient’s entire medical history, both physical and mental.
“This is definitely a positive thing –integrating the physical and mental health,” said Johnston County Health Director Dr. Marilyn Pearson. “We all want to have one system of care and now providers will be able to work together and provide continuity of care across physical and behavioral health lines.”
While the state has changed legislation for mental health providers in recent years, the number of patients needing mental health care has increased, according to Nutt.
“Every year there has been a several-percentage increase in the number of people who come here for services,” said Nutt. That includes patients who require short-term counseling for divorce or the death of a loved one, to people who have very serious psychiatric disorders, or who have substance abuse issues.
There is a 20-bed behavioral health unit at Johnston Medical Center in Smithfield where patients can stay overnight. The psychiatric staff and social workers in that unit were all transferred to the Health Department, in their same positions.
The Health Department will now be hiring a few care coordinators, people who stay in touch with patients in crisis or who are at high-risk for needing mental health services.