Mental health advocates are concerned that care for a fragile population will decline if Wake County and UNC Health can't reach a contract extension agreement to operate UNC WakeBrook, the mental health hospital in east Raleigh.
"I'm just devastated that has come to this," said Ann Akland, a past president of the National Alliance on Mental Illness (NAMI) Wake County and a longtime advocate for mental health services. "I think it's such an important part of the crisis services in Wake County. It's helped so many people, and it's ... just an excellent model."
We have this wonderful program that is helping so many people, and we can't seem to find the funds to keep it going.Ann Akland, mental health services advocate
The county owns WakeBrook, and UNC Health operates services at the facility. The county's funding for this contract is $14 million for the current fiscal year, which ends June 30. While that contract is set to expire on that date, UNC Health has agreed to provide inpatient and crisis assessment services for an additional year, and to provide certain other services through November of this year, which could allow a transition to a new provider.
Akland says UNC is the best provider for that facility because it has massive institutional support and can offer high-level integrated care. She says she's sad and angry that the contract hasn't been extended.
"It really was a huge disappointment, you know? That's probably another way to express it," she said. "We have this wonderful program that is helping so many people, and we can't seem to find the funds to keep it going."
Akland is part of a group called Save WakeBrook, which is pushing for the county and UNC to reach a resolution
Neither the county nor UNC divulged anything about the ongoing contract negotiations, except to say that UNC has sent the county a new proposal, which the county is considering. Wake County Manager David Ellis says the county wants UNC to continue to operate WakeBrook, but that the county needs to consider mental health services in the county holistically. In addition to the $14 million in the WakeBrook contract, the county budgeted another $19 million this year for mental health services for providers other than UNC.
"No one wants to see these services go away," said Ellis. "We need more behavioral health services, not less."
The county commissioned a report to broadly analyze the mental health care needs of the entire county. That report will be available to county commissioners soon. Ellis said the county is unlikely to make any major decisions before reviewing that report.
While UNC says it is committed to providing mental and behavioral health care to adults, it says it has turned more specifically to treating children and adolescents. In December, UNC Health announced it would partner with the N.C. Department of Health and Human Services to convert a facility in Butner, N.C. into a 54-bed inpatient psychiatric hospital for children and adolescents.
Doctors and health researchers around the country agree the pandemic accelerated a youth mental health crisis.
"Since the pandemic, our state and nation has wrestled with a mental health crisis that is plaguing our children and adolescents," according to a statement released by UNC Health. "It's a crisis that has impacted every hospital emergency department around the state. As the state’s health care system, UNC Health is working with state leadership and our board of directors to begin to specifically address this problem."
A charged history
UNC WakeBrook didn't happen by accident.
In 2011, WakeMed Health made an unsolicited, and some said hostile, bid to buy Rex Healthcare from UNC Health. WakeMed's CEO at the time, Bill Atkinson, argued that Rex didn't provide its fair share of indigent and charity care. That allowed Rex, he said, to profit from patients with good health insurance, while WakeMed had to care for patients who couldn't afford to pay. UNC, the state's health system, benefitted from this as well, he argued.
UNC Health at the time was led by Dr. Bill Roper, who agreed to invest $40 million in mental health services in Wake County. Some $30 million of that commitment became UNC WakeBrook, which opened in 2013.
If UNC were to leave that facility, it would be just one decade after making commitments to investing in mental health services in the county.
Akland, the advocate who was instrumental in opening the WakeBrook facility, said if UNC leaves, it will mean a lower level of services. She praised UNC for how they operate.
"The difference in WakeBrook is that they're there, trying to really get people better, and then get them out the door. Instead of waiting until the insurance runs out, and then no matter what get them out the door," she said.
Wake County says it is working with Alliance Health, the entity that funnels Medicaid money to providers, to find a new provider should the contract with UNC not be extended.
