Freedom House’s many rooms

Freedom House Recovery Center, based in Chapel Hill, is the only residential detox facility in Orange County and this side of the Triangle. If you’ve heard of Freedom House, chances are that’s why. But since its founding in 1974 the world has changed, and so has Freedom House. Serving eight counties now, it offers comprehensive mental health services for children, adolescents, adults, and families suffering from a broad range of behavioral issues, as well as substance abuse disorders.

Navigating the regulatory maze of “mental health reform” that has been unfolding since the state of North Carolina took its first steps toward privatization fifteen years ago would have been daunting enough, had the needs stayed the same. But the needs have grown. Freedom House served almost 15,000 people this past year, according to executive director Trish Hussey. That’s up from 10,000 in 2012-13. And the number presenting with primary mental illness has almost caught up with the numbers for substance abuse, she said. Not fewer people with substance abuse disorders, just more people. Many are dually diagnosed.

I spoke with Hussey last week to learn more about a recent announcement. Mental Health America of the Triangle, a regional organization that has long partnered with Freedom House, is being absorbed as a part of Freedom House. MHAT operates five programs: the Family Advocacy Network, Compeer (mental health mentoring relationships), the Pro Bono Counseling Network, the Orange Partnership for Alcohol and Drug-Free Youth, and Orange County’s Family Success Alliance. All five are coming under the umbrella of Freedom House on July 1, with the transition being led by MHAT’s executive director Marci White.

This is a natural fit. MHAT specializes in stepping into the gaps where service is unavailable, where people for example don’t have insurance and can’t qualify for Medicaid. They offer services such as family-parent advocacy, enlisting people who’ve been through similar ordeals as guides, navigators, and advocates. A network of volunteer licensed therapists stands willing to provide up to eight free sessions to the uninsured, and that is often enough. But MHAT can’t provide the more intensive services that Freedom House offers.

Bringing MHAT within Freedom House also offers the practical advantage of operational economies in a time when, according to the news announcement, the General Assembly is planning to cut $262 million in “single stream funding” that would have paid for mental health services for the uninsured or underinsured.

This move is the latest example of the astonishing resourcefulness with which Hussey and her colleagues at Freedom House are able to meet seemingly every new challenge, as the needs increase and public resources shrink.

For example, thanks to a grant from the Kate B. Reynolds Charitable Trust, primary medical care is now available onsite. This is helpful because, as Hussey notes, the folks they see often have so much going on in their lives that they don’t have a primary care doctor: it doesn’t make sense to send them to the ER when what they need is an antibiotic.

In yet other ways, creative thinking has led to the happy result of both improved care and reduced cost. An innovative partnership with UNC Hospitals is strengthening continuity of care and improving outcomes. When a person in crisis arrives in the ER, a care coordinator is available to take them straight to Freedom House for detox, for example; or if the person is so ill as to need hospitalization, the care coordinator helps devise a treatment plan that will get them out of the hospital as soon as possible. According to the data, so far since the program’s beginning in 2012-13 it looks like some five or six million dollars, at least, in savings have been realized.

Every serious behavioral disorder is “a disease of loss,” as Hussey points out–sometimes catastrophic loss. To listen to Hussey tick off a few of the scenarios that can lead to trauma is to gain some understanding of how the pain of the world settles unevenly in the vulnerable spaces around us.

Often, the weight of a crisis falls upon the children: the child of an alcoholic; the child-witness of domestic abuse shuttled from parents to DSS and back; the child suffering the neglect of a single parent who works for subsistence wages, unable to provide secure housing, let alone day care. Freedom House’s youngest client is three years old.

Fundamentally, Freedom House has evolved to respond to evolving community needs. The range of services now offered extends from crisis stabilization and transitional/halfway housing to a variety of outpatient services, and in-home support services, including individual and family therapy, peer support, and medication management. But there’s one critical gap: the existing facility-based crisis center serves adults only.

There’s room for a facility-based crisis center for children and adolescents on the Chapel Hill campus. Navigating the associated regulatory and funding barriers is the next challenge that Hussey and her capable team have placed firmly in their sights.

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