In response to the growing crisis in North Carolina due to lack of access to acute care psychiatric inpatient services for individuals in crisis, Smoky Mountain Center and Haywood Regional Medical Center have entered into a joint venture to ensure access to these services for citizens of Haywood County as well as citizens of the greater Smoky Mountain Center catchment area. Funding for indigent care is provided by the Division of Mental Health, Developmental Disabilities and Substance Abuse services through a pilot initiative awarded to Smoky Mountain Center to reduce use of the State Psychiatric Hospital system.

The Behavioral Health Unit is dedicated to providing treatment and support for individuals experiencing psychiatric symptoms or co-occcuring problems with substance abuse in a supportive caring setting which acknowledges individual strengths, promotes personal responsibility, encourages participation of family and informal supports, affirms each person's potential for recovery, and provides opportunities for service to others. It is the practice of Smoky Mountain Center and Haywood Regional Medical Center that all persons seeking psychiatric inpatient admission who meet established admission criteria will be treated with respect and offered equal access to treatment regardless of race, ability to pay, religion, sex, marital status, national origin, age (adult), handicap, or prior treatment history.

The Behavioral Health Unit utilizes the Recovery Model in all aspects of the program. Recovery encourages wellness, symptom management, and individual empowerment. Clients are engaged as partners. Every effort is made to honor client preferences. Psychiatric symptoms and substance dependence are addressed concurrently.

The Behavioral Health Unit is a 16 bed adult psychiatric inpatient program. Haywood Regional Medical Center is the licensed provider of the service, which is carried out by Smoky Mountain Center under contract with the hospital. The Behavioral Health Unit is unique in the public/private partnership between a general hospital and a local management entity, and it the use of the Recovery Model within an inpatient environment. The Behavioral Health Unit operates 24 hours per day, seven days per week, 365 days per year. Staff include registered nurses, psychiatrists, nurse practitioners/physicians assistants, community mental health assistants, peer support specialists, social workers, and other licensed mental health clinicians. Ancillary support services are provided by Haywood Regional Medical Center; these include food service, housekeeping, administrative services, billing/collections, laboratory, radiology, and a full range of clinical services and specialized medical services available as needed. The unit is available to treat persons with a primary Axis I diagnoses, including clients who may also have a secondary diagnosis of substance abuse/dependence. The unit license precludes treating those individuals with a primary diagnosis of substance abuse only, and those who require specialized geriatric services.

The Balsam Center for Hope and Recovery is dedicated to providing treatment and support for individuals experiencing psychiatric symptoms or problems with substance abuse in a setting which acknowledges individual strengths, promotes personal responsibility, encourages participation of family and informal supports, affirms each individual potential for recovery and provides opportunities for service to others.

Mobile crisis management is an assessment, intervention and crisis prevention service available 24/7/365 which must be delivered “in the least restrictive environment”, and the response must be mobile. Though not a requirement, we prefer that our mobile teams have hospital privileges so they can also respond in local hospital emergency rooms. All staff are licensed clinicians with specialized training and at least one year of crisis experience. Most are eligible to complete the 1st exam for involuntary commitment. Mobile crisis evaluations are conducted to assess need and stabilize and refer for appropriate care.

Mobile Crisis Management staff also authorize inpatient and crisis stabilization resources for Smoky Mountain Center Local Management Entity and serve as intake for the Balsam Center Adult Recovery Unit and the Behavioral Health Unit at Haywood Regional Medical Center.

Criteria for referral:

• Individual is suspected of having a mental health, developmental disability or substance abuse disorder
• Individual is identified as being in crisis and in need of an immediate mental health/substance abuse evaluation
• Individual does not adequate support/skills to manage the crisis
• Individual is willing to participate in an evaluation or there are safety concerns which may warrant a petition for involuntary commitment
• Individual is medically stable enough to participate in an evaluation (able to communicate)
• Individual is expected to be medically cleared within 24 hrs

To request services call 888-315-2880. Emergency Dispatch will need the following information:

• Name of person calling for the request
• Phone number of caller
• Name of the Consumer
• Date of Birth of the Consumer
• Current location of Consumer
• Number/pager to reach individual who made the referral/consumer
• Brief reason for the referral (substance abuse referral, concern for suicide, recent overdose etc.)

The service definition for Mobile Crisis Management includes requirements around providers responding to individuals in crisis. The mobile crisis management service definition states the following:

Mobile Crisis management is a direct and periodic service e that is available at all times, 24/7/365. It is a “second level” service, in that other services should be billed before Crisis Management, as appropriate and if there is a choice. MCM staff will use the consumer’s First Responder in an effort to serve the consumer in the least restrictive manner and connect them to persons who have an established helping and trusting relationship. MCM staff will become involved and serve a consumer when appropriate after all resources have been applied by the First Responder.