Changing the Way We Look at Behavioral Health in our Communities LS3P’s Healthcare design team has had the recent privilege of working on the Alliance Child Crisis Center, the first behavioral health urgent care and crisis center of its kind for children and adolescents in Wake County, North Carolina. In partnership with Kid’s Peace, who will operate The Hope Center, this new treatment facility will provide age and acuity appropriate care for young people in crisis in our region. The Hope Center will feature 16 beds for a facility-based crisis program and a 4-chair Behavioral Health Urgent Care walk-in clinic, both of which will operate on a 24/7 basis to divert behavioral health patients away from local emergency departments to a facility that has been purpose-designed and built for their care. No child will be turned away from treatment, regardless of insurance or ability to pay. This beautiful center features calming and healing interior spaces that utilize biophilic design, as well as access to a therapeutic outdoor courtyard. The project team was led by Raleigh Healthcare Sector Leader, Jeff Mural, along with Eileen McDonough and Julia Badorrek. The team had the opportunity to interview Kate Peterson, Director of Healthcare Network Project Management, Alliance Health, and Tammy Margeson, Crisis Program Director, The Hope Center & Kid’s Peace. How did the partnership between Alliance Health and Kid’s Peace come to fruition? What was the common goal with beginning this project? Kate: November 2016, the NC Division of MH/I/DD/SU issued a Request for Application to be awarded 1 million dollars toward the development of a facility-based crisis program for children and adolescents. To apply, Alliance would have to select a provider partner to work with Alliance. We put out a request for proposal and received several applications, which were evaluated by a group of executive leaders at Alliance. Kid’s Peace was selected through this project. The common goal was to serve very vulnerable youth and families. What were some of the trends you were seeing within your community regarding mental/behavioral health and the youth population? Kate: At that time, we had crisis facilities for adults but not for children and adolescents. They sometimes sat for observation/assessment in adult facilities. Alliance leadership was concerned that this population needed a more specialized approach, much like children’s emergency departments. We pulled data on where youth were coming from that showed up in emergency departments and in crisis and assessment – most were in the southwest area of Wake County. Many youths, with support, could return home. Tammy: As a previous director in adult crisis, I worked often to assist local hospitals in trying to find placement for youth in mental health crisis. There was an obvious need for behavioral health services. for youth and family. Hospitals were often boarding youth in crisis. “It was very rewarding working on the Alliance Child Crisis Center project! There were many obstacles along the way, but the shared vision between client, user group, design team, and city are what brought this project through to success. It’s my opinion that the best buildings are the ones that have a positive impact on the world; I truly believe this building will have a far-reaching positive impact on the welfare of children in North Carolina for decades to come. It was an honor working alongside the team that made it possible.” – Eileen McDonough What are the services available at “The Hope Center”? What ages can be served here? How many staff members work here? Kate: Services include triage, assessment, and discharge planning and assistance in a Behavioral Health Urgent Care by licensed clinicians and nursing. These services are accessed 24/7/365 by walking in. If the situation is emergent, a facility-based crisis admission can be done where the medical and clinical team can work to stabilize the situation and begin the work toward discharge, with support and connections to the appropriate providers. Tammy: The Hope Center for Youth and Family Crisis offers mobile outreach response and engagement services in Orange, Durham, Wake, and Johnston counties, 24/7 behavioral health urgent care, and a licensed 16 bed facility-based crisis inpatient unit for stays of up to 2 weeks for ages 6 through 17. What impact on the community are you hoping this facility will have? Do you think that we are starting to see a shift in the prioritization of mental health services across the board in our communities? Kate: We hope it will serve as a specialized place that is conducive to work with children, adolescents and their families that is trauma informed and responsive. We want to see children and adolescents safely be in the community with family as quickly as we can and give families the support they need. Tammy: The impact will be a reduction in the number of youth and families seen in local emergency rooms for mental/behavioral health care, a reduction in long-term out of home placement, and a reduction in placement disruptions for youth involved in foster care and juvenile justice. “Like all good design, this project provides safe, beautiful, and relatable architecture in which to heal and explore wellness. A critical component to this success is the integration of nature and our built environment. From a colorful and bright entry vestibule to the colored and blinds-operable windows in the patient rooms – the views to nature are abundant. Huge skylights in social spaces, experiential graphics on the walls, and a joyful color palette bring the outside in. A central, secure outdoor space is also integrated into patient therapy. This outdoor space allows for fresh air, outdoor games, and safe sensory engagement.” – Julia Badorrek What was your favorite part of managing this project, overall? Kate: Mine, hands down, is program design. Tammy: The process. Although projects like this are long, watching the progress, and being a part of it, has been an excellent experience. “We are not yet there as a society where people see their brain health as part of their physical health or where people see mental health as something that all of us need, not just that person over there on the street corner.” – Jeff Mural What are the critical goals for this facility in its first year of operation? Kate: Some of the critical goals are to obtain its Involuntary Commitment Process (IVC) designation, and to become a destination for families and their children/adolescents experiencing significant stress. Other goals are to get youth out of non-therapeutic settings and emergency departments when it is appropriate for a sub-acute facility. We also want this facility to become a significant community resource, not only as an employer, but to support first responders in behavioral health crises. Tammy: Once open, to change the way youth and family experience our system of care, by drastically reducing the number of youths that are seen in emergency rooms for mental/behavioral health, and who experience placement disruption due to mental/behavioral health needs. Learn more about behavioral health, the building selection process, and how this amazing project was pulled together by listening to our “Human Scale” podcast episode here. About Kate Peterson, MS, PMP, PMI-ACP Kate Peterson has had over 30 years working in behavioral healthcare, with most of her career being in leadership roles in provider organizations serving youth and families in North Carolina. She joined Alliance Health, a Medicaid Managed Care Organization, in 2015 and now is Director of Healthcare Network Project Management. In this role she and her team develop and implement service initiatives within Provider Networks. In this role, her team has implemented the Mobile Response Stabilization Services model (MRSS). She has managed a change in crisis program model for adults and youth, and is working on the development of the Hope Center, a full service crisis center for youth and families projected to open for the Alliance catchment in 2023. Currently, she and her team are leading projects to cover multiple counties and to serve children and families in stress, most with severe trauma. Much of the current work mirrors the objectives in SAMHSA’s release of the New National Guidelines for Improving Youth Mental Health Crisis Care. About Tammy Margeson Tammy Margeson is the Crisis Program Director at The Hope Center/Kid’s Peace in Fuquay-Varina, NC. Tammy received a Master of Science in Mental Health Counseling from Walden University in 2011 and currently holds dual licensure as a Licensed Clinical Addiction Specialist and a Licensed Clinical Mental Health Counselor. She is also a certified clinical supervisor in addictions. Tammy has been working in mental/behavioral health since 2002, where the first 6 years were in residential treatment for adolescents. In 2008, she took a new position where she worked with adult crisis services and continued this work until 2021. She then joined the Kid’s Peace team to bring similar services to youth in Wake, Durham, Orange, Johnston and surrounding counties.