Guilford County & Sandhills Behavioral Health Center

guilford county & sandhills behavioral health center Transformation Story

Our emergency departments are designed to do many things well, including round-the-clock triage, diagnosis, and treatment of acute medical issues from broken bones to cardiac arrest.

Emergency departments excel at saving lives and providing critical services to treat physical issues. When a mental health crisis, or concurrent mental and medical health crises occur, patients seeking assistance with behavioral health issues often have limited options to access the same level of care available in a medical emergency. Fifty-five percent of US counties do not have a practicing psychiatrist1 , so emergency departments become the default care providers for many patients in crises.

A 2010 study found that one in eight emergency department visits involve mental health and substance abuse disorders, accounting for roughly 12 million visits per year in the US2. The number of patients seeking treatment for mental health issues in the emergency department is steadily rising, and the average length of each visit for these issues is increasing3.

This situation is less than ideal. Most emergency departments are not designed for mental health emergencies, lacking therapeutic treatment spaces and also spaces designed for patient safety for those who may attempt to harm themselves or others. Providers who are already stretched thin are struggling to find staff to monitor patients continuously during the duration of their stay, at great expense to the healthcare system. The scarcity of beds in appropriate settings for behavioral health means that emergency departments end up hoteling people who are not getting the specialized care they need during their stay, and few organizations have available funding to address a problem of this magnitude.

This all-too-common situation is not working for anybody.

2

1.

55%

of US counties do not have a practicing psychiatrist1.

1 in 8

emergency department visits involve mental health and substance abuse disorders2.

National Council for Mental Wellbeing. “The Psychiatric Shortage: Causes and Solutions.” March 28, 2017: The National Council, https://www.thenationalcouncil.org/wp-content/

uploads/2017/03/Psychiatric-Shortage_National-Council-.pdf?daf=375ateTbd56 .

2.

Owens, Pamela L., Ph.D.; Mutter, Ryan, Ph.D.; and Stocks, Carol, R.N., M.H.S.A. “Mental Health and Substance Abuse-Related Emergency Department Visits Among Adults, 2007.”

Healthcare Cost and Utilization Project, July 201, Statistical Brief #92, https://www.hcup-us.ahrq.gov/reports/statbriefs/sb92.pdf 3.

Holt, Stephanie. “National Trends in Mental Health-Related Emergency Department Visits by Children and Adults, 2009-2015.” USC Schaeffer Leonard D. Schaeffer Center for Health Policy and Economics, https://healthpolicy.usc.edu/research/national-trends-in-mental-health-related-emergency-department-visits-by-children-and-adults-2009-2015/

a new model for care

4

Realizing that a viable solution to this complex problem would require an innovative approach, a small group of passionate people from different institutions in Greensboro, NC came together to propose a new plan. Three entities - Cone Health, Guilford County, and Sandhills Center - formed a unique partnership dedicated to expanding behavioral healthcare services in the community.

Working with healthcare providers Cone Health and Alexander Youth Network, and with input from North Carolina’s Department of Health and Human Services, and architecture firms LS3P and TFF Architects, the team envisioned the Guilford County Crisis Center: a place where children, adolescents, and adults could come to receive walk-in care, residential treatment, and outpatient services. This innovative model of behavioral healthcare delivery is built upon best practices for providing integrated care while reducing stigma for those seeking behavioral healthcare. The means that patients seeking treatment for behavioral health conditions can also get assistance with routine medical needs such as managing blood pressure or refilling prescriptions for chronic conditions without having to visit multiple clinics.

building a campus for all The project began with careful site selection, and the team found an ideal location in terms of access, use, and opportunities for collaboration.

The formerly industrial area of town is near a hospital and is transitioning into an office park with medical uses, and another medical office building already exists across the street. The proximity to existing healthcare facilities helps to normalize the process of seeking care, and the proximity to public transit makes the site easy to access. The Center is also adjacent to a county-owned office building and across the street from the police station, encouraging collaboration for programs such as the Crisis Intervention Teams (CIT) that will operate from the Center.

6

a comprehensive program

8

The Guilford County Behavioral Health Crisis Center, which celebrated its grand opening in the summer of 2021, provides comprehensive behavioral health services 24 hours a day and 7 days a week. The Center creates a “one-stop shop” for mental health needs, helping patients to avoid long waits in crowded emergency departments and connecting them with resources to address behavioral health concerns and other co-occurring medical conditions. The Center includes a behavioral health urgent care center for all ages, an outpatient clinic, a peer center for drop-in interaction and a 16-bed unit for adults operated by Cone Health. The facility will also alleviate pressure on emergency departments by diverting an anticipated 3,0004,000 visits per year from the main hospital. Next to the Crisis Center is a 16-bed child and adolescent facility operated by Sandhills Center.

two facilities The two adjacent buildings are technically on separate properties, but are designed to feel like part book ends of a shared campus. And, though operated by two separate providers, the programs allow for coordination of services for anyone experiencing a mental health crisis. A similar architectural language helps to unite the buildings visually and underscore their common purpose.

10

one purpose

designing a better patient experience The design of the buildings conveys a sense of welcome, underscoring the message that each patient is valued and important. The team wanted the buildings to share a contemporary aesthetic in keeping with the “New Greensboro” vibe of the surrounding modern buildings that signal growth and investment in the area. Double-height lobbies filled with natural light, clerestories at the nursing stations, and a palette of therapeutic, enlivening, and vibrant colors all help to create a healing environment communicating that each patient matters, that these facilities deliver the same toplevel patient care as any other medical facility, and that behavioral health is an important and valued part of holistic healing.

12

The 16,000 SF child behavioral health Crisis Center, operated by Sandhills Center, features a sloped roof over an inspiring atrium to create a human-scale residential aesthetic.

The 35,000 SF Crisis Center supports multiple programs. The behavioral health urgent care has exam and evaluation rooms, observation areas, and pharmacy/lab capabilities, and offers separate clinics for children and adults.

“Now we have have a destination for someone where we know that they are going to begin their journey to recovery and stabilization...That is an incredibly exciting process for us.”

Jim Albright, Emergency Services Director, Guilford County

The team implemented a variety of strategies to make the space both therapeutic and welcoming.

Experiential Graphic Design (EGD) was essential to this goal, adding inspiring artwork through economical, durable, and beautiful wall coverings which transform the waiting areas with a positive, uplifting distraction during a visit. Windows at the ends of corridors and in patient spaces provide daylight and views to nature, creating visual connections to the outdoors throughout the buildings. In the residential wings, the design emphasizes lightness and transparency.

14

a new beginning

16

As the result of three community organizations collaborating to solve a problem that none of them could solve alone, this model of comprehensive care is unique within the region, and one of just a few similar facilities nationwide. The Center will transform care for patients and their families by providing a compassionate, therapeutic care experience in an uncertain time. Providers, likewise, will be able to offer holistic care in an appropriate behavioral health setting tailored to healing, and emergency rooms will be able to spend more of their resources on what they do best. Better still, this innovative partnership can set an example for other systems seeking a solution to a complex problem, potentially leading to a new era of behavioral healthcare for all.

“there is no wrong way to enter, you can walk right in to a stigma-free space.”

Archana Kumar, MD, Medical Director of Behavioral Health Services, Cone Health Chief of Psychiatry

The light-filled lobbies provide a welcoming front door for the facilities, offering stigma free access to services.

The child behavioral health Crisis Center’s central nurse station is visually connected to each of the three wings with patient rooms, flex rooms, and both noisy and quiet social areas.

The three residential wings include one for children, one for teenage boys, and one for teenage girls.

18

Courtyards accessible in both buildings provide a safe place to connect with nature.

A peer center with a coffee-shop vibe is open to drop-ins to provide a safe, welcoming place for guests to rest or talk with others.

Other program spaces include an emergency vehicle entrance, screening, waiting, consult areas, dining, group therapy rooms, and staff support spaces such as offices, lockers, lounges, and showers.

.COM