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Mental Health Care in North Carolina

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Mental Health Care in North Carolina School of Social Work The University of North Carolina at Chapel Hill Contact Fall 2008 Mental Health Care in North Carolina Advocating for care and the challenges ahead establish a professorship focused in the area of poverty. Also in September, the School unveiled its new Web site. It was created completely to train its social workers. We are currently in-house, by staff members Manuel Garcia, From the Dean... planning our next summer study abroad trips Michelle Rogers, John Anderson and Susan to South Africa and China. White, with input provided by faculty, staff In August, we welcomed three new assis- and students. his issue of Contact spotlights the criti- tant professors to our faculty—Gina Chowa, In October, UNC-Chapel Hill installed cal issue of mental health care reform Gary Cuddeback and Joan Yoo. a new chancellor, Holden Thorp. He shows a in North Carolina, the challenges Gina Chowa is the principal investigator great understanding of social work and I look Tahead, and the many ways we are advocating for AssetsAfrica, a research demonstration forward to working with him. for better care. Here are some highlights. project in Sub-Saharan Africa. AssetsAfrica, Several of our faculty have received grants Our faculty are actively engaged in in- now in its 5th year, is a quasi-experimental, for their projects recently, many of which are novative research that examines programs, matched savings project in Masindi, a rural detailed in the Faculty Spotlight section on policies and services geared toward improving district in Uganda. Her future research will pages 16-17. the state’s public mental health and addiction draw on lessons learned from the Uganda Unfortunately, along with the good there care system. And our programs, such as the pilot project as she refines and expands the is some sad news to report. In October, we Behavioral Healthcare Resource Program AssetsAfrica project. lost a great friend and our building namesake, and the Developmental Disabilities Training Gary Cuddeback has been associated Jack Tate. Institute, bridge the gap between academic with our School since 2004 as a research as- You may have heard about the mandatory resources and the state’s clinicians. sistant professor, as well as a faculty research budget cuts affecting the UNC system state- A promising new Mental Health Policy fellow at UNC’s Cecil G. Sheps Center for wide. The School of Social Work has received Institute, a UNC-Duke collaboration, is in the Health Services Research. His areas of inter- a 5.5% budget reduction since August. We planning stages. est include evidence-based interventions for expect to sustain additional budget reductions Our board of advisors member Ruth justice-involved persons with mental illness. this spring, and an additional 5% permanent Cook worked with the legislature on our Joan Yoo’s research focuses on under- cut in our state allocated funds in July. These behalf to establish a study commission to ex- standing the risk and protective factors reductions will mean that less than 20% of our amine ways to increase the number of mental associated with at-risk children’s well-being total operating budget is provided by the state. health social workers in underserved areas over the course of their development. She is Now more than ever, the School must rely of the state, including tuition remission for interested in identifying socioeconomic, be- on the generosity of our alumni and friends. students in the MSW program. havioral, and familial factors associated with With your support, together we will weather In response to the many changes in the at-risk children’s mental and physical health. this economic storm. N.C. mental health care system, our School Soon we will begin recruiting for the Thanks for everything you do for the revised its MSW curriculum to better prepare Spears-Turner Distinguished Professorship. School of Social Work, and all my best for a graduates to meet the needs of the state. We’re seeking a leading scholar and researcher happy holiday season and new year. In other School news, we continue our with expertise in research related to children, global work. Last summer, we traveled to families and social work practice. Lynn Usher China for a summer study abroad session, and Natasha Bowen are chairing the search and to conduct disaster response training committee. following the devastating earthquake there. In September, the School received a $1 Jack M. Richman Also, a UNC delegation traveled to Lithuania million bequest from an anonymous donor to 2 Contact | UNC-Chapel Hill School of Social Work Contact contents Dean Jack Richman Focus on Mental Health Care in North Carolina: Advocacy and Challenges Associate Dean for Advancement Mary Beth Hernandez Broken: North Carolina’s mental health reform leaves patients, providers in its wake • 4 Faculty lead innovative research in mental health and addiction • 6 Director of the Annual Fund and UNC, Duke researchers work to create a Mental Health Policy Institute • 10 Alumni Relations Tuition forgiveness program proposed • 11 Kristen Huffman Programs bridge gap between academic resources and state’s clinicians • 12 Mental health reform and the School of Social Work’s MSW curriculum • 13 Editor and Designer Students learn to navigate the mental health and addiction care systems • 14 Director of Communications Michelle Rogers School News Writers Remembering Jack Tate • 15 Michelle Rogers Faculty spotlight • 16 Susan White N.C. Child Welfare Education Collaborative prepares students for public child welfare practice • 18 UNC School of Social Work faculty train social workers in Lithuania • 18 Contributing Writers Blazing trails: Hortense McClinton • 19 Mary Beth Hernandez New studies show a significant financial burden on families raising disabled children • 20 Kristen Huffman Meet our new doctoral students • 22 Kathleen Rounds Clinical Lecture Series • 23 Anna Scheyett UNC School of Social Work helps China tackle growing pains • 24 Evelyn Williams Graduation pictorial • 26 Photography Alumni and Development News Tom Fuldner iStockPhoto Molly Barker named UNC Alumna of the Year • 23 Jupiter Images Honor Roll of Donors • 28 Michelle Rogers Scholarship established in memory of bipolar sufferer • 30 Susan White $1 million given to the School to establish professorship • 30 Thorp joins the School’s board of advisors • 30 School of Social Work Three receive Distinguished Alumni Awards • 31 The University of North Carolina at Tate-Turner-Kuralt champions named • 31 Chapel Hill Alumni update • 32 CB# 3550, 325 Pittsboro St. Alumni profile: Sally Knight • 34 Chapel Hill, NC 27599 Alumni president’s letter • 35 (919) 962-1225 http://ssw.unc.edu Printed with soy ink on recycled paper Check out our NEW Web site at http://ssw.unc.edu Contact | UNC-Chapel Hill School of Social Work 3 North Carolina’s mental health reform leaves patients, providers in its wake By Susan White hen North Carolina introduced mental health care reform county’s director of social services and an alumna of UNC’s School of in 2001, Susan McCracken was optimistic that changes Social Work. “Those were the two areas where we were most lacking over the following years would bring Lincoln County and saw changes quickly.” Wlong-needed services. For a while, the new efforts appeared successful, But like other communities around the state, Lincoln County especially as private providers popped up to offer psychiatric and crisis watched with disappointment as many new private agencies quickly counseling—resources that most residents could usually only find 35 stumbled. Some didn’t have enough qualified licensed clinicians to miles away in Charlotte. meet demand. Those that did have the expertise struggled to serve “We had more services for kids who had been sexually abused clients who qualified for Medicaid, the government insurance pro- and for those struggling with substance abuse,” said McCracken, the gram for low-income residents and those with disabilities. Program 4 Contact | UNC-Chapel Hill School of Social Work reimbursement rates were so low that some private providers were reward the use of evidence-based practices.” financially challenged and couldn’t offer the more expensive services Workforce issues are likely to grow more complicated next that some clients needed. year. That’s when a new state regulation is expected to stop allowing A few providers only seemed interested in helping those who provisionally-licensed providers such as social workers, counselors and could afford it, McCracken said. For residents already desperate for psychologists from billing Medicaid unless they are supervised by a services, state reform was more of a hindrance than a help, she added. physician such as a psychiatrist. “There were so many providers and so much going on, it was hard Traditionally, provisionally-licensed providers could practice as to weed out the good from the bad,” McCracken said. “And then people long as they were supervised by a licensed clinician in a similar disci- who were able to get services, they disappeared quickly so they were pline. constantly having to relocate to another provider. I think that constant “The provisionally licensed issue has been a train wreck in several change might have been more damaging than if the service had never pieces as far as we’ve been concerned,” said Jack Register, director been here.” of advocacy and legislation for the North Carolina chapter of the Mental health reform was supposed to save money and provide National Association of Social Workers. “The first disconnect is the more choices for those with mental illnesses by shifting care from the idea that because you’re a provisionally-licensed person and you’re not state’s psychiatric hospitals and government-run agencies to private reimbursable, then you’re not a clinician. This notion that monetary companies. As promoted, people would receive “community support reimbursement drives ability to practice is just not the case.” services” and be cared for closer to home, enabling state hospitals to For rural areas, the regulation may create lengthier waiting lists open more beds for the sickest patients.
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