What information led to the selection of this health issue and related result?

Mental health has been a CHA priority for Henderson County since 2003. Access and quality of mental health services has been a source of concern for many years. Over the last 20 years, changes to the mental health system have occurred, which have negatively affected those facing mental health challenges in our community, as well as their caregivers and other organizations that provide support for them. The system that replaced the previous community mental health model is siloed and disjointed, leaving community members and healthcare providers alike confused about where to begin when they need referrals for behavioral health services.

Further, suicide stands as the 7th overall leading cause of death in Henderson County, and the 3rd leading cause of death among individuals ages 20-39. As described in Chapter 6- Health Resources of the Community Health Assessment, the capacity of behavioral health providers in Henderson County is stretched, limiting the total number of individuals that can receive care and treatment.

The Henderson County Behavioral Health Summit is the action team responsible for addressing mental health in our community. The organizations and individuals that make up the Henderson County Partnership for Health and Henderson County Behavioral Health Summit will address this priority collectively. These partners include:

• AdventHealth Hendersonville
• Blue Ridge Community College
• Blue Ridge Community Health Services
• Children and Family Resource Center
• Community Foundation of Henderson County
• Council on Aging, Henderson County
• Crossnore Communities for Children
• Department of Juvenile Justice
• Family Preservation Services
• Henderson County Department of Public Health
• Henderson County Department of Social Services
• Henderson County Public Schools
• Henderson County Sheriff's Office
• Hendersonville Pediatrics
• Hendersonville Police Department
• Hope Coalition
• MAHEC
• NC Courts
• Pardee UNC HealthCare
• Safelight
• Sparc Foundation
• The Free Clinics
• Thrive
• United Way of Henderson County
• Vaya Health
• WNC Source
• Youth Villages

Mental Health and the related result, "All people in Henderson County are resilient, supported, healthy and productive", are aligned with the following Healthy NC 2030 health indicators and desired results:

• Adverse Childhood Experiences- Improve child well-being
• Suicide Rate- Improve access and treatment for mental health needs

The Behavioral Heath Summit is the action team responsible for addressing mental health, as a Community Health Assessment prioirty, in Henderson County. The group is led by the Henderson County Behavioral Health System Coordinator who convenes partners to identify gaps and strategies. The partners that make up the Behavioral Health Summit met in August 2022 to collectively identify actions that may improve mental health outcomes in our community. Working through a modified Results Based Accountability Whole Distance Exercise, the Summit members brainstormed actionable items that have evidence to support their effectiveness, have already bubbled up within the group, require an intentionally collaborative approach, and/or are from people who are most affected by the issue. After presenting all possible strategies/ideas, the group utilized dot-voting to select strategies that have the highest potentional to positively impact the selected indicators. 

The following actions have been identified by the Behavioral Health Summit as ideas for what can work for our community to make a difference on Mental Health.

(A) Actions and approaches identified by our partners. These are actions and approaches that we think can make a difference for mental health.

• Addition of after-hours care, especially evenings
• Include people with lived experience in Behavioral Health Summit
• More intensive outpatient programs for all ages
• Community Health Workers
• Mental Health Center with evidence-based trainings
• Infrastructure around MAT services
• Community Education, prevention, and advocacy
• Mental Health Resource Navigator
• Pre-crisis Intervention
• Community Trainings
• Rehab/Detox in Detention Center
• Recovery Court
• Chronic Care Management
• Increase access to Behavioral Health providers
• “Apple Corps”- Teaching fellowship for social workers, psychologists, therapists, etc.
• Community Paramedic
• Youth Mental Health Education

(B) What is currently working in our community. These are actions and approaches that are currently in place in our community to make a difference on mental health.

• Youth Mental Health First Aid
• Living Road Maps. (This started as a task force, but may be better served as an online Resource Tool)
• Trauma Sensitive Schools Training
• School-based therapists and crisis-counselors
• Substance Use Navigator at the Detention Center and P.O.R.T. Program
• Henderson ACEs, Resilience and Trauma (HART) Coalition
• After-hours Crisis Task Force (now transitioning into the Henderson County Crisis Collaborative)

(C) Evidence-based strategies. These are actions and approaches that have been shown to make a difference on mental health.

• Providing community-based, pre-crisis and crisis services (going to the client). Community Paramedic/ Co-responder programs; home-based and school-based interventions.
• Peer Support. Trained people with lived experience connect with people in need of support.
• Mental Health First Aid/ Resilience Training/ Trauma-informed care. Teaching children, families, employees, etc. resilience tools and trauma-informed interventions

In 2023, members of the Behavioral Health Summit collaborated to address mental health in the community. This Action Team has had a shift in focus, due to local incidents and data.  Henderson County had three completed youth suicides in 2023. 177 emergency department visits from youth ages 11—17 years old for behavioral health, 110 of those listed suicidal ideation.  Youth behavioral and mental health resources and response will be the focus in 2024. Even with a shift of focus, programs, and partnerships such as the HART subcommittee and WNC Trauma Resilient Communities Project will continue throughout 2024.

Henderson County Schools offered several Youth Mental Health First Aid (YMHFA) trainings with 174 participants. YMHFA teaches how to identify, understand and respond to signs of mental health and substance use challenges among children and adolescents ages 12-18. This YMFA training opportunity will continue throughout the Spring 2024.

Crisis Response Collaborative (CRC) continued to meet throughout 2023, improving communication between stakeholders, and to assess the availability and quality of crisis and early prevention services in Henderson County. The CRC has been successful in understanding gaps and addressing staffing needs across agencies.

Hope Coalition, local law enforcement and Henderson County Public Schools continued and expanded Handle with Care. Handle with Care is a trauma-sensitive curricula to support students who have been exposed to a traumatic event, if needed, this response allows for immediate mental health care for the student. To increase awareness and use of Handle with Care, a short training video was created, along with distributing Handle with Care reminder stickers.

This Action Team along with other community partners offered several new initiatives throughout 2023 with a focus on mental health. 

• Mental Health Awareness Signage Campaign – Children & Family Resource Center (CFRC) teamed up with the Partnership For Health to develop 240 colorful yard signs with positive messages like “You are seen and loved” and “You are worth so much.”
• Sesame Street in Communities— Emotional Toolkit; Eating Well Toolkit; Resilience Toolkit
  Smart Start Partnership for Children Henderson County and Henderson County Department of Public Health distributed 75 English and 55 Spanish toolkits.
• Zen Dens—Innovative Approaches created a safe space to provide respite for children with special health care needs during events.

  ViewFromHereWNC View From Here - Henderson County Social Media Campaign (Facebook & Instagram) August 7, 2023—September 29, 2023
In 2023, Henderson County joined the #ViewFromHereWNC social media campaign led by the WNC Health Communicators Collaborative. The ad campaign addresses several health priorities in Henderson County, including mental health, substance misuse, and physical activity/nutrition. Geo-targeted ads, which featured Western North Carolina residents, garnered 60,600 impressions, 1,549 ad clicks, 44,659 video plays, and 21,568 engagements in Henderson County’s first cycle. Initial online survey results showed 62% of respondents found the ads helpful and 72% sought more information on the health topics. The next campaign cycle starts in spring 2024.
Mental Health:
Feeling anxious or overwhelmed? Take a slow, deep breath for three seconds, then breathe out for six seconds to reset your nervous system. For extra support, reach out to a local professional in Henderson County. #ViewFromHereWNC
Reach: 9,048
Clicks: 535
Impressions: 19,405
Video Plays: 14,228
Post Engagements: 6,952