The list of governmental and community based organizations below are actively engaged in the development and implementation of the Community Health Improvement Plan addressing emergency department admissions for behavioral health patients, as well as providing wrap around supports for those who were previously incarcerated or have experienced trauma.

• Amazing Grace Advocacy
• Atrium Health Cabarrus - Emergency Department
• AYA House
• Cabarrus County
  • County Commissioners - Mental Health Advisory Board
  • Emergency Medical Services
  • Department of Human Services
• Cabarrus County Partnership for Children
• Cabarrus County Schools
• Cabarrus County Sheriff's Department
• Cabarrus Health Alliance
• Cabarrus County's Juvenile Crime Prevention Council
• Concord Police Department
• Daymark Recovery Services
• Department of Juvenile Justice
• District Attorney's Office
• Genesis: A New Beginning
• Kannapolis Police Department
• Partners Behavioral Health
• Probation and Parole (NC DPS)
• Opportunity House
• RHA Behavioral Health
• S&H Youth and Adult Services

Alternative Destination Transport program provides pathways of care other than transport to the emergency department for 9-1-1 patients. This strategy would include transport of patients with low acuity medical conditions to urgent care centers and clinics for treatment, the transport of medically stable intoxicated patients directly to the detoxification center, and the transport of medically stable psychiatric patients directly to mental health facility for medical clearance and admission.

Co-responder Models for Individuals in Behavioral Health Crisis enhance law enforcement’s capacity to develop an immediate and targeted response to acute and non-acute situations. At its core, the co-responder framework typically features a specially trained team that includes at least one law enforcement officer and one mental health or substance abuse professional responding jointly to situations in which a behavioral health crisis is likely to be involved, often in the same vehicle, or arriving on scene at generally the same time.

Crisis Intervention Team Training and programs create connections between law enforcement, mental health providers, hospital emergency services and individuals with mental illness and their families. Through collaborative community partnerships and intensive training, CIT improves communication, identifies mental health resources for those in crisis and ensures officer and community safety.

Mental Health First Aid (MHFA) is a training course to help laypeople know how to assist individuals with mental health problems or at risk for problems such as depression, anxiety, and substance use disorders. Courses last 8 to 12 hours and include information about signs and symptoms of mental health problems and appropriate responses, as well as interactive activities using MHFA’s five-step action plan: assess risk of self-harm, listen non-judgmentally, reassure and share information, encourage self-help, and encourage professional help. 

Question, Persuade and Refer (QPR) is intended to reduce suicidal behaviors and save lives by providing innovative, practical and proven suicide prevention training for general community members. The skills and techniques taught during this 1-hour training empowers all people, regardless of their background, to make a positive difference in the life of someone they know.

Peer Supports placed within the Emergency Department, assist individuals with the develop of crisis plans, support patients during their hospital stay if admitted to inpatient service, educate them on harm reduction, and link them with community-based resources after discharge. 

RECONNECT for Resilience trainings are trauma-informed and resiliency-focused, and offer practical strategies that individuals, organizations, and whole communities can use to promote balance and wellbeing. Attendees are taught about trauma, the brain, and the human nervous system in a way that participants of all ages, educations, or backgrounds can understand. Our simple, teachable format is designed for anyone to learn. The 14-hour Reconnect training is a strengths-based, somatic program. Through demonstrations and group practice, participants are given the “owner’s manual” to the body’s safety and threat management system and learn to use their own natural ability to find balance.

School-based social and emotional instruction (SEL) focuses on five core competency areas: self-awareness, self-management, social awareness, relationship skills, and responsible decision making¹. Such instruction typically includes efforts to develop skills such as recognizing and managing emotions, setting and reaching goals, appreciating others’ perspectives, establishing and maintaining relationships, and handling interpersonal situations constructively. Skills may be modeled, practiced, and then applied throughout the school day.

Telemental health services are mental health care services provided over a distance via telephone or videoconference. Services can include psychotherapy, counseling, supplemental support services accompanying face to face therapy, and self-directed services such as online cognitive behavioral therapy. Patients can receive care via their home computer through services such as Skype or be hosted at clinics or hospitals where telemedicine equipment is housed.

Trauma Informed Communities (TIC) includes the use a comprehensive, multi-stakeholder, and multilevel approach to support and strengthen traumatized and distressed residents and communities and address the effects of unresolved community trauma such as historical community disinvestment, poverty, inadequate and insufficient housing, violence, social isolation, and structural racism.

A Mental Health Action Planning retreat was held by Healthy Cabarrus virtually, due to COVID-19 restrictions, on January 28, 2021. During the retreat, a multi-sectoral group of community partners and individuals with lived experience were convened to review the Community Needs Assessment findings and identify strategies, partnerships or new initiatives that could address factors that are driving up psychiatric ED admissions and limiting individual's access to mental and behavioral health services. The discussion led to three main themes for the Mental Health Advisory Board and the associated task forces to focus on:

• Coordination of Services for Justice Involved Persons
• Data and Assessments
• Trauma Informed Communities

The table below outlines strategies identified to improve the mental and behavioral health of individuals in Cabarrus County. Lead agencies and recommended performance measures are also included. It should be noted that as interventions are implemented and data is shared across agencies, modifications may be necessary to best capture appropriate performance measures to highlight impact of efforts.

Additional Community Interventions and Strategies

• New In-Patient Mental Health Facility in Cabarrus County
• Amazing Grace Advocacy: Respond to the desperate need of support and case management for children in Cabarrus County with complex disabilities of the brain, involving mental health, childhood trauma, autism, intellectual disabilities, and neurological brain disorders.
• Atrium Health Cabarrus: Create an expanded behavioral health holding unit outside of the Emergency Department at Atrium Health Cabarrus. The new behavioral health holding unit will be a 3,623 square-foot locked space encompassing between 12 to 14 beds, a dedicated shower, a telepsych unit, and other behavioral health care needs.
• Cabarrus County and Kannapolis City Schools: RECONNECT for Resilience trainings are trauma-informed and resiliency-focused, and offer practical strategies that individuals, organizations, and whole communities can use to promote balance and wellbeing. 
• Cano Family Services: Provide culturally competent, specialized, behavioral health and parent education services to individuals and families in Cabarrus County.
• Camino Health Center: Support to launch a bilingual behavioral health services program and expand primary care services at Concord locations
• Genesis A New Beginning: Provide on-site therapy in Cabarrus County and Kannapolis City Schools.
• Kannapolis Head Start: Mental health provider to determine mental health needs within the Head Start program.
• Mental Health America: Emotional Toolbox for Building Resilient Communities is a comprehensive, county-wide initiative that serves to provide the community with access to the resources, awareness, education, and online screening tools needed to address mental health concerns for themselves, their families, friends, coworkers, and neighbors.
• Silver Linings for Seniors: Employ Community Health Workers (CHWs) to promote mental health services and provide mental health first aid training in communities. Provide direct services, mental health counseling to Cabarrus County residents (via teletherapy and in-person counseling).
• Vida Wellness Center: Mental health counseling services through individual sessions, family sessions, and group counseling services.

Mental and behavioral health continues to be a top identified need among Cabarrus County residents and community stakeholders. Mental health includes an individuals emotional, psychological, and social well-being. Good mental wellness is important at every stage of life, but limited access to services and providers, as well as the stigma associated with mental illness have left many individuals feel isolated and alone. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people with co-occuring disorders are at risk for developing one or more primary conditions or chronic diseases (HIV, Hep C). The coexistence of both a mental illness and a substance use disorder, are known as co-occuring disorders. Evidence has also shown that individuals diagnosed with chronic health conditions or disease like cancer, diabietes, chronic pain and heart disease are at higher risk of suffering from a mental illness as well. 

Just like physical health, mental health needs to be taken care of and maintained, with available, affordable, and timely access to care. Access to mental and behavioral healthcare has been identified as a priority need in Cabarrus County since 2012. This result statement and local community health improvement plan (CHIP)align with Healthy NC 2030 indicator:

• Health Indicator 19: Suicide Rate or Self Harm