By Taylor Knopf
In his State of the State address Monday, Gov. Roy Cooper said the “youth mental health crisis cannot be ignored,” adding that he would soon “propose a plan that makes historic investments in the whole-person health.”
On Wednesday, Cooper announced his plan to invest $1 billion in mental health and substance use services in North Carolina. The money will come from the $1.8 billion sign-on bonus the Biden administration has extended to get holdout states such as North Carolina to expand Medicaid coverage.
“The highest priority for that bonus must be making smart investments in our mental health and substance use system across the entire continuum of care,” the governor’s plan reads.
In the wake of the pandemic, North Carolina is contending with a growing mental health and substance use crisis.
More and more people are waiting longer at emergency departments to go to a psychiatric hospital. Drug overdose deaths increased by 72 percent over the pandemic. Crippling workforce shortages in health care mean that psychiatric beds sit empty as the state struggles to fill vacant positions. People with disabilities have lost their direct service providers to higher-paying jobs. And teenagers are reporting high levels of depression and suicidal thoughts.
“Clinics closing, people can’t find care […], folks waiting in emergency departments, staff levels at record lows… Folks, it is only going to get worse,” NC Department of Health and Human Services Secretary Kody Kinsley said in February at the annual Legislative Breakfast on Mental Health, where he gave an update on the state of North Carolina’s mental health needs. “And I do not want to stand here next year and tell you how much worse it is. I want to sit here in front of you and say, ‘Here’s all the extra things we’re able to do because of Medicaid expansion.’”
Kinsley has repeatedly said Medicaid expansion is the best investment for the state’s mental health system, as more people with behavioral health needs will be able to afford care.
“But after decades of no one being able to pay, we need to jumpstart our system of care,” Kinsley said Wednesday. “This plan does just that. It helps us invest wisely to make a system of care that prevents crises, serves people where and when they need it most, and helps increase health and decrease costs over people’s lifespans.”
“Not only is the system not working, it’s inefficient,” Kinsley added. “This plan allows us to save costs over time, by building better places and ways for folks to get preventative care and recovery supports.”
Support from state lawmakers
After nearly a decade of debate, leaders of the North Carolina House and Senate announced in early March that they have reached an agreement on Medicaid expansion.
Cooper’s plan to