When someone with a behavioral health complaint shows up in an emergency room, providers often have no idea of their backstory. They have to start from scratch in piecing the puzzle together.

In Winston-Salem, North Carolina, a patient recently arrived at Novant Health Forsyth Medical Center after an attempted suicide. While the patient insisted this was the first time, team members started digging and learned from family that it had happened before.

State budget shortfalls often push these patients out of the state’s inpatient beds and on to the streets, leaving local hospitals to deal with care. Mental health authorities recommend 50 mental health beds per 100,000 people. North Carolina had just eight state-psychiatric beds per 100,000 in 2017.

While millions of people are affected by behavioral health conditions in the United States, only half of them receive treatment. Forsyth Medical Center is taking steps to change that.

Dr. Derek Ayers, a psychiatrist at Forsyth Medical Center, is part of a team spearheading the challenge to meet the growing needs of the behavioral health community.

Focus on the patient

Dr. Derek Ayers
Dr. Derek Ayers

When a patient comes into the emergency room, it’s usually during one of the scariest moments in their life. Forsyth Medical Center is working to make this process a little easier for patients.

And contrary to what many might think, patients are not “put in straitjackets or locked in a padded room like you might see in the movies,” Ayers said.

For instance, patients who present with mental health concerns are directed to a calmer waiting area that they may find more inviting than the busy ER waiting rooms.

“Novant Health wanted to make this process for patients as supportive and smooth as possible,” Ayers said. “It’s important that we take behavioral health concerns seriously and I think it is a step in the right direction by making it a priority in our emergency department.”

When in the behavioral health triage, nurses are specially trained to use the Columbia Suicide Severity Rating Scale, which is built around a series of questions to determine if patients are a danger to themselves.

Once the nurses get the results from this test, patients and their families are directed to one of two secluded rooms with comfortable chairs and what every patient wants most — privacy. From there, they meet with the behavioral health team comprised of specialty trained nurses, behavioral health therapists and psychiatric providers. Families are encouraged to be involved in those meetings as treatment is focused from a holistic and patient-centered approach. In many instances, immediate interventions are started, allowing patients to leave the hospital with the care, support and long-term treatment plans in place.

For patients that need hospital level of care, they are then are then guided to one of the 20 single rooms housed in the behavioral health emergency department, the largest in North Carolina. The team consults with patients to come up with a treatment plan to address their most pressing issues in a safe and supportive environment.

In some instances, there is a temporary stay while waiting for a bed to open up in the psychiatric unit, while other patients are transferred to a long-term care facility.

Treatment plans differ on a case by case basis. Each patient has the behavioral health team supporting them with one unified goal in mind: to help them get better with the best care possible.

New clinic coming

For some of the patients discharged from the emergency behavioral health department, it might mean a referral to a psychiatrist for ongoing care. Novant Health is making this transition a little smoother by opening a clinic focused on behavioral health.

In summer of 2019, Novant Health is expanding psychiatric services to include a new clinic to serve the greater Winston-Salem area. Novant Health Psychiatry - South Fork will house psychiatric and therapy services for:

  • General adult behavioral health.
  • Child and adolescent behavioral health.
  • Geriatric behavioral health.
  • Women’s health and behavioral wellness.
  • Substance use services.
  • Neuropsychology.
  • Neuromodulation (use of electrical/magnetic stimulation for behavioral health conditions).

“Novant Health is constantly looking at ways to improve care surrounding behavioral health,” Ayers said. “By opening this new clinic, it makes getting the proper care and attention more accessible to the greater Winston-Salem market.”

Not only is it providing more accessible care, the clinic helps patients get specialized care.

“Each need for every behavioral health patient is different,” Ayers said. “But we hope to address those specific needs and concerns by getting behavioral health patients specialized attention based on their individualized needs.”

“Novant Health Psychiatry – South Fork will be a great addition to the Winston-Salem community,” Ayers said. “My hope is that this clinic will help people get the care they need before they end up requiring emergency behavioral health interventions. We are looking to be proactive more so than reactive when it comes to behavioral health so that the people we serve can continue living happy, healthy lives.”

The new clinic will be located at 140 Club Oaks Court in Winston-Salem.

Novant Health understands that depression, or any other behavioral health needs, can happen at any time. Licensed therapists are available around the clock to help by calling our Behavioral Health Call Center toll-free 1-800-786-1585 if you are in the Greater Charlotte area and 1-800-718-3550 if you are in the Winston-Salem area. If you think you may hurt yourself or someone else, call 911 immediately or go to the nearest emergency room. If you think you may be suffering from depression, please schedule an appointment to talk with your doctor.