On opening day of the James Hagen Crisis Care Center, Melanie Swisher greeted the crowd that had gathered inside the brand new building for a ribbon cutting ceremony.
“Today marks a milestone in expanding access to care for this community,” said Swisher, executive director of the Paint Valley Alcohol, Drug Addiction and Mental Health Board.
The new facility, which opened in July, includes an eight-bed crisis stabilization unit, designed to meet the area’s high need for emergency behavioral health care.
“It's designed for folks that maybe don't need a hospital, but maybe they need a little bit more care than just being at home. So they'll be with staff 24/7. They’ll have therapy. They’ll have groups,” Swisher said.
On the other side of a walled-off nurse’s station, there’s a receiving unit, where police can bring in people experiencing mental health or substance use crises — instead of taking them to jail or the ER.
“The idea is just you're met with somebody who specializes in your emergency, right? Just like if you're having a heart attack, you'd want somebody who specializes in heart disease, that's what we're trying to do for behavioral health,” Swisher said.
Thanks in part to a $90 million investment of COVID-relief funds, facilities like this are popping up all over the state — from Mount Orab to Mount Vernon to Canton. But some are struggling with staffing challenges and other barriers to care created by changes taking place at the federal level.
In eastern Ohio’s St. Clairsville, the Coleman Health Services Behavioral Health Urgent Care opened in April.
The facility has a similar layout to the new crisis center in Chillicothe. Both also house mobile response teams, which are sent out into the community to help people in crisis where they are. In St. Clairsville, one team serves people under the age of 20 and the other serves adults of any age.
But four months since opening, Coleman Health’s new behavioral health center has yet to admit any patients. They’re still waiting for licensure from the Ohio Department of Behavioral Health to come through — and they’ve also struggled to hire qualified candidates.
Behavioral health staffing challenges
Chief Officer Kasey Osselborn says it’s hard to recruit people to the rural area. It doesn’t have a local university, and the poverty rate in Belmont County is higher than average in Ohio.
Also, not everyone is right for crisis care.
“You might get spoken to in a way that doesn't feel good,” Osselborn said. “Some people… just want to work in an office and see people with minimal needs.”
But those who choose to work in crisis care, she said, “thrive in this kind of environment — it's a privilege to see [patients] and to see what a little bit of positive and safe support can allow them to achieve.”
Behavioral health staffing is an issue across the state, said Becky Carroll, director of policy research and analysis at the Health Policy Institute of Ohio.
“They're opening these wonderful facilities and sometimes they can't find people to actually provide the care, which is really sad,” Carroll said.
Federal data shows 75 out of Ohio’s 88 counties have a shortage of mental health care providers. But the state is working to change this. Last month, it announced an $18 million scholarship and internship program for graduate students pursuing behavioral health degrees in Ohio.
Carroll says that's a good step.
"But we also need to think about retaining the workforce that we already have," she said. "The insurance reimbursement for mental health professionals is, on average, 18% less than physical health providers. So those reimbursement rates are just not helping the situation."
Access to insurance creates another barrier
Despite investments from the state, changes at the federal level are making it harder and more expensive for people to access health insurance — and could also create financial challenges for providers.
Last year’s federal congressional budget reconciliation bill, called the “One Big Beautiful Bill Act,” is expected to reduce Medicaid payments to providers by billions.
Beyond Medicaid, Ohio saw the nation’s largest drop in Affordable Care Act enrollment this year — a decline of 32% — after pandemic-era subsidies expired.
Carroll says that could cause bigger issues.
“Without insurance, more people might forgo that early care, and then that may lead, unfortunately, to higher care needs down the line,” she said.
But when patients are able to access care and succeed, it makes the struggles of the industry worth it to providers like Coleman Health’s Kasey Osselborn.
She recalled a recent incident with a young patient.
“Nobody was sure she was gonna be alive to graduate high school. She did. And she is struggling a little bit right now, but she had the tools to reach out,” Osselborn said.
It’s what these facilities around the state are all about: giving patients a safe place to recover from a crisis so they can go on to lead healthy lives.
If you or someone you know is in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.
