LISTEN: Georgia leaders are continuing to invest in mental health treatment by funding additional crisis stabilization centers including a new one in Fulton County. GPB’s Ellen Eldridge reports.
In the recovery community, the phrase "being sick and tired of being sick and tired" signals a person's need to detoxify the body and heal the mind by understanding the root issues of their substance misuse.
This feeling of having nowhere further to fall and no clue how to climb out of the hole created by addiction leads some people to thoughts of suicide. When someone with substance use disorder needs immediate care due to withdrawal symptoms or mental health struggles, a behavioral health unit or a crisis stabilization unit can help.
Georgia has a total of 546 adult crisis beds and 74 child crisis beds, according to the Department of Behavioral Health and Developmental Disabilities (DBHDD).
These emergency accommodations are available within 14 adult Behavioral Health Crisis Centers (BHCC), nine adult Crisis Stabilization Units (CSU), four Crisis Stabilization Units for children, and one Crisis Stabilization Unit for Georgians with Autism.
The 22 Community Service Boards across Georgia serve people with serious mental illness, intellectual/developmental disabilities, and/or addictive diseases who have no insurance and limited to no means to pay for treatment.
Kalia Sprouse, of Gainesville, attended the annual Addiction Recovery and Awareness Day at the state Capitol on Thursday, Jan. 18 as an advocate with lived experience of recovery from substance use disorder.
She grew "sick and tired of being sick and tired," she said, and reached out to a crisis facility in Gainesville.
"I called them," Sprouse said. "I said, 'Hey, you know, I'm full-blown addiction right now. I'm lost my mind. I need help.' And they're like, 'OK.'"
Sprouse spent a week in Laurelwood, which is part of Northeast Georgia Medical Center.
"They got me started on my recovery journey," Sprouse said.
The 54-bed facility is a private, not-for-profit, inpatient behavioral health facility dedicated to the stabilization and treatment of individuals with mental illness and/or substance abuse. Once there, Sprouse connected to a residential rehabilitation program in Atlanta.
Fortunately, Sprouse was covered under her father's insurance plan.
That isn't always the case.
Many people enter addiction treatment through the criminal justice system.
An estimated 63% of people in jail and 58% in prison have a substance use disorder, according to the Substance Abuse and Mental Health Services Administration.
The Fulton County Accountability Court reported one-third of all defendants housed in its jail receive some type of psychotropic medication, and more than 75% test positive for illegal drugs upon arrival (or refuse to take the test).
A former medical administrator at the jail, George Herron, estimated as many as 60% to 80% of people incarcerated in the county’s jail system suffer from psychiatric disabilities, leading him to characterize the Fulton County Jail as “the new mental health hospital,” Mab Segrest wrote in Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum.
The Fulton County Jail is called Georgia’s largest de facto mental health facility because of the high prevalence of mentally ill detainees. Often, they have no place else to go until a crime is committed. Worse, incarceration often exacerbates the symptoms of behavioral health disorders, making it more likely to trigger a relapse in victims or force them to stay locked up longer.
Upon release from incarceration, people with behavioral health issues also face many barriers to successful reentry into the community, such as lack of health care, job skills, education or stable housing, and poor connection with community behavioral health providers.
Even when a person has insurance, such plans never cover costs of living like food and housing.
Medical detox, inpatient rehabilitation and ongoing counseling are also not often covered by insurance, even when patients have access to coverage.
Many substance abuse counselors run cash-only practices.
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Marcus York, also of Gainesville, entered substance use disorder treatment through the court, which mandated him to a month-long rehabilitation program out of state.
"I got caught up in a distribution charge, and they sent me to rehab in Greenville, S.C.," York said. "It was a real eye opener."
When Edward Westmoreland reached out for help in 2019, the intake counselor at the Cobb County Crisis Stabilization Unit told him the facility does not detox people from cocaine or methamphetamine.
He had been grieving his mother, who died in 2015, by misusing cocaine and methamphetamine. After he got addicted, he and his partner continued to struggle with substance misuse.
Then he became a father. And his partner disappeared.
He knew he wanted sobriety and felt he was the only hope for his children, so he pleaded his case and begged for crisis intervention.
“She said, 'I could keep you for three days.' But they kept me for a week,” Westmoreland said.
During that week, staff at the crisis center connected Westmoreland to additional rehabilitation programs in the county, such as the Men's Extension in Marietta.
“When I called, [a counselor] told me to give him a little story about what's going on with me,” Westmoreland said. “I told him I was dealing with Georgia Division of Family & Children Services (DFCS), trying to get my kids.”
The counselor on the phone told Westmoreland they had room for him.
“[The counselor] said, ‘Once you leave there, come straight to the Extension; we got you a bed,’" Westmoreland said. "I went straight there.”
Westmoreland experienced several relapses over the past five years and had only recently stopped misusing drugs when he attended the Addiction Recovery and Awareness Day Jan. 18 at the Georgia Freight Depot, but he’s determined to stay a sober, productive, and present father.
He doesn’t blame outside factors for his relapses; recovery is a journey, he said.
"[Access to] housing and treatment works, but to me, personally, going to treatment is getting you out the area that you was in and that that helps a lot," Westmoreland said. "But it's really the individual person who has to put the work in order to stay clean."
A bed study completed last year shows Georgia will need eight additional crisis centers in the next decade, Department of Behavioral Health and Developmental Disabilities Commissioner Kevin Tanner said.
The FY 2025 budget before the state legislature includes $6,599,785 to complete operational funding for three behavioral health crisis centers already in development Fulton, Dublin and Augusta, Tanner said.
The newest BHCC in Fulton County is expected to open in June. When they’re completed, the centers will also be able to accept patients through the state’s 988 suicide prevention and crisis hotline network.
Additionally, $9,481,532 would help fund a new BHCC in Region 1, which includes 31 counties in North Georgia.
When asked why funding more crisis facilities for behavioral health is a priority for the department, Tanner said he was reminded of a woman whose recovery started with a stay in a crisis facility.
"Because of the services that were provided, she's now working full time as a forensic peer mentor in one of our programs in Lowndes County," Tanner said. "It's just a miraculous story of someone who was homeless, who was in crisis, who's now living a very productive life of recovery.
He said her story and the stories of the 1,100 attendees of Addiction Recovery and Awareness Day show that recovery is real in Georgia.
"It can all start there in that crisis center," Tanner said.
