County negotiating with architect for crisis center

For tens of thousands of hours each year, people struggling with mental health and substance use problems fill UNC Health Blue Ridge’s emergency department. Now, Burke County is moving forward with plans for a 16-bed crisis center designed to ease that burden and provide an adequate alternative to the hospital and the jail.

The Burke County Opioid Advisory Committee officially received approval from the County Commissioners to negotiate a contract with Holland & Hamrick Architects, based out of Shelby, on the development of the crisis center at the former NC Works building at 722 E. Union St. in Morganton.

The facility-based crisis center is currently about 6,800 square feet, but will eventually be between 10,000 and 12,000 square feet and provide both voluntary and involuntary commitment. Facility-based crisis centers are residential centers with 24/7 operation for short-term mental health and substance abuse care.

Dr. Katie Samuels, the county’s opioid settlement director, intends for the crisis center, purchased for $865,000 in March, to act as a detox center and emergency behavioral health space, allowing an average stay of seven to 14 days.

The doctor explained that between July 2024 and June 2025, more than 1,060 visits to the emergency department at UNC Health Blue Ridge were attributed to behavioral health and substance use — 860 and 200, respectively.

Across those visits, patients spent more than 33,600 hours waiting for behavioral health placement, with the average stay being 43 hours for psychiatric evaluations and 58 hours for overdose patients.

“This is demonstrating the need that the emergency department is flooded with a lot of psychiatric and overdose calls, and we currently don’t have an alternative,” Samuels said. “What’s happening is people are going into the hospital and they’re having to wait long periods of time to be evaluated or to be placed in long-term care.”

The crisis center will provide a place for stabilization, reducing the strain on the jail and emergency department, and acting as a middle ground before long-term treatment and recovery.

Holland & Hamrick was one of six vying for the contract, with CPL and Atriax, PLLC, also being invited in for interviews before local Burke, hospital, and behavioral-health officials scored Holland & Hamrick at the top of their list.

Holland & Hamrick has direct behavioral-health, crisis, and secure-facility design experience. According to the county’s opioid settlement director, customer references and the final interview cemented their decision because of its emphasis on schedule and quality.

Although the project is estimated to cost $6.5 million total, Samuels said that between grant allocations from the North Carolina General Assembly and the North Carolina Department of Health and Human Services’ Mental Health, Developmental Disabilities, and Substance Use Services, no local capital will be used on this project.

Under Holland & Hamrick’s proposed timeline, the facility will potentially be opened by September 2028.

After negotiations, Samuels will return to the Board of Commissioners for final approval before awarding Holland & Hamrick the contract. If negotiations fall through, the county will move on to the next-ranked firm, CPL.

The behavioral-health provider that contracts with the county to operate the facility will be determined at a later date, and will manage the operating costs for services and staffing.

IS IT ENOUGH?

Although other members of the Opioid Advisory Committee were optimistic about the crisis center, a member of the audience pointed out that 14 days for treatment was “really a drop in the bucket” and that without long-term recovery options, patients would be “recycled” back into the community.

Samuels responded, explaining that the first steps in fighting opioid abuse in the county started with stopping fatalities, saturating the area with Naloxone, and increasing emergency responses.

The next phase focused on connecting people with resources and treatment options. However, many long-term recovery options require that initial detox and crisis treatment already be finished before admittance.

Also, long-term recovery options aren’t completely off the table for the future of the county, although not in active discussion or consideration.

Former County Commissioner Johnnie Carswell has pushed for expanded recovery options for years.

“(The crisis center) is one of the better things we’ve done, right now,” Carswell said following the Opioid Advisory Committee meeting. “I could’ve went back in a lot of history and cried about us not opening a long-term facility. But if you can’t get long-term, you might as well get short-term (and) do what you can do.”