Bold opening: North Carolina’s mental health overhaul is already drawing a crowd—and it’s only the first year of a broader, five-year plan to reshape how care is delivered. And this is the part most people miss: the demand is immense, and the system is scrambling to keep up.
Coastal Horizons, a Wilmington-based substance use and mental health treatment center, reports around 700 people seeking help each day as the state releases its inaugural year progress report on the statewide reform effort.
The North Carolina Department of Health and Human Services says the state is stepping up to meet rising demand, with Secretary Dev Sangvai describing a turning point for the state’s approach to behavioral health.
The General Assembly invested nearly $1 billion in behavioral health in 2024 to drive these changes.
In the plan’s first year, the state opened seven new urgent care centers, launched mobile opioid treatment programs, and expanded access to care. Sangvai emphasized a simple, patient-centered aim: if someone has a behavioral health need, there should be a clear point of contact, a responsive professional, and a safe place to seek help.
Coastal Horizons received close to $1 million to expand infant mental health services and to grow its opioid treatment program, ultimately serving nearly 1,000 individuals across the tri-county area.
“We’re building a strong infrastructure—across the state and in our region—to meet people’s needs,” said Ryan Estes, Coastal Horizons’ chief operating officer.
Despite progress, Wilmington still lacks a 24-hour behavioral health urgent care center, and staffing in community health remains a persistent hurdle.
Across the state, 97 of North Carolina’s 100 counties are designated as mental health professional shortage areas, including counties in southeastern North Carolina. That means fewer providers and, in some places, long travel distances to access care.
Estes acknowledged the gap: “We know there are more people needing care than our system could handle years ago—and likely still today. Our job is to rise to meet that demand.”
The state says it will continue addressing these capacity and access challenges while monitoring outcomes to measure progress.
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