A new doctor’s office could improve access to primary care for over 1,000 residents treated for severe behavioral health disorders through Alliance Health.

The office will be located on the fourth floor of Cape Fear Valley Health’s Community Mental Health Clinic at 711 Executive Place in Fayetteville. It will be the first co-located in a behavioral health care facility in Alliance Health’s coverage region of Cumberland, Harnett, Johnston, Wake, Durham, Orange and Mecklenburg counties.

Alliance Health is a public and state-funded behavioral health care management organization that connects uninsured residents to treatment for mental health, substance use, and intellectual and developmental disorders. It developed the doctor’s office in partnership with Cape Fear Valley Health to lower barriers to care for Cumberland County residents with behavioral health disorders.

“It’s like one-stop shopping where they can get their needs met right there in that one spot,” said John Bigger, corporate director of behavioral health and sleep medicine at Cape Fear Valley Health. “It helps them realize the importance of not just getting their mental health and behavioral health needs met, but also their medical needs met as well.”

People with severe behavioral health disorders like schizophrenia and bipolar disorder are almost two times more likely to have a chronic illness, according to a systematic research review published in the peer-reviewed journal BMJ Mental Health. Even less severe diagnoses like depression can increase a person’s risk for chronic conditions like diabetes, heart disease and stroke, according to the National Institute of Mental Health.

At the same time, people with at least one mental health condition were more likely to have an undiagnosed physical health condition or receive a late diagnosis than the general population, according to a systematic review published in eClinicalMedicine. Its findings, which were externally peer reviewed, also found that people with mental health conditions were more likely to be misdiagnosed.

The doctor’s office within the Community Mental Health Clinic looks to address these inequities, said Sean Schreiber, Alliance Health chief operating officer. Co-locating primary and behavioral health care in one clinic has been shown to increase access to both forms of health care, improve patient outcomes, and decrease care costs, according to a fact sheet from the American Psychological Association.

“These are populations that are challenged with transportation and keeping up with needed appointments,” Schreiber said. “We wanted to be able to maximize getting their care needs met every time they had a contact with a health care provider.”

A primary care physician and nurse will staff the Fayetteville co-located doctor’s office. Cape Fear Valley Health is currently hiring for the positions, and Bigger said the health system is vetting applicants to ensure they are suited for working with patients with the most severe behavioral health disorders. The staffing format is similar to co-located care at the UNC Schizophrenia Treatment and Evaluation Program (STEP) clinic in Carrboro, which Schreiber said has seen a lot of success.

As demand increases at Fayetteville’s office, Cape Fear Valley Health will consider increasing staff, Bigger said. Since the Community Mental Health Clinic sees an average of 45,000 to 50,000 patient visits per year, he said the doctor’s office should have a full appointment schedule. Cape Fear Valley Health is one of the largest providers of behavioral health services to Alliance members, according to Schreiber.

While Cape Fear Valley Health and Alliance Health are primarily funding the new office, the Cumberland County Board of Commissioners is providing a one-time allocation of $750,000 from the county’s roughly $9 million behavioral health fund to help with start-up costs. 

“How we’re all partnering, I think it speaks highly of our community,” Bigger said. “We’re really focused on meeting all the needs of our community. We want a healthy community.”

The doctor’s office was one of several behavioral health care expansions proposed by Alliance Health that the commissioners approved to be paid for in part using the county behavioral health fund. Discussed by county commissioners and Alliance Health over the past two years, the fund is also contributing to:

  • The continued funding of Cape Fear Valley Health’s emergency medical services Post-Overdose Response Team (PORT), which was previously funded through a grant that ended in October 2024. Since 2022, the licensed clinical social workers and peer support professionals on PORT have connected residents treated for an overdose by EMS with support groups and treatment. 
  • The creation of a jail liaison and post-release coordination team at the Cumberland County Detention Center. The team will help connect those formerly incarcerated at the detention center and diagnosed with a behavioral health disorder with reentry services and treatment. It builds off the work of the Healing from Within team, a project funded by national opioid settlement money that helps provide medications for opioid use disorder treatment within the detention center.

Alliance Health’s contribution to the new doctor’s office and other projects primarily comes from Medicaid dollars. Cuts to the federal health insurance program through the passage of H.R.1, also called the One Big Beautiful Bill Act, led county commissioners to question the sustainability of Alliance Health’s expansion into the county when it was first presented in April. 

Current stalemates over Medicaid funding in the North Carolina General Assembly could also impact the organization’s services. If left unresolved, the decreased funding for the state’s application of Medicaid will lead to cuts to payment rates of up to 10% for providers accepting the federal health insurance starting Oct. 1.

“There’ll be hard decisions to be made,” Schreiber said. “I think as we start having models of care that have been nationally proven to be more effective, I think we’ll have to really do our best to figure out how to continue to support those things in a difficult environment.”

CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the News Foundation of Greater Fayetteville.