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New Center Will Offer Hope in the Storm



A warm and soothing environment in which patients and their parents can feel comfortable and safe. Comprehensive and critical inpatient treatment available without the necessity of an hour-long, or longer, drive. Skilled professionals on hand around the clock to help families in crisis.

That’s the vision for a new, 16-bed inpatient adolescent psychiatric unit, scheduled to break ground this month as part of Cape Fear Valley Behavioral Health Care. The Dorothea Dix Adolescent Care Unit at Cape Fear Valley Health, which will serve children ages 12-18, is expected to be completed by fall of next year.

And if it were already open?

“It would be full,” said John Bigger, Corporate Director of Cape Fear Valley Health’s Behavioral Health and Sleep Center. “And our anticipation is, once we open, it will be full.”

The idea of the center is years in the making, a longtime mutual goal of Bigger and Ken Fleishman, M.D. Dr. Fleishman is one of four board-certified child psychiatrists with Cape Fear Valley Health. They recognized the need for inpatient treatment for adolescents in Cumberland County, but also knew the cost could be prohibitive.

“This was generously funded by the Division of Health and Human Services through the Department of Mental Health,” Bigger said. “They saw the need we have here in this community and came up with a funding amount for us to be able to build this unit.”

Never has the need been greater, agreed Fleishman and colleague Sree Jadapalle, M.D., who is also a child psychiatrist with Cape Fear Valley Health. COVID-19 has wreaked havoc globally, but the effect is magnified in children and families who were already fragile.

“Currently, with all the crisis going on with online schooling and everyone cooped up in the houses, we’re having six to eight children come into the emergency room per day,” Jadapalle said.

Fleishman pointed out that both the American Academy of Child and Adolescent Psychiatry and American Academy of Pediatrics agree that it is healthiest for children to be in school, and that children are losing out not just on academics, but also on important social interaction. The problem is even greater for children with special needs.

“It’s impacting families significantly,” Fleishman added. “People don’t realize how limiting it’s become. Combine dysfunction at home with the inability to get out of the home, and you have a disaster waiting.” Children in crisis and their families typically must now wait in the emergency room until a bed is available at one of the other adolescent psychiatric treatment facilities in North Carolina, the closest of which is 60 miles away. That wait can take from two to five days. And even once space is available, distance can strain the hope of an effective treatment plan, which almost always involves therapy for the entire family, rather than just medication, Fleishman said.

“When a child comes to the hospital, it’s a crisis in the family,” Fleishman said. “And so, at that point, you have the opportunity to make changes in how the family operates normally. And we just have to take advantage of that. While medication may be part of it, the bulk of it is understanding what’s happening and helping the family manage it. How can you turn the situation into an experience of change so that things can move forward?” Bigger agreed. “If you’ve got to take your child 60 miles away and you’ve got other children in the home, or you’ve got a spouse that’s deployed, how are you going to do visitation? How are you going to participate in the treatment program?” Bigger added.

“Having something local just really helps meet that need for the whole family. We’ll be able to keep it right here in the community and help as many as we can.” Fleishman said psychiatric providers on Fort Bragg have thoroughly endorsed the proposed center. “They want us to be able to do this so that they don’t have to keep sending children 60, 70 miles away from their families,” he said. The center will have longtime benefits as well.

“One of the things that is going to be tremendously helpful with this is that we will be working with our psychiatric residents who will be able to learn about child psychiatry,” Bigger said. “They will be able to further help the community because our goal is that they will become trained in child psychiatry and stay in this community when they complete their residency.

So, we’re helping to build the field.” All of which is another step in Cape Fear Valley Health’s goal of broadening its scope. Bigger said that Cape Fear Valley Health CEO Mike Nagowski and Chief Medical Officer Dr. Sam Fleishman both have been strong advocates for the center. “It’s a very exciting time because of the tremendous need in the community for this service,” Bigger said. “We’re excited to be able to meet that need. Let’s get this thing started.”