WILMINGTON — A local nonprofit specializing in substance abuse crisis intervention is planning to soon offer emergency care in both areas, though its long-term plan is to open a new facility using $6 million in recently secured state funding.
Coastal Horizons is opening a behavioral health urgent care, which are facilities designed for adults and children suffering from a crisis involving a substance use disorder, mental health disorder, or intellectual or developmental disability. The goal is to stabilize the patient within 24 hours of arrival and then refer them to a long-term care option, whether that be outpatient or inpatient.
Though others exist in the state, the local facility would be the only behavioral health urgent care in the Cape Fear region.
The state-funded Coastal Horizons’ facility is intended to operate 24 hours and with up to 16 beds, though it won’t open for at least a year. In the meantime, the nonprofit plans to use one of its current spaces offering nine beds, though maybe not as many hours.
Both facilities will have clinical staff who will be able to diagnose, create treatment plans and in cases where it’s needed, prescribe medication, including medication-assisted treatment for substance abuse. They will be able to collaborate with the patient’s regular care team as well, or if they don’t have one, get them started on treatment without having to wait for an appointment date.
“This will now create a staffing pattern that’s truly designed to see people and get them started on medication same-day,” Coastal Horizons Chief Operating Officer Ryan Estes told Port City Daily.
Additionally, the center will be staffed with peer support from people with lived experience in mental health or substance abuse crises.
Estes said Coastal Horizons is already seeing that these services are needed based on its own clients. The nonprofit has almost 200 intakes a month. He explained many of the clients coming to Coastal Horizons in crisis would be best served by stabilization, rather than a 90-minute assessment designed for long-term care.
“This gives us that ability to let them calm down and get to a place of being truly able to engage in more traditional therapy services,” he said.
The nonprofit already coordinates with law enforcement and the hospital to provide care for behavioral health issues, though the new facility is designed to take the pressure off both.
Amy Akers, chief nursing officer for the Novant Health Coastal Region, said Novant is supportive of the “community-led efforts to offer new access points” for behavioral health services. Across its three local hospitals, Novant logged 10,800 behavioral-health related emergency room visits last year.
“We see this being a huge resource for the community,” Estes said. “Most people do stabilize in a shorter period of time, and we already have those resources or some resources for periods that need that longer period. But when that’s all that’s available, and you’re coming in on an [involuntary commitment order] where you have to be evaluated within 72 hours, most of the time, they end up waiting that full 72 hours. Now within this model, we’re able to look and say, can we take you off sooner?”
The nonprofit was awarded $6 million to cover all capital costs of the new facility in the North Carolina General Assembly’s fiscal year 2027 budget with the help of Sen. Michael Lee (R-New Hanover).
Lee provided the following statement to Port City Daily regarding the allocation:
“One of the hardest gaps we have in our behavioral health system is what happens when someone hits a crisis point — too often the only options are the ER, law enforcement, or nothing at all. A Behavioral Health Urgent Care changes that by giving people immediate, walk-in access to care for a mental health or substance use emergency. Coastal Horizons has the experience and the community relationships to do this well, and directing these funds toward New Hanover County is a direct response to the toll the opioid epidemic and mental health crisis have taken here. I was glad to work with local stakeholders to get this into the budget, and I’ll be watching the planning and implementation closely to make sure it delivers for the people who need it.”
Estes told Port City Daily Coastal Horizons is working with a real estate agent on evaluating a few locations and was not yet able to share where the facility will be permanently located.
While the permanent facility is built out, Coastal Horizons is looking to run an urgent care, just for adults, out of the space at 615 Shipyard Blvd. This location once housed the nonprofit’s Open House Youth Center.
Last year, the New Hanover Community Endowment granted Coastal Horizons $1.45 million for a new youth center, allowing for the repurposing of the Shipyard Boulevard space. Though this means the urgent care will be less visible to the general public at first, the Shipyard space will be able to start serving clients potentially by the end of the year.
“The community needs a behavioral health urgent care yesterday; they needed it years ago,” Estes said. “If we can get this launched and serving adults now, then when we scale it up … we’re even more prepared because we’ve got the workflow, the staff trained, and the community knows about it.”
Coastal Horizons has already started advertising for positions, but he said his team was still in conversation with other community partners and couldn’t share details about operational support or additional funding for the Shipyard facility yet.
These details include whether the Shipyard facility would be a Tier III or Tier IV under North Carolina Department of Health and Human Services guidelines. The goal is for the permanent facility to be Tier IV.
A Tier IV facility is open 24 hours a day, seven days a week, 365 days a year; in contrast, a Tier III facility only has to be open 12 hours but otherwise everyday and six of those hours must occur after 4 p.m.
Estes explained the difference in hours could mean a disparity between someone having 24 hours before discharge from the facility or only a handful depending on how close someone came in before closing.
If the Shipyard facility was a Tier III, patients who are not brought out of their crisis state by 10 p.m. for example, would need to be transferred to another facility with an opening, go to the hospital, or be sent home to return the next day with connections to other crisis lines or resources.
A Tier IV facility, with 24-hour services, would allow a patient a full day to stabilize, no matter the time they walk in.
“We would never want to discharge someone that is premature and not ready for going back into the community safely,” Estes said.
However, both tiers must provide the following services:
- Involuntary Commitment first evaluations capable
- Crisis/risk assessment
- Physical health screening/medical screenings
- Clinical evaluation
- Psychiatric services
- Referrals and case management
- Disposition and discharge planning
- Inclusion of family or natural supports (as available, with consent)
Estes said Coastal Horizons plans to issue requests for proposals in the next month for construction companies for the permanent facility.
At Port City Daily, we aim to keep locals informed on top-of-mind news facing the tri-county region. To support our work and help us reach more people in 2026, please, consider helping one of two ways: Subscribe here or make a one-time contribution here.
We appreciate your ongoing support.
