The Macon County Behavioral Health Task Force met Thursday, April 17, for one of its regular monthly meetings to discuss the state of behavioral health, mental health and resources available to individuals and families within the county. Thursday’s meeting saw a discussion of children’s mental health needs and the lack of resources available to the Macon County School System to offer support and counseling.
Morgan Mathis from Appalachian Community Services said a new Behavioral Health Urgent Care, in cooperation with Vaya Health, had been opened in Waynesville, which could serve as a place to receive screenings, crisis assessments, medication, examinations and referrals.
Greta Metcalf, the clinical director at HIGHTS, shared some details about the organization, the children it serves and their relationship with addiction. HIGHTS (Helping Inspire Gifts of Hope, Trust and Service) provides mentoring, counseling and workforce development for “underserved” youth in the region, among other services.
Metcalf said there were several factors complicating children’s relationships with addiction, whether they be addicted themselves or coming from families with members struggling with addiction. Metcalf said that it is difficult to help children work through trauma when the source of that trauma is still present; when all the work they do during the day can be undone when the children get home.
The biggest factor that can lead to children’s substance use is access, Metcalf said. Children are most likely to be exposed to substances at home, where parents regularly use legal drugs like alcohol and tobacco. With the ability to access beer in the refrigerator or vapes on the counter and a home life that treats the use of these substances as normal, kids may be more likely to start using, and then abusing, substances themselves.
The next issue for children’s addiction is screen use, Metcalf said. Rampant device use, combined with the COVID-19 pandemic, has facilitated the isolation of children and the development of attention and other behavioral issues. She said children are “losing the ability to be bored.”
Huge portions of screen use each day are devoted to videos (YouTube, Netflix) and gaming — high-octane entertainment — with additional hours spent on social media. All of these can be harmful under the right circumstances, Metcalf said, especially children who are already isolated or struggle to make friends.
HIGHTS has an out-of-school suspension program that seeks to provide some of these children with counseling, workforce development and community service opportunities to keep them from using those out-of-school suspension hours on screens and substances. The organization is also able to provide at-home weapon checks to help secure weapons, part of an effort to both protect the children and lessen the opportunities for them to face charges.
“It’s important to love these kids, guys,” Metcalf said, calling it the “antidote.”
Ronnie Beale invited a collection of Macon County Schools employees to discuss their experience with school counseling and the needs and resources available to them.
Speaking about their jobs and schools were Macon Middle School counselor Regina Seagle, Gear UP Coordinator Stacy Raby, Franklin High School counselor Lorraine Pevia, Mountain View Intermediate social worker Hillary Shockley, student services coordinator Annie Wishon, and mental health specialist Michael Geoghagan.
The counselors discussed the lack of funding and resources proportional to the need faced by students, with multiple counselors describing their existence with the system as “constantly putting out fires,” with each counselor responsible for hundreds of students.
This locks counselors into a kind of permanent crisis mode, unable to work with children on long-term recovery and forced to turn all children away except those with the absolute direst needs — thoughts of suicide and self-harm — leaving children very much in need of support in the wind.
Counselors said the key issue was a lack of personnel and funding. There are earpieces and technology they could use to better communicate with Spanish-speaking students, but the funding is not there. They could add more group sessions to work with more students, but they lack the personnel to make those kinds of programs possible. Telehealth can work well under the right circumstances, but children can find it difficult to trust strangers rather than their school counselors.
Child Health Report Card
This testimony is corroborated by NC Child and the North Carolina Institute of Medicine’s 2025 Child Health Report Card, which examines 14 indicators of children’s health biannually. Though North Carolina did well in insurance coverage and decently in preconception and maternal health support, the state has received below-average grades for nutrition, substance use and education. A failing grade was assigned to birth outcomes, school health, housing and economic security, child abuse and mental health.
According to the report:
• 51.9% of children ages 3-17 struggled to access mental health treatment from 2020 to 2023.
• 19.1% of students ages 12-17 suffered major depressive episodes from 2018 to 2019 and 2022-2023.
• 9.5% of high school students attempted suicide in 2021 and 2023.
Related to Thursday’s discussion, the report also found that, in 2021 and 2023, 21% of high school students used vapes, 20.5% used alcohol and 14.8% used prescription drugs without a doctor’s permission.
The report discussed studies finding that children were using social media at high rates, with 90% of youth 13-17 using social media and about 80% using social media several times per day.
Mental health staffing
The report cited the North Carolina Department of Public Instruction, which found that the ratio of students to social workers was nearly four times the recommended level.
“These roles are critical and often overburdened,” the report read. “School psychologists and social workers provide support for students with developmental, learning-based and social-emotional needs. They develop prevention and intervention programs, monitor progress and serve on threat assessment teams. Social workers support students in foster care or the juvenile justice system, those experiencing homelessness or violence and harassment, those going through substance use and mental health treatment and those who are at risk of dropping out.
“If North Carolina aims to improve youth mental health outcomes, we must prioritize meeting their needs where they spend most of their day. The data is clear that our support workforce is too small to sufficiently address these needs, which warrants further investment and innovation to improve school-based access.”
A March press release from the Department of Health and Human Services shared news about a partnership with Hazel Health to provide access to virtual mental health care for students in North Carolina. They plan to serve almost 30% of North Carolina’s K-12 population through Hazel Health’s services.
The next Behavioral Health Task Force meeting will be on June 19 at Discover Church. Beale said it may act as a follow-up to last week’s meeting, discussing the need for mental health resources at schools and options for getting (and keeping) it funded.