Overview
The North Carolina Statewide Telepsychiatry Program (NC-STeP) was created in response to a growing crisis in North Carolina's emergency departments (EDs) due to the increasing number of mental health visits. According to the North Carolina Hospitals Association (NCHA), in 2013, the year NC-STeP was founded, North Carolina hospitals had 162,000 behavioral health ED visits. In the same year, 10% of ED visits had one or more mental health diagnosis (MHD) codes assigned to the visit, twice the estimated national average. According to the Centers for Disease Control and Prevention (CDC), there was a 17.7% increase in the rate of ED visits of patients with MHD in 2013; compared to 5.1% increase in overall rate of ED visits and people with mental health disorders were admitted to the hospital at twice the rate of those without.
Elizabeth City State University (2021-2026)
In recent years, the mental health and well-being of college students have received significant attention from educators, researchers, healthcare professionals, and policymakers. Mental health problems are common among college students. It is estimated that 26.2% of Americans ages 18 and older, or about one in four, have a mental disorder in any one year. During the 2020–2021 school year, more than 60% of college students met the criteria for at least one mental health problem, according to the Healthy Minds Study, which collects data from 373 campuses nationwide. In another national survey, almost three-quarters of students reported moderate or severe psychological distress.In the past decade, mental health symptoms have nearly doubled in college student populations. Academic pressures, along with the usual stressors of starting and attending college, can trigger the initial onset of mental health and substance use issues or worsen existing symptoms. While mental health challenges are common among college students, they are especially severe for minority students in rural areas, who face limited access to mental health care compared to their urban peers, leading to significant disparities. Additionally, cultural and normative barriers, including stigma, can prevent individuals from seeking help, further widening these disparities. In 2022, Blue Cross and Blue Shield of North Carolina https://www.bluecrossnc.com/ Blue Cross NC invested $1.54 million in ECU to develop telepsychiatry services for students at Elizabeth City State University (ECSU), a historically black public university in Elizabeth City, North Carolina, over five years.
The partnership was developed to address the shortage of psychiatric providers in Pasquotank County, where ECSU is located, and a growing need to foster connectedness at a time when mental health concerns on college campuses were surging. ECSU was selected because it is located in a smaller town where mental health services are not easily accessible, and it offers a model similar to the NC-STeP but on a college campus. This model demonstrates the importance of having access to mental health resources in college, especially in institutions where these resources are limited.
As of spring 2025, the program has produced following results:
- 2,316 PHQ9 screenings
- 2,317 GAD7 screenings
- 184 referrals to LCSW/counselors
- 100 referrals to psychiatrists/Psych NPs
- 481 scheduled mental health service sessions
- 1,026 e-mail followups
- 786 phone checkins
- 26 on-call/evening sessions,
- 99 walk-ins seen
- 170 marketing/outreach activities
