Solace for the many

Mental illness — particularly depression — is second only to heart disease in its socioeconomic impact in our country, reports Susan Brooks of Asheville’s All Souls Counseling Center. “That includes lost work as well as dollars for medical care and medication,” she notes. “Depression that is untreated can lead to permanent disability, and there are so many things in our lives that cause us anxiety, depression or grieving.”

But in a time of escalating health-care costs and a fundamental retooling of the state’s mental-health infrastructure, many people aren’t getting the help they need. Accordingly, the nonprofit, nonsectarian center offers short-term counseling to uninsured and underinsured people who don’t qualify for publicly funded critical-needs care. Underinsureds include many people who have health insurance but whose high deductible or co-pay requirements put mental-health care out of reach.

Ever since state-mandated mental-health reform began in 2003, North Carolinians have been living with a system in flux. And though the recently dissolved Blue Ridge Center and its slowly coalescing replacements have been providing treatment for patients who are suicidal or who have chronic and persistent conditions (such as developmental disabilities, major depression, bipolar disorder and schizophrenia), these agencies don’t offer marital or family counseling, except for people in crisis.

“All Souls takes clients who are stable and able to take care of themselves and who need short-term help,” explains Brooks, the agency’s director. “And while some of the new community programs do offer similar counseling, at least on paper, it takes a long time for people to get in there. One difference between a community mental-health setting and a private one is that we can get people appointments in as little as two weeks.” Besides individual therapy, the center periodically offers such programs as women’s and men’s groups, marriage and family counseling, and children’s services. A support group for people dealing with depression will be launched soon. “We have a Buddhist therapist, Jewish therapists, ordained people who can do Christian counseling, and others who can relate to atheists and agnostics. We really do extend our services to all souls,” Brooks reveals. “And while our name came from the center’s beginning at the cathedral, we are a completely independent organization. We have no religious affiliation.”

The center set up shop nearly five years ago, the creation of local counselors Stephanie Citron and Michael Penland. Both parishioners at All Souls Cathedral in Biltmore Village, they were concerned about the lack of treatment options for people without resources. So they decided to create a counseling service modeled on St. Luke’s in Atlanta, where Citron had worked before moving to Western North Carolina.

In 1999, the pair recruited a board of directors and began talking to other therapists about joining the effort. All Souls Counseling Center opened for business in October 2000 with just Citron and Penland providing counseling services. Since that time, the center has seen explosive growth; there are now 26 counselors and a psychiatrist under contract. “They are essentially volunteers,” notes Brooks. “They work for one-quarter to one-third of what they are paid in private practice or other positions, and do it as a form of public service.”

Besides providing therapy at the center, All Souls counselors work with local churches and agencies for the homeless; an All souls counselor visits both A-Hope and Hospitality House once a week, for example.

Services are offered on a sliding scale, and more than half the center’s clients pay $10 or less per session. Even so, client fees account for a substantial portion of the counseling center’s operating budget — more than $180,000 in 2004.

Initially, All Souls Cathedral contributed both startup funds and office space for therapy sessions (the center has since relocated to 33 Orange St. in Asheville). Current funding comes from United Way, the Mission Hospitals Foundation, the Sisters of Mercy and the KB Reynolds Charitable Trust. But foundation grants are often specifically targeted for the startup period, and like many nonprofits, the center faces financial challenges.

“We just sent out a mass mailing,” Brooks reports. “And just for fun, we included Oprah, Tiger Woods and Montel on the mailing list. There are people out there who care about people in other communities, and you never know.”

The center is also seeking funding for a full-time development director who would put together ongoing financial support. “We don’t have any shortage of clients,” says Brooks. “But eventually we will have to limit growth due to lack of funds.”