Supporting Mental Health: Sanctuary and Community Matter Now More Than Ever
By Kate Welsh, MS, LMSW
Mental illness affects one in five adults in the United States each year. In North Carolina, the need for mental health care access is urgent. Many individuals and families here continue to struggle with affordable and accessible mental health services—often because they are uninsured or underinsured. According to The National Alliance on Mental Illness (NAMI), more than 11% of North Carolina residents were uninsured in 2021, leaving them to navigate medical and mental health care without adequate support.
Over the past several years, we have seen and helped create meaningful progress in destigmatizing mental health and expanding access to care. More people feel comfortable reaching out for help.
However, recent and upcoming changes to Medicaid funding threaten this progress. These changes may significantly reduce or eliminate mental health coverage for many current Medicaid recipients.
The Ripple Effect of Medicaid Cuts
Right now, Medicaid clients can receive outpatient mental health care from in-network providers without out-of-pocket costs. If their benefits change—or disappear—many will no longer be able to afford services, even with sliding-scale fees. Practices like Sanctuary Counseling Group, who are committed to serving all clients regardless of financial means, are preparing for a surge in demand for our Samaritian Scholarship Fund (SSF). Approximately 11% of Sanctuary’s clients in 2025 are insured through Medicaid plans.
But the impact doesn’t stop with those insured through Medicaid.
Private insurance companies are already reacting. Anticipating an increase in provider fees—insurance carriers are preparing to raise monthly premiums for people with employer-sponsored plans, Affordable Care Act marketplace plans, and privately purchased plans.
As premiums rise, many individuals will be forced to choose higher-deductible plans with lower monthly costs. These plans require people to pay more money up front before coverage begins. This is what it means to be underinsured: having insurance on paper, but not being able to afford to use it.
📈 Higher Monthly Premiums ➡️ People Switch to High-Deductible Plans
High-Deductible Plans Mean:
💰 Lower Monthly Premiums, BUT…
💸 Higher Upfront Costs (full session fees)
🧾 Insurance Only Helps After the Deductible is met
💳 Often still owe Copays & Coinsurance, Start After the Deductible is met
This shift means that even individuals who previously had stable, comprehensive insurance coverage may struggle to afford mental health care. As a result, Sanctuary Counseling Group expects increased need for financial assistance not only from former Medicaid clients but also from privately insured clients who simply cannot meet their deductibles.
How the Community Can Help
The growing gap between the cost of care and people’s ability to pay underscores why support from individuals, businesses, churches, and foundations is essential.
Sanctuary Counseling Group’s mission is to ensure that anyone who seeks care can receive it, regardless of their financial circumstances. To sustain this commitment, we rely on community generosity in several forms:
Monetary donations that support our mission to make mental health care accessible!
Business and foundation partnerships that help us expand our impact
Word-of-mouth support that connects more people to support and receive our services
Social media engagement, which helps raise awareness
Community advocacy, reminding friends, coworkers, and neighbors that mental health care is essential and should be accessible to all!
Your Voice and Support Make a Difference
At a time when many North Carolinians are facing increased financial pressure and fewer mental health care options, your support helps ensure that no one has to navigate mental illness alone.
Whether you give, share, speak up, or partner with us, you are helping build a stronger, healthier, more connected community. Sanctuary Counseling Group remains dedicated to providing compassionate, affordable mental health care—and with your help, we can continue to meet the growing need.
Kate Welsh, MS, LMSW
kwelsh@scgnc.org
Director of Operations & Development
