Atrium Health’s emergency rooms currently hold about 50 patients daily who are waiting for psychiatric beds, even when all existing facilities are occupied. Lisa McCanna, the health system’s vice president of behavioral health, confirmed this backlog during a recent interview. These individuals, often in acute distress, remain in emergency departments for hours or days—a situation known as boarding—while hospitals struggle to find space in overburdened psychiatric units.
North Carolina’s statewide shortage of roughly 1,500 behavioral health beds exacerbates the crisis. Nationally, psychiatric patients represent 21.5% of all emergency department boarding cases and stay nearly three times longer than those with medical conditions. The strain on emergency resources not only delays critical care but also increases costs and worsens patient outcomes. Additionally, it blocks beds needed for other urgent cases.
To address the issue, Atrium is investing $340 million over five years, including the construction of a new 168-bed behavioral health hospital in Charlotte’s University City area. Scheduled to open in 2028, the facility will include 48 pediatric beds, a mental health emergency department, and outpatient services. The project will repurpose a vacant four-story office building, reducing construction time and accelerating the timeline. Atrium acquired the property for $24.5 million last September and plans to hire 800 staff for the new hospital.
The new hospital will add 102 net beds by relocating 66 existing beds from an older site, but relief will take time. Other regional projects, such as the 72-bed Katie Blessing Center (opening in 2027) and WakeMed’s 150-bed facility (expected in 2029), will not immediately alleviate the pressure. Families in Mecklenburg County will continue facing delays for loved ones in crisis during this two-year gap.
Expanding mental health care beyond hospital walls
Beyond expanding inpatient capacity, Atrium is allocating about $140 million to community-based services, including school therapy programs, street psychiatry initiatives, and day hospitals in underserved areas. These efforts aim to reduce unnecessary emergency room visits by providing alternatives for less severe cases. However, advocates emphasize that additional beds alone will not resolve the broader systemic challenges.
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Cherene Caraco, director of the Charlotte-based Promise Resource Network, highlights that peer-managed crisis respite centers cost $650 per guest per day, significantly less than the $2,700 daily average for a hospital stay. Her organization operates such centers in Charlotte and Raleigh, arguing that these resources could prevent some emergency room visits before they occur. Despite these efforts, the current system remains overwhelmed.
Atrium’s expansion represents the largest single investment in behavioral health infrastructure in years, but immediate improvements for patients are limited. Psychiatric beds remain full, and the new hospital is still two years away. In the meantime, families bringing a loved one to an emergency room can inquire about wait times, whether evaluations can begin immediately, or if transfers to crisis units are possible. Providing records of medications, diagnoses, and warning signs may help streamline decisions, though the backlog persists.
Who benefits, and who’s left behind?
The new hospital will serve Medicaid patients, uninsured individuals, and those involuntarily committed, addressing gaps left by private facilities that often exclude patients based on insurance status or clinical criteria. Until the facility opens, emergency rooms will continue functioning as makeshift psychiatric holding areas.
The hospital’s design emphasizes efficiency and adaptability. The 159,000-square-foot office building, originally constructed in 2021 but left vacant, will be converted into a behavioral health center with flexible treatment spaces. These modular areas can accommodate different patient needs, including secure units for individuals requiring involuntary commitment. Its central location in University City will reduce travel barriers for patients across Mecklenburg County, many of whom already endure long emergency room waits due to distance from existing care sites.
