UNC Horizons Wins $1.18M for Mothers With Addiction, Mental Illness

UNC Horizons has been approved by the North Carolina Department of Health and Human Services, in partnership with Alliance Health, to launch Project PRIMA, a two-year pilot that will open a six-bedroom residential behavioral health home for pregnant and postpartum women who have both a substance use disorder and a severe mental illness. The program is backed by $1.18 million in state fiscal year 2027 funding administered by Alliance Health, the regional behavioral health plan that partners with the state on the pilot.

The Chapel Hill-based program, whose full name is Pregnancy, Recovery, Integrated Mental Health and Addiction Treatment, is designed to serve women whose psychiatric needs are too complex for the residential addiction programs that already exist for mothers.

Why existing family programs are not the same thing

North Carolina does not lack residential treatment for pregnant and parenting women. What it lacks, according to the announcement, is a residential setting built around intensive psychiatric care.

Existing programs "provide essential addiction treatment and recovery support," the release states, but "are not specifically designed to provide the intensive, integrated psychiatric treatment required by women experiencing severe and persistent mental illness." The announcement ties that gap to women with trauma histories and involvement with the justice system, groups it says face "significant barriers to appropriate treatment."

Project PRIMA is meant to sit at a different level of the continuum: a licensed residential behavioral health facility where psychiatric stabilization and addiction treatment are delivered by one team rather than two, and where the medical and parenting needs of a woman and her infant are part of the same plan. People seeking the more standard version of this care can find it through residential treatment programs that vary widely in what they are licensed and staffed to handle.

What a six-bedroom house can hold

The physical plant described in the release is modest and specific. Six bedrooms, configured for mothers and infants up to 12 months old, along with clinical space for nursing care and medication management, shared living and dining areas, a children's activity room, and safety and accessibility features designed for a maternal-infant population.

Staffing is a psychiatric mental health nurse practitioner, a licensed behavioral health counselor, a certified peer support specialist and registered nurses, with 24-hour coverage and residential support staff around the clock. The service list runs from psychiatric care and medication management to addiction treatment, individual and group therapy, family engagement, parenting support and discharge planning, delivered by one team rather than split between a psychiatric provider and an addiction program.

The program expects to serve about 12 to 18 women a year and will take referrals from all 100 North Carolina counties.

Twelve to 18 women a year is a small number against the size of the population it is meant to reach, and the release does not offer a count of North Carolina women with co-occurring perinatal conditions, so there is no way to measure the shortfall from the announcement alone. What the number does establish is the scale of a pilot: this is a unit meant to prove a model, not to absorb statewide demand.

The workforce piece may outlast the beds

Attached to the residential unit is a training mandate: at least 100 professionals across pregnant and parenting women's treatment programs and partner organizations, covering perinatal screening for substance use and serious mental illness, trauma-informed care, medications for opioid use disorder, referral coordination, and the ethics of caring for pregnant and postpartum women with complex behavioral health conditions.

That component is the part of Project PRIMA with reach beyond six bedrooms. A clinician who learns to screen for both conditions in the same visit, or who learns how to coordinate a referral into a program like this one, changes practice in facilities that will never share a building with it.

The program will be led by Elisabeth Johnson, a family nurse practitioner, Hendrée Jones, and Essence Hairston, a licensed clinical social worker and clinical addictions specialist, all of UNC Horizons.

What the pilot will and will not answer

The evaluation described in the release tracks psychiatric stability, access to medical and developmental services, and coordination of ongoing care, with findings intended to inform future expansion. That is an implementation study, not an outcomes trial, and it will not produce the kind of mortality or retention data that would settle whether the model works.

The funding structure is also annual. The release calls Project PRIMA a two-year pilot and says its scope of work and funding agreements are issued yearly, without describing what happens if the second year is not renewed.

For families, the practical question is narrower than any of that. A woman who is pregnant, in withdrawal and hearing voices has, until now, been a poor fit for the state's residential addiction programs and a poor fit for inpatient psychiatric care, because each is organized around one problem. Project PRIMA is an attempt to build a room where both are treated as the same problem, and it will hold a handful of people at a time.