In Western North Carolina, mental health and substance use are persistent community health priorities. But navigating care and long-term supports can be complex, confusing and layered with systemic barriers. At the national level, “No Wrong Door” is a framework for making fragmented systems easier for people to navigate. But one regional program in Macon County answers the question: “What does No Wrong Door look like when it is built from the ground up by people responding to the realities of one community?“

On August 28th, the Western North Carolina Health Policy Initiative (WNC HPI), a program of the North Carolina Center for Health & Wellness (NCCHW) at UNC Asheville, convened healthcare and community leaders from across the region for a discussion with HCA Healthcare CEO Sam Hazen and Mission Hospital CEO Greg Lowe.

The meeting took place at the Mountain Area Health Education Center (MAHEC) and provided an opportunity for regional stakeholders to hear directly from HCA and Mission top leaders about Mission Hospital’s ongoing efforts to improve access to care, strengthen quality and patient safety, build a more stable healthcare workforce, and improve patient flow.

On Friday, June 27th, 2026, WNC Health Network’s Meron Abebe (M.S., MBA, MPH), Director of Operations/Evaluation & Learning Advisor, along with Emily Kujawa (MPH, RD), Director of Partner Engagement, joined WNC HPI partners to share findings from the analysis. The researchers shared data across five major themes shaping youth mental health in the region—access to care, care coordination and navigation, prevention and early intervention, youth engagement and supportive spaces, and social determinants of health—and invited feedback from providers, policymakers and others regarding their experiences and insights.

Western North Carolina is facing a sustained mental health and substance use crisis. But improving behavioral health access and outcomes will require more than simply increasing the number of providers. It will require building a system that enables clinicians to stay in community practice, supports patients in accessing timely care, and aligns incentives with long-term health outcomes. In a recent conversation with clinician Lissa Carter, we learned about the challenges and opportunities facing mental health providers—and patients—in our region.

Data from the WNC Health Network shows a 39% increase in poor mental health in the region since 2012, alongside widespread impacts of substance use across households. In this episode of the WNC Health Policy Podcast, we begin to explore the mental health and substance use landscape of Western North Carolina through the experience of clinician Lissa Carter, who has worked across recovery, community mental health, education, and clinical leadership roles in Buncombe County.