Community support can help if it's well-focused

Not all private providers of mental-health services are in trouble with the state.

Tim Brooks, a co-owner of Carolina Outreach, a company based in Durham, said the rules on community support haven't been clear, but what's important is that workers make sure time spent with clients connects to treatment goals. His workers rarely spend their time in classrooms, he said.

The state could do more to help mold a better mental-health system, Brooks said, by taking the reams of information it collects from service reviews and company reports on patient progress to figure out what makes clients better.

Ryan Ort, a community support worker with Carolina Outreach, says he takes an active role in teaching children and teenagers how they can control their behavior and getting them to think about what they want to accomplish.

Ort, 34, doesn't see the boys every day. Usually it's twice a week for two or three hours at a time. The children he works with usually are diagnosed with ADD, ADHD, or oppositional defiant disorder, which can get them in trouble at school and at home.

Ort has been working with 14-year-old Frank Davis of Chatham County to get him to attend school regularly and relate better to his parents. Frank is repeating seventh grade because he missed so much school last year. Frank was depressed. His parents were living apart, and his mother was ill.

The job involves working with Frank's parents, too. One recent Tuesday, Ort spent an hour talking to the family about goals met during the week and what steps they could take to prepare for Frank's graduating from community support.

"We're not there just to be a friend," Ort said in an interview.

"The time we spend together, we're talking about their goals and plans and how to reach them."

Community support should be a temporary service, he said, because one of the goals is to show the children and their families how they can go on without it.

From the start, Ort said, he starts talking to children about how the service will end.

"All the while, we have discharge in mind," he said. "The whole purpose is to work yourself out of a job."