Cuyahoga County Executive Chris Ronayne has a plan to balance the budget next year – and it will likely require major cuts to the area’s network of mental health and addiction services. 

Across the board, county social services are likely to take a hit. The current proposal suggests cutting $20 million from the health and social services fund in 2026. 

It’s what had to be done to make the budget work, said David Merriman, the county’s director of health and human services. The services are funded almost entirely by a property tax, which fewer and fewer people are paying. In order to cover the growing costs of employee health care and placements for foster kids, the county is proposing to cut back on social service spending, he said.

The proposed cuts include $4 million from what the county typically pays to the local board that coordinates addiction and mental health services, the Alcohol, Drug Addiction and Mental Health Services board of Cuyahoga County (ADAMHS).

Since the ADAMHS board will likely have less money to pass out next year to the dozens of addiction and mental health providers it supports, it’s planning for a 20% across-the-board cut to the programs it supports. That compares to the 10% cuts it initially planned for. (The board will vote on its budget Wednesday. The county will vote on its final budget in early December.)

In budgeting, the cuts are a number. But how would that translate to services lost in the community?

In an October county council meeting, Ronayne said that the county will maintain “vital services.” In a statement, the ADAMHS board wrote that it can’t predict what the cuts will mean for individual organizations. On a system-wide level, though, it said it’s working to “protect essential services and maintain stability across the safety net.” ADAMHS dollars often aren’t the only source of funding agencies rely on to run programs: Medicaid reimbursement, donations and money from the state can be used, too.   

Nonprofit leaders and workers are less rosy in their assessments. Many flocked to the county council in the wake of the budget announcement to share their concerns: less money often means less staff, which means fewer people facing addiction or mental health crises who can be served.  

“The county has been so generous with … the levy dollars for health and human services. And that has created a very strong safety net in Cleveland,” said Ed Gemerchak, the senior vice president of behavioral services at Y-Haven, a facility that treats and houses people with substance use disorders. “And this will rip holes in that net, unfortunately.” 

Signal Cleveland visited three programs that serve people with addiction or who are facing mental health crises. What would budget cuts look like on the ground? Kara Poth, a licensed professional clinical counselor, is the associate director of crisis services at FrontLine Service. She’s worked for agencies offering mental health support for 25 years, where she’s seen her fair share of layoffs and budget cuts.  

“Working in nonprofit world, it’s kind of normal,” Poth said. “But this extent – of what’s happening now? No. This is a level beyond what I’ve ever experienced.” 

Click on the image below to read more about the program

Stricklin Crisis Stabilization Unit, FrontLine Service

The first thing social worker Gina Maher did after getting to work was review new patients who might come to the Stricklin Crisis Stabilization Unit near West 85th Street and Detroit Avenue. 

On a Friday in November, a local hospital called to ask whether the unit could take three patients. Two had been involuntarily hospitalized by a court. One was suicidal and another had been acting aggressively at the place they were living, she said. A third was hospitalized after starting a fire in their apartment. 

The patients couldn’t stay at the hospital indefinitely. But none had housing to return to, Maher said, and they still needed mental health support. At the unit, the patients could get their medications delivered on-site. There would be time for one-on-one conversations with mental health professionals. And daily group therapy sessions could offer techniques for handling challenging emotions. Maher had just led a conversation about how to offset negative thoughts.  

That day, though, the unit could only take one of the patients. Four staff were laid off several weeks ago due to budget shortfalls and in preparation for a 10% cut from the ADAMHS board, Oliver said. The facility has always been hesitant to accept people who have a high risk of hurting themselves or others, and caution intensified when staffing went down. Now, if somebody has more acute mental health symptoms, the facility might not be able to accept them, said Poth, who manages the unit.

Where do patients discharged from the hospital go if not the crisis stabilization unit? Those without housing often go to an emergency shelter, Poth said. If the crisis unit closes completely, she fears that’s where most people will end up after hospitalization.

Poth and her staff are concerned about the possibility of closing. The full extent of the cuts will be seen in 2026 and 2027. With those, Poth and FrontLine aren’t sure whether the unit can stay open.  

Larger shifts in the crisis service network are responsible for some of the more significant cuts that Stricklin is facing. The county and its mental health and addiction board decided to fund a new crisis center, operated by a separate nonprofit, that will come online in fall 2026. In theory, that will take the place of Stricklin and the county’s diversion center on East 55th Street.  

Even so, Poth said there’s enough demand for both facilities. The stabilization unit is nearly 50 years old, a community fixture that many struggling with mental health and homelessness on the Near West Side rely on. It took one woman with severe mental illness four to five stints at the crisis unit before she finally moved into stable housing after years of chronic homelessness, Maher said.

“It takes a couple times for them to come and finally realize, ‘OK, I need to do this, this and this,’” Maher said. “And we’re always here for them to come back.”

Cuts have already eroded the services the unit can offer. An activities director who led arts and crafts is no longer there, leaving afternoons less structured. Staff used to be able to drive patients off-site for appointments, but there’s no longer enough people to do that.  

On that fall Friday, several patients paced the main hallway, which leads up to a circular workstation with mental health staff. Theo Smith, a peer support worker there, leaned over the desk to chat with one of the patients. The person was getting help for struggles with depression and self-esteem, he said, and he’s trying to build her confidence to prepare for leaving the facility.   

Y-Haven, run by YMCA of Greater Cleveland 

When Venus Henderson first decided she wanted to get sober, she headed to Y-Haven’s front doors. She had been living at her daughter’s home, with no lease of her own — technically homeless, she called it. Henderson was tired of it.

She didn’t have a phone to call ahead to Y-Haven, so she walked. The staff at the front desk told her that before she could be accepted to the program, she needed to go to detox, a place to safely withdraw from drugs or alcohol.

It took her six months to get to detox. The disease of addiction kept saying “one more, one more,” Henderson said. That’s often the case for people with substance use disorders, who have to overcome mental hurdles before getting into treatment at places like Y-Haven. Here, residents like Henderson live and spend their days with counselors, social workers, therapists and nurses. The program takes up three stories of a tall building near Woodland Avenue and East 55th Street. 

Y-Haven is worried, though, that clients in the near future may also have to overcome financial obstacles and logistical hurdles to get help. Less funding means the facility may have to start requiring Medicaid to be admitted, said Gemerchak, Y-Haven’s director. It also could limit the number of people who can be seen, leading to longer wait times.  

Right now, Y-Haven tries to schedule callers into the facility in about a week. Henderson got in about six days after calling, never having to leave detox before she entered treatment. Van Holloway, another resident, said he called on a Friday and started the program the next Tuesday. The ability to move as quickly as possible is important for people with substance use disorders, said Bradford Nickel, another resident. 

“I know for myself, when I call, I’m ready to go ASAP,” Nickel said. “If I don’t go when I want to go, it’s, like, I can end up back in the street. Be running around for another month, year, five years, you know. Dead.” 

Shorter wait times aren’t the only thing Y-Haven has going for it. For Nickel, Y-Haven offers more “freedom” than other treatment facilities. Residents are able to leave the building at times to go to meetings or buy food. Each person gets a private bedroom, which is near-universally appreciated after moving out of homelessness or incarceration. And Holloway said many of the counselors are recovering from addiction themselves and have a close connection with clients. 

Then there’s the programming. The walls next to the elevator at Y-Haven read like a community events bulletin board. Yoga is on Mondays and Wednesdays, a poster says. Costumes were encouraged at this year’s Halloween party. A murder mystery party appears to be in the works, too, though it requires at least 18 people to sign up. Abeni Wright, another resident, takes crocheting classes. 

“Being bored is one of those things that can take you right out the door,” said Henderson, who leads a game night for women on Wednesday and attends creative writing classes. “And a lot of people don’t know what sober fun is.”

It has worked for Henderson. Several weeks ago, she “coined out” — a ceremony that represents her graduation from an intensive therapy program into the next step of Y-Haven, in which residents plan for a future outside of treatment. She’s already signed up for a Christian job-readiness program. Y-Haven gave Henderson a “better hope” for herself. She’s just worried about whether the opportunities will remain for others who need it, too.

“I have a child out there in active addiction,” Henderson said. “And those cuts could mean she has no place to go when she wants to reach out for help. And that would be devastating for me.”

Mobile Crisis Team, Frontline Service

When John Rudolph and Andrew Getz first knocked on the front door on an October afternoon, no one answered. 

They dropped a Client Rights handbook in the mailbox, with their names and a crisis phone number attached, and returned to the car. That’s when they saw the woman they were looking for. Middle-aged with curly hair, she carried a large green grocery bag. She seemed to have come out of nowhere. Perhaps she circled around from the back of the home, they wondered? Now, she was walking around to the front door and letting herself in. 

Rudolph and Getz got out of the car to try again. 

“We’re from mobile crisis,” Rudolph said. “We got a call from someone who was concerned about you.”  

The woman appeared frazzled and a bit exasperated by their presence. She didn’t have time to talk right now, she told them. Her pressing concern was a man who she said had been hiding in the corner of a yard across the street, a concern authorities were not taking seriously.  

Rudolph asked if she goes anywhere for services. She said no and told him, once more, that she really had to go. She headed inside, and the team left.  

“She didn’t seem manic,” Rudolph told his supervisor over the phone. “I think it’s more just paranoia and psychosis.” Psychosis means someone is not in reality, he explained, potentially having delusions or hallucinations. Angry signs posted on the home also raised alarms.  

Interactions like these illustrate a tough part of the team’s work — to “convince the ill that they’re ill,” Rudolph said. Social workers and counselors don’t have the power to make anyone seek mental health services. But in this case, the team acted as a connector. A peer support worker had initially asked the mobile crisis team to check on the woman, out of concern for her mental state. Now, the mobile crisis team could pass back the information they gathered in hopes the worker could advocate for a judge to mandate a mental health evaluation. 

FrontLine has about 14 mobile crisis workers who take shifts responding to calls in-person. About one in 10 callers need the face-to-face support, Oliver said. They are primarily people with suicidal thoughts, severe depression or psychosis. If the person is willing, the mobile crisis team asks them a series of questions and, if needed, can sign them up for a psychiatric appointment. 

In urgent circumstances, staff can drive a person directly to mental health treatment, like FrontLine’s crisis stabilization unit or the hospital. In some cases, like if the caller says they’re wielding a weapon, FrontLine has to alert the police. The goal is to avoid that, Rudolph said.  

“A lot of times when they see the police, they’re just going to clam up,” Rudolph said.

Already this fall, though, FrontLine laid off four people from the mobile crisis team in response to separate budget shortfalls this year and in preparation for a 10% cut from the ADAMHS board, Oliver said. Now, more dollars are at risk, and staffing could drop even further. When staffing is short, the team has to cut back on field visits because the team’s number one priority is answering the phone. About 200 calls come in a day.  

“If we can’t get out, what would happen is a lot of times we are sending the police for a wellness check, when really we should be doing it,” Rudolph said.

It’s happened in years past, he said, when staffing levels fell. People or hospitals requesting the team go out and assess residents’ mental health sometimes got frustrated. 

“I said, if you understood the staffing, you’d get it,” Rudolph said. “It’s not like we’re sitting here twiddling our thumbs. We’re working like crazy. The sheer volume is just overwhelming.”

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