Unprofitable with Elly Molina

That’s the word that plays over and over again in my mind as I drive twenty minutes out to an eating disorder and mental health treatment center in Durham, North Carolina. Carolina House offers residential, partial hospitalization (PHP), and intensive outpatient care (IOP) for adults. And yet, despite being one of the few facilities of its kind in the state, it has been shut down and deemed financially unsustainable. Clients were forced to transfer elsewhere, and staff members to work overtime, fighting insurance companies, finishing notes, and saying rushed goodbyes in a matter of weeks. The phrase “unprofitable” lingers, cruelly in my mind. The irony behind a facility so clearly effective and so monumental in the recovery journeys of hundreds of clients, being labeled “unprofitable” feels immeasurable and unjust. With the sites final few clients being discharged in October, and its doors closely entirely in November, I can still look back at my time on site as something irreplaceable and an experience that inadvertently opened many more doors that I can reflect on. 

When I officially stepped into Carolina House on August 25, I immediately noticed something striking: there was no hierarchy in the way care was discussed. Treatment team meetings included dietitians, therapists, psychiatrists, behavioral health assistants, clinical directors, and even the CEO discussing each client on a case-by-case basis: diagnosis, severity, treatment progress, and setbacks. It was collaborative, not top-down. Every voice mattered.  

That team-based, holistic approach was what drew me to Carolina House in the first place. I wanted a worksite that felt like a community, not a business. Eating disorders had touched my own life through my fifteen years as a competitive dancer, where I witnessed firsthand how perfectionism and body image pressures could spiral into harmful behaviors. So when I matched with Carolina House and learned that Emily Dolegowski, former Gil Program Manager, would be my supervisor, it felt meant to be. 

With Emily’s guidance, I designed a flexible schedule: four to five hours on site Mondays and Tuesdays, paired with off-site research work. This balance allowed me to grow in two directions: directly with clients in clinical settings such as shadowing group therapy and honing my research skills through my independent study. I shadowed a wide range of clinical sessions, from body image groups and psychodrama to CBT and yoga mindfulness flows. These experiences showed me that Carolina House offers far more than traditional talk and face-to-face therapy but rather provides clients with long-term tools like intuitive movement and psychoeducation. 

In terms of my work off-site, which fills my current days with the site’s closing, my work has focused on designing an independent research project evaluating success outcomes. Specifically, I am looking at constructs like anxiety and depression and how they changed from the time the client was at intake to after discharge. I am measuring this through scales like the GAD-7 (Generalized Anxiety Disorder Scale) and the PHQ-9 (Patient Health Questionnaire for depression). I also plan on assessing trends and patterns in length of stay and symptom severity across time. My project aims to assess whether treatment at Carolina House leads to measurable improvement in mental health symptoms and cognitive distortions, even as the facility itself faces shutdown. This data has several implications: a site deemed “unprofitable” by insurers may, through the data I present, reveal itself to be highly successful in helping clients improve. 

Lastly, I would like to extend a huge thank you to Emily Dolegowski for being the most incredible mentor I could ask for. The time and effort Emily put in to make sure my days were filled with a wide range of clinical experiences did not go unnoticed. Emily and I will continue to meet at coffee shops and on campus to discuss advancements with my data analysis and research paper.  

The word “unprofitable” will likely continue to echo in my head, but being present in the months I have left here feels more important than dwelling on its ending.