NC accused in lawsuit of letting people with mental disabilities languish in local jails

North Carolina’s lack of assessment and treatment services results in people with severe mental disabilities languishing in county jails while waiting months for psychiatric services, a lawsuit contends.

The federal complaint contends the long waits also burden county jail administrators, which don’t have the resources, staff or training to deal with people with serious mental disabilities.

Often people with severe mental and cognitive disabilities, who have challenges following jail rules and staying calm, end up isolated, or in restraints, the lawsuit states.

“Use of these measures, especially if prolonged, often increases the risk of further decompensation and self-harm,” the lawsuit states.

Civil rights advocacy organizations the ACLU of North Carolina Legal Foundation, Disability Rights North Carolina and a private law firm filed the lawsuit Thursday against the North Carolina Department of Health and Human Services and its secretary, Kody Kinsley.

The lawsuit asks a judge to confirm the state is violating the constitutional rights of people who are suspected or found to be mentally incapable of proceeding to trial. The lawsuit also asks a judge to order the state to increase services and develop a remedial plan.

North Carolina experienced an increase in demand for mental and behavioral health services in recent years, while state psychiatric hospitals are facing unprecedented staffing shortages, Health and Human Services spokesperson Kelly Haight Connor wrote in an email.

“The impact of increased need and limited space has overwhelmed state hospitals,” for those in jail and others who need beds, Haight Connor wrote.

In response, the department has been investing in new programs, such as a 2022 Mecklenburg County pilot that partners with other agencies to help individuals deemed unable to proceed to trial to receive treatments while in jail.

Too sick for trial

The complaint centers on people who end up staying in jail for months or years if there are concerns that they are too sick to understand the court process or defend themselves due to mental disabilities.

Those individuals wait on average two months for an assessment to be completed and nearly five months for treatment at a state psychiatric hospital, the lawsuit states. While waiting they remain in jail, sometimes longer than they would be if convicted.

In 2023, there were 197 people on the wait list for the 82 beds at forensic hospitals available to those in jail, according to the lawsuit.

As of March 28, there were 159 people in jail waiting for a bed in one of the three state psychiatric hospitals, Haight Connor wrote.

Burden on local jails

Eddie Caldwell, executive vice president of the North Carolina Sheriffs’ Association, said jails are meant to detain people before trial, not to provide mental health services.

“So you can imagine the difficulty of dealing with and trying to help people who have mental illness without having adequate resources to do it,” he said.

What’s needed, Caldwell said, is a regional facility for people with mental-health disabilities and substance abuse issues, he said.

Instead, Caldwell said, those individuals are just sitting in jail.

People with mental-health disabilities are especially vulnerable to manipulation and threats, which is compounded by sometimes overcrowded jails, the lawsuit states.

Last year, WFAE in partnership with PBS Frontline published a series on North Carolina’s mental health system, including individuals in jails waiting for assessments and mental health services,that found that the median wait from incarceration to hospitalization was 313 days in the 34 counties they studied.

The lawsuit is one of at least three that includes Disability Rights accusing the state of violating constitutional rights due to a lack of appropriate services for people with mental disabilities. Last week, Disability Rights and the Department of Health and Human Services settled a complaint on services for people with intellectual and developmental disabilities.

Also last week, a judge dismissed the state’s push to end a lawsuit that contends DHHS is warehousing foster youth at psychiatric facilities.

Virginia Bridges covers criminal justice in the Triangle and across North Carolina for The News & Observer. Her work is produced with financial support from the nonprofit The Just Trust. The N&O maintains full editorial control of its journalism.