Lengthy waits for mental health care in NC are violating constitutional rights, lawsuit claims
North Carolina is violating the rights of people with mental illnesses or disabilities who are accused of committing crimes by keeping them in custody for longer than should be allowed, a new lawsuit alleges.
The lawsuit, filed last week by advocacy group Disability Rights North Carolina, blames a decline in government services and a sluggish bureaucratic process. Because of those problems, it says, people who face questions over their mental competence to stand trial are being improperly forced to spend months in jail after being arrested — and in some cases longer than they would have spent in prison even if found guilty.
“North Carolinians with serious mental health disabilities and other cognitive disabilities are languishing in jails for months, and in some severe cases, years at a time,” the lawsuit says. “Their prolonged detention extends well beyond what is reasonable under the circumstances for an evaluation and determination of whether they possess the requisite mental capacity to proceed to trial.”
Disability Rights North Carolina wants a federal judge to force officials at the North Carolina Department of Health and Human Services — which oversees mental health hospitals — to speed up its processes.
The agency hasn’t formally responded in court. DHHS spokeswoman Hannah Jones said Monday that the department doesn’t otherwise comment on pending litigation — but that, in general, DHHS does plan to continue making services available to the accused. “Prioritizing the behavioral health needs of individuals awaiting trial will not only resolve the legal charges of detainees but will strengthen the legal and mental health systems of North Carolina,” she said.
DHHS also noted that the most recent state budget spent $835 million on beefing up North Carolina’s behavioral health care system, of which $99 million will be spent on the criminal justice system and those in it.
A judge has ordered the case to go to mediation to see if both sides can reach a compromise without the need for a trial.
For some, waits last years
Notably, the case features a Democratic state lawmaker — Sen. Lisa Grafstein, D-Wake — suing the administration of Democratic Gov. Roy Cooper. Grafstein has worked for years for Disability Rights, a civil liberties group that has a history of suing the federal, state and local governments, as well as private companies, over their treatment of individuals with disabilities.
The group is also partnering with the NAACP in a separate class action lawsuit against DHHS, claiming widespread discrimination against the hundreds of children with disabilities who have been placed into foster care in North Carolina. Earlier this month, Disability Rights and DHHS agreed to settle yet another lawsuit seeking to create more care options for people with intellectual and developmental disabilities.
Grafstein is one of a dozen lawyers involved in this case for Disability Rights, the American Civil Liberties Union and national law firm Arnold & Porter. When the lawsuit was first filed a different Disability Rights lawyer, Susan Pollitt, said DHHS could fix some of the problems by doing more to help people with mental health issues before they get involved in the criminal justice system at all.
“Many who are sitting in jail are there because of lack of services and support in the community,” Pollitt said.
The lawsuit focuses on the rights of people accused of crimes who are suspected of maybe not being mentally competent to stand trial. The lawsuit says even getting an appointment for a doctor to rule on their competency takes two months on average.
And then, for anyone found to need mental health treatment before standing trial, it takes an average of five more months for a bed to open up in one of the state’s mental health facilities so they can begin their treatment, the lawsuit says.
It cites several cases as recent examples:
- A Columbus County man who spent 17 months in the county jail, much of it locked in solitary confinement and awaiting mental health treatment before he could stand trial, after being accused of a probation violation in 2021.
- A Sampson County woman arrested on Halloween in 2021, accused of having meth. She was declared incapable to stand trial but was only admitted to a mental hospital this month, nearly two-and-a-half years later.
- A Cleveland County man arrested and charged with assaulting an officer in July 2022, declared incapable to stand trial but is still in the county jail nearly two years later, waiting for a bed to open up in a mental hospital so he can begin receiving treatment.
- An Iredell County man whose mother called the police asking for him to be involuntarily committed to a mental hospital in May 2023. It took six months for him to be evaluated, during which time he was held in the county jail. His assessment was finished two months ago, the lawsuit says, but that report still hadn’t been submitted to the court at the time the lawsuit was filed. In the meantime, he remains behind bars.
The long waits are a violation of the U.S. Constitution and the Americans with Disabilities Act, the lawsuit claims, and are due in part to North Carolina’s shrinking mental health services.
“Making matters worse, the number of beds in state facilities for people with mental health disabilities has declined significantly over the last decade,” the lawsuit states, citing a report that found “North Carolina’s capacity has fallen from 892 to 453 beds during the last seven years.”
DHHS acknowledges difficulty in keeping its mental hospitals fully staffed, which has in turn led to some beds being kept empty.
WRAL reported last year that across all of state government in 2022, more than 16,000 job openings were unfilled. More than a quarter of those vacancies, 4,379 of them, were in DHHS specifically — double the number of vacancies the health agency had before the Covid-19 pandemic, which officials last year blamed on pandemic-era burnout.
“In recent years, the state has seen an increase in demand for both capacity restoration and behavioral health services,” DHHS said in a statement Monday. “At the same time, state psychiatric hospitals have struggled with unprecedented staffing shortages, limiting their ability to operate at full volume. The impact of increased need and limited space has overwhelmed state hospitals, causing long waitlists for beds — both for people who need capacity restoration, and people not involved in the justice system who require other services.”
