Long waits for mental health care in NC are violating constitutional rights, lawsuit claims

North Carolina is violating the rights of mentally ill or disabled people accused of crimes by keeping them in custody longer than it should allow, a new lawsuit claims.

The lawsuit, filed last week by the advocacy group Disability Rights North Carolina, blames a decline in government services and a slow bureaucratic process. Because of these problems, he says, people who face questions about their mental competency to stand trial are unduly forced to spend months in jail after being arrested and, in some cases, longer than they should. time in prison, even if they pleaded guilty.

North Carolinians with severe mental health disabilities and other cognitive disabilities are incarcerated for months and, in some severe cases, years at a time, the lawsuit says. Their prolonged detention extends far beyond what is reasonable under the circumstances for an assessment and determination of whether they have the necessary mental capacity to stand 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 their processes.

The agency has not formally responded to the court. DHHS spokeswoman Hannah Jones said Monday that the department does not comment on pending litigation, but that, in general, DHHS plans to continue making services available to the defendant. Prioritizing the behavioral health needs of people awaiting trial will not only resolve detainees’ legal charges, but strengthen North Carolina’s legal and mental health systems, he said.

DHHS also noted that the most recent state budget spent $835 million on strengthening North Carolina’s behavioral health system, of which $99 million will be spent on the criminal justice system and those involved.

A judge has ordered the case to go to mediation to see if both sides can reach a settlement without the need for a trial.

For some, wait for the last few years

In particular, 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 federal, state and local governments, as well as private companies, over their treatment of people with disabilities.

The group has also partnered with the NAACP in a separate class action lawsuit against DHHS, alleging widespread discrimination against the hundreds of children with disabilities who have been placed in foster care in North Carolina. Earlier this month, Disability Rights and DHHS agreed to settle another lawsuit that seeks to create more care options for people with intellectual and developmental disabilities.

Grafstein is one of a dozen lawyers involved in the case for disability rights, the American Civil Liberties Union and the national law firm Arnold & Porter. When the lawsuit was first filed, a different disability rights attorney, Susan Pollitt, said DHHS could fix some of the problems by doing more to help people with mental health issues before getting involved in the criminal justice system.

Many of those sitting in prison are there because of a 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 not having the mental capacity to stand trial. The lawsuit says it takes an average of two months to even get an appointment for a doctor to rule on his competency.

And then for anyone who needs mental health treatment before being tried, it takes an average of five more months for a bed to open up in one of the states’ mental health facilities so they can begin their treatment , the lawsuit says.

He cites several cases as recent examples:

• A Columbus County man who spent 17 months in the county jail, much of it in solitary confinement and awaiting mental health treatment before he could stand trial, after being charged with a parole violation in 2021.
• A Sampson County woman was arrested on Halloween 2021, charged with possession of methamphetamine. She was declared unfit to stand trial but was only admitted to a psychiatric hospital this month, nearly two and a half years later.
• A Cleveland County man arrested and charged with assaulting an officer in July 2022 has been found incompetent to stand trial but is still in the county jail nearly two years later, waiting for a hospital bed to open up mentally to be able to start receiving treatment.
• An Iredell County man whose mother called police to have him involuntarily committed to a mental hospital in May 2023. It took six months for him to be evaluated, during which time he was locked up in the county jail His evaluation was completed two months ago, the lawsuit says, but that report had not yet been filed in court at the time the lawsuit was filed. Meanwhile, 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 shrinking mental health services in North Carolina.

To make matters worse, the number of beds in state facilities for the mentally disabled has declined significantly over the past decade, the lawsuit claims, citing a report that found North Carolina’s capacity has dropped from 892 to 453 beds over the last seven years.

DHHS recognizes the difficulty of keeping its psychiatric hospitals fully staffed, which has resulted in some beds remaining empty.

WRAL reported last year that across state government by 2022, more than 16,000 job openings were unfilled. More than a quarter of those vacancies, 4,379 of them, were at DHHS, double the number of vacancies the health agency had before the Covid-19 pandemic, which officials blamed last year of pandemic era exhaustion.

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 capacity. The impact of increased need and limited space has overwhelmed state hospitals, resulting in long waiting lists for beds both for people who need capacity restoration and for people not involved in the justice system that require other services.