Federal lawsuit alleges mental illness in North Carolina county jails

By Carolina newspaper staff

• A new federal lawsuit blames the North Carolina Department of Health and Human Services for delays in providing needed mental health services to people in the state’s local jails.
• The lawsuit filed by Disability Rights North Carolina claims that inmates with mental health issues wait an average of two months to be assessed for competency to stand trial. They wait almost five months to receive treatment in a state psychiatric hospital.
• The lawsuit calls the situation a “statewide crisis.”

A new federal lawsuit alleges that people with mental health problems sit in North Carolina county jails for months before receiving the services they need. The lawsuit blames the state Department of Health and Human Services.

Pursuant to the Due Process Clause of the Fourteenth Amendment, a person with a mental disability charged with a crime and detained solely because of his or her incapacity to stand trial may not be detained longer than a reasonable period of time necessary to determine if there is a crime. substantial likelihood that he will achieve that ability in the foreseeable future, wrote attorneys representing Disability Rights North Carolina. The group filed a lawsuit Thursday.

In violation of this basic principle, North Carolinians with severe mental and other cognitive disabilities are held in prisons for months and, in some serious cases, years at a time, the complaint continued. Their prolonged detention extends far beyond what is reasonable under the circumstances for an evaluation and determination of whether they have the necessary mental capacity to stand trial.

The lawsuit seeks to reduce deeply harmful and unconstitutionally prolonged detention times.

DHHS is systematically violating the Fourteenth Amendment, [Americans With Disabilities Act]i [Rehabilitation Act] by not providing in a timely and appropriate manner the capacity assessment and restoration services to prisoners in pretrial detention who are suspected or considered incapable of proceeding (collectively, those arrested for ITP), in such a way timely and appropriate.

Disability rights points to two main problems. First, people who have been charged with a crime and have had their capacity to stand trial often spend months waiting for a capacity assessment by Local Authority/Managed Care Organizations (LME/ MCO) or the Central Regional Hospital (Central Regional).

Second, individuals in North Carolina who have been charged with a crime, declared incompetent to stand trial, and ordered to a state mental hospital to undergo an involuntary commitment examination or have the services of capacity restoration wait months for the necessary bed space to receive these court orders. services, the complaint alleged.

According to the lawsuit, detainees wait an average of two months for competency evaluations to be completed and nearly five months for treatment at a state psychiatric hospital. In contrast, the average wait time for a capacity evaluation in Virginia is seven days.

Because of the long wait times, some detainees spend more time in pretrial detention awaiting a competency assessment and further treatment than they would ever receive as a sentence if convicted.

The number of state mental health treatment beds has dropped from 892 to 453 in the past seven years, the suit argues. Of the remaining beds, about 35% are occupied by people who are ready for discharge but cannot leave, according to the lawsuit. Very often in these cases, people who are ready for discharge cannot be discharged due to a lack of adequate services available in the community.

Disability Rights blames DHHS for failing to ensure that LMEs/MCOs meet their statutory and contractual duties to develop and maintain community-adequate provider networks.

County jails are intense and stress-inducing environments, generally unfit for those diagnosed with any type of debilitating illness, let alone severe mental disabilities, the lawsuit said. Prolonged detention in these settings can cause ITP detainees to experience a further decline in mental health, which can lead to self-harm and threats to the safety of ITP detainees.

This is a statewide crisis. NCDHHS’s mismanagement and failure to provide essential mental health services in a timely manner exacerbates existing problems and inflicts cruel and unusual pain and suffering on ITP detainees who wait long periods for services that NCDHHS is legally entitled to required to provide, disability rights advocates argued.

The lawsuit names DHHS and Secretary Kody Kinsley as defendants.