Federal suit claims mentally ill languish in NC county jails

North Carolina Department of Health and Human Services Secretary Kody Kinsley (Image from ncdhhs.gov)

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  • A new federal lawsuit blames the North Carolina Department of Health and Human Services for delays in providing required mental health services to people in the state's local jails.
  • The suit filed by Disability Rights North Carolina contends inmates with mental health issues wait an average of two months for assessments of their ability to stand trial. They wait nearly five months for treatment at a state psychiatric hospital.
  • The suit labels the situation a "statewide crisis."

A new federal lawsuit contends that people with mental health issues sit in North Carolina’s county jails for months before getting required services. The suit blames the state Department of Health and Human Services.

“Under the Fourteenth Amendment’s Due Process Clause, a person with a mental health disability who is charged with a crime and detained ‘solely on account of his incapacity to proceed to trial cannot be held more than the reasonable period of time necessary to determine whether there is a substantial probability that he will attain that capacity in the foreseeable future,’” wrote lawyers representing Disability Rights North Carolina. The group filed suit Thursday.

“In violation of this bedrock principle, 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 complaint continued. “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.”

The lawsuit aims “to reduce the profoundly harmful and unconstitutionally prolonged detention times.”

DHHS “is systemically violating the Fourteenth Amendment, [Americans With Disabilities Act], and [Rehabilitation Act] by failing to provide capacity assessments and restoration services to pretrial detainees who are suspected of, or adjudicated to be, incapable to proceed (collectively, “ITP detainees”), in a timely and adequate manner,” according to the complaint.

Disability Rights points to two main problems. First, people “who have been charged with a crime and had their capacity to stand trial questioned often spend months waiting for a capacity assessment by Local Management Entities/Managed Care Organizations (“LME/MCOs”) or Central Regional Hospital (“Central Regional”).”

“Second, individuals in North Carolina who have been charged with a crime, adjudicated incapable to proceed to trial, and ordered to a state psychiatric hospital to undergo an involuntary commitment examination or capacity restoration services wait months for bed space necessary to receive these court-ordered services,” the complaint alleged.

Detainees “wait an average of two months for their capacity assessment to be completed and nearly five months for treatment at a state psychiatric hospital,” according to the suit.  In contrast, the average wait time for a capacity assessment in Virginia is seven days.

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

The number of state beds for mental health treatment has dropped from 892 to 453 in the last seven years, the lawsuit argued. Of the remaining beds, “about 35% are occupied by individuals who are ready for discharge but unable to leave,” according to the suit. “Most often in these instances, individuals who are ready for discharge are unable to be discharged because of a lack of appropriate services available in the community.”

Disability Rights blames DHHS for failing to ensure “that LME/MCOs fulfill their statutory and contractual duties to develop and maintain adequate provider networks in the community.”

“County jails are intense and stress-inducing environments, generally not suitable for those diagnosed with any kind of debilitating ailment, let alone severe mental health disabilities,” the lawsuit contended. “Prolonged detention in such environments can lead ITP detainees to experience a further decline in mental health, which can result in self-harm and threats to ITP detainee safety.”

“This is a statewide crisis. NCDHHS’s mismanagement and failure to provide essential mental health services on a timely basis exacerbates existing problems and inflicts cruel and unusual pain and suffering on ITP detainees who wait at length for the services NCDHHS is legally obligated to provide,” Disability Rights’ lawyers argued.

The suit names DHHS and Secretary Kody Kinsley as defendants.