NC defendants with mental illness wait months in jail for court-ordered treatment
By Rachel Crumpler
For nearly a year, Jake Davis languished in jail, waiting for a bed in a state-run psychiatric hospital to get court-ordered mental health treatment.
Davis, 37 and diagnosed with bipolar and delusional disorder, was arrested and booked into the Watauga County Detention Center in Boone on Mother’s Day Weekend 2023 for nonviolent crimes. His mother, Jama Hinson, said he committed those crimes while in a state of psychosis. His mental status continued to be “off the chain” in the weeks that followed, she said.
But her son sat untreated for months in the detention center, waiting until October before a forensic evaluator declared him “incapable of proceeding.” The designation means someone is so mentally impaired that they can neither comprehend the court proceeding before them nor rationally work with an attorney to help in their defense. It also halts legal proceedings, putting one’s case at a standstill until their capacity is restored.
But it took nine months before Davis got a spot at Broughton Hospital in Morganton — in July 2024 — to start that capacity restoration treatment. During the wait, his mother told NC Health News his mental health continued to deteriorate.
Seeing her son locked away and spiraling without adequate mental health care took a toll.
“I never in a million years would have thought it would have taken so long,” she said. “It took probably five years off my life.”
Davis’ story isn’t an outlier. Capacity restoration services, which have historically only been provided in state psychiatric hospitals in North Carolina, aim to restore people’s ability to understand and continue trial proceedings. These services consist of mental health therapy, including medication, and education about the legal system.
An increasing number of criminal defendants are being declared incapable to proceed in North Carolina and wait an average of 173 days — nearly six months — before being admitted to one of three state psychiatric hospitals for capacity restoration treatment, according to the N.C. Department of Health and Human Services.
State health officials are working to reduce wait times by expanding options for capacity restoration outside of state hospitals. Just over $9 million has been allocated to stand up and support three detention-based and three community-based capacity restoration pilots.
Many of the programs are still finding their footing, but Robert Cochrane, DHHS’ statewide director of forensic services, said the new settings have great potential to serve people more quickly and more economically. Importantly, he said, they can relieve some of the load on the state’s overburdened psychiatric hospitals, shortening wait times for anyone else in crisis who needs a bed.
“It is a paradigm shift of sorts,” Cochrane said. “The alternative restoration sites — the community and the jail — are a huge part of deflecting from the hospitals those people who don’t need to go there, so that everybody can get care in a more expeditious manner.”
Limited beds
Beds in North Carolina’s state-run psychiatric hospitals are limited — with demand significantly outpacing available space. In addition to criminal defendants, like Davis, who wait months in jail for a state hospital bed for the treatment they need to be well enough to stand trial, hundreds of North Carolinians in crisis in the community wait weeks or even months in emergency rooms for beds to open in those same facilities.
Cherry Hospital in Goldsboro is one of the three state-run psychiatric hospitals in the state. State hospital resources are stretched thin as demand increases and staffing shortages remain. Credit: Taylor Knopf / NC Health News
North Carolina’s three state-run psychiatric hospitals — Cherry, Central Regional and Broughton — have a total bed capacity of 910. However, due to crippling staff shortages, only about 600 beds are in operation, a DHHS spokeswoman told NC Health News.
In recent years, a growing share of that limited bed space has been taken up by people involved in the criminal justice system who have been deemed incapable of proceeding. These patients made up 10 percent of the total annual admissions to the state’s psychiatric hospitals in fiscal year 2016; that number swelled to 28 percent of admissions in fiscal year 2024.
Nearly one-third of the patient population currently in state psychiatric hospitals are people deemed incapable to proceed, according to DHHS data provided to NC Health News on Feb. 7. This means these beds are unavailable for others who might be waiting in emergency departments.
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