NC Gov. Josh Stein: Keeping people safe means getting people help

In recent months, North Carolinians have witnessed a series of heartbreaking tragedies as a consequence of people suffering a severe mental health crisis: on a train in Charlotte, at a restaurant in Southport, and, most recently, in a home in Raleigh. In each case, innocent people were killed, breaking the hearts of family and friends. In each case, our systems failed.

Most people living with mental illness pose no danger to themselves or others, but some experiencing severe forms of psychosis can. When their serious mental illness goes untreated, the results can be devastating.

These tragedies demand that we do better. And we can. That’s why this week I signed an executive order to strengthen North Carolina’s behavioral health and criminal justice systems.

Over the past several months, my team and I have met with law enforcement officers, mental health care providers, and frontline workers across the state. We visited crisis centers and behavioral health urgent cares and asked a simple question: Where are the gaps? The answers were consistent. We have a talented and passionate workforce in public health and public safety, but there aren’t enough of them, they don’t have the resources they need, and they aren’t as coordinated as they need to be. We need to get this right.

The first opportunity to thwart a crisis often comes during an initial crisis call. Law enforcement officers are frequently the default responders to a mental health crisis call even when no crimes have been committed. This takes law enforcement officers away from fighting crime and places them in challenging situations where others with specialized training might be better suited to respond. That’s why we need to expand co-responder models that pair officers with mental health professionals and better coordinate 911 with the 988 suicide and crisis lifeline so people get the right help at the right time.

We must also fix North Carolina’s involuntary commitment process, or IVC. IVC can be a critical tool when someone poses a danger to themselves or others, but we have more people in need than we have beds to treat them. Too many people wait for a slot that takes months to open up.

I am directing DHHS to engage the many organizations already working to get IVC right and make recommendations. I also look forward to the work of the House Select Committee on Involuntary Commitment and Public Safety and the NC Collaboratory.

When someone commits a serious crime, they should be held accountable, including going to jail. We need to be aware of the strong link between crime and behavioral health challenges. Three-quarters of people entering state custody struggle with drug addiction, and more than 40 percent report mental health needs. For juveniles, the numbers are even more alarming: Nearly all have at least one mental health diagnosis. Since 90 percent of incarcerated people eventually leave prison, failing to address these issues while they are in custody only makes our communities less safe when they get out.

Reentry – when people leave incarceration and return home – is another critical moment in health care delivery. Without access to health care, housing, transportation, and employment, people leaving custody are far more likely to engage in the behavior that got them in trouble in the first place. Strengthening these supports is smart public safety policy.

None of these efforts work without a strong workforce. Law enforcement officers, correctional staff, and behavioral health professionals are stretched thin. Staffing vacancies are not abstract numbers; they are the reason a quarter of in-patient units that could serve as many as 300 people sit empty -- simply because we do not have enough personnel to staff them. Nearly half of all correctional officer positions are unfilled, which is not shocking given our starting pay ranks 49th in the country. We must pay people better to compete with the private sector and improve working conditions. I have directed my Office of State Human Resources to partner with the Departments of Adult Correction and Public safety to improve recruitment and retention, and I look forward to partnering with the legislature to do more to grow the workforce and keep people safe.

This executive order is not a cure-all. We know that mental health outcomes are shaped by access to basic needs, such as food, housing, education, health care, and employment. I continue to push to fully fund Medicaid, protect SNAP benefits, build more housing, and strengthen our public schools to create meaningful opportunity for people.

Too many North Carolinians are struggling with their mental health. Ignoring the problem will not make it go away. Families need a way to treat a loved one who is in crisis. People who have made mistakes need a real second chance. And every North Carolinian needs to feel safe.

 Improving behavioral health care and strengthening public safety are not competing goals. They go hand in hand, and they are essential to building a safer, stronger, and healthier North Carolina.

Josh Stein is governor of North Carolina.