Raleigh, N.C. — With the final version of the state budget now in hand, advocates say they remain wary about funding meant to reform mental health treatment in North Carolina prisons.
The budget negotiated by House and Senate leadership, released Monday night, calls for about $12 million over the next two years to expand the mental health facility at Central Prison in Raleigh and create eight treatment units at maximum-security prisons across the state. The funding would provide for 218 new positions within those prisons, with hiring divided roughly in half between 2015 and 2016.
The push for mental health reform in state prisons has gained ground over the last year after an inmate died of thirst in the back of a prison transport van in March 2014. Michael Kerr, who suffered from schizoaffective disorder that went untreated for at least six months, had been in solitary confinement for more than a month and was left handcuffed and unresponsive in his cell for five days prior to his death.
House holds line on reform funding
Although the compromise plan for prison mental health treatment is much closer to the House version than the $6 million Senate version, it's still only about half of what Gov. Pat McCrory recommended in his proposal earlier this year.
But at the first meeting of the Governor's Task Force on Mental Health and Substance Use Tuesday, McCrory said he was pleased to see the additional mental health assistance for prisoners.
"That is something we fought for, and I appreciate (the Department of) Public Safety's support of that effort," McCrory told the audience at the meeting. "I know that's going to make a big difference, because so many of the people that we have in our state prisons are people who are dealing with mental health issues."
Officials with the Department of Public Safety were unavailable for comment Tuesday or Wednesday. But David Guice, commissioner of the Division of Adult Correction and Juvenile Justice, has expressed support for the House version, which he said "will carry us a far piece."
Advocates including Jack Register, executive director of the North Carolina chapter of the National Alliance on Mental Illness, are regarding the new funding with cautious optimism.
"It's not anywhere near the capacity for effective and quality treatment, but it gives us a place to begin," Register said. "It's more than we've seen in the past."
Vicki Smith, executive director of Disability Rights North Carolina, said that, although she's glad the House didn't back down during budget negotiations, she remains concerned about the Department of Public Safety's ability to address the problems of mental health treatment in prison with the funding. That's in part because better screening for inmates who enter the system is noticeably absent from the compromise.
Better screening is important, says Disability Rights NC Public Policy Director Corye Dunn, because Department of Public Safety consultants have repeatedly said the 12 percent prevalence of mental illness in state prisons is on the low end of the national average of 12 to 22 percent. She said comprehensive reform means expanded treatment and screening go hand in hand.
"We need both of those pieces, because we can't assume people are coming into our prison system appropriately identified in terms of their mental health needs," Dunn said. "The governor's proposal would have invested in screening, which would have been an essential component in determining who gets treatment."
Given the two-and-a-half-month delay on a budget originally due July 1, Smith said she's also worried it will be difficult for prisons to hire the 100-plus mental health staff, medical professionals and correctional officers needed to begin phasing in changes starting in January.
More to do, advocates say
Smith and Dunn said they were glad to see the legislature won't be done with the issue once the budget is signed into law by the governor in the coming days.
Tucked into the 429-page bill is a provision for a special committee of lawmakers to study the intersection of behavioral health and public safety. Smith hopes the committee's efforts will help tackle the root problems of mental health issues, which can often land patients in jails instead of treatment centers.
"Prison reform in and of itself is just the tip of the iceberg in terms of mental health services in North Carolina," Smith said.
What Register wants to see is results. But he said he sees efforts by Department of Public Safety officials and the administration to make mental health treatment a priority – both with public investment and efforts such as the governor's mental health task force – as a positive step.
"I look at it as an advocate that we're seeing more commitment than we ever have before," Register said. "We want to see some lives change because of that before we celebrate."
Smith said there's little doubt Kerr's death has raised awareness about mental health treatment among lawmakers and the public, and she said she's been encouraged by the commitment to reform by both prison officials and the administration.
But true reform, she said, will take additional work, education and buy-in from lawmakers controlling the state's purse strings.
"I think we have more legislators who recognize the problem than we had in the past, but we still don't have the momentum we need," Smith said. "We don't have a movement yet."
WRAL News photojournalist Richard Adkins contributed to this story.