NC lawmakers advance proposal to amend involuntary commitment process

North Carolina legislators on Tuesday took their first step toward amending state laws for treating criminal suspects who suffer from a mental illness — an effort launched last year after the stabbing death of a woman on Charlotte’s commuter train. 

A House of Representatives judiciary committee gave a favorable report to House Bill 1104, which attempts to shift some mental evaluations out of emergency departments and expand the number of people who can conduct them. The legislation, spearheaded by state Rep. Tim Reeder, R-Pitt, is expected to go to another House committee for review.

State lawmakers began reviewing the state’s procedures for treating suspected criminals  with mental illness after the August death of Iryna Zarutska, a 23-year-old Ukrainian who moved to Charlotte in 2022 and was fatally stabbed on a city train. DeCarlos Brown, the man charged in her death, was deemed incapable of proceeding following a mental evaluation.

The General Assembly in October approved a judicial reform package titled, “Iryna’s Law,” in an attempt to keep more suspects in custody while awaiting trial. Brown had been arrested multiple times prior to Zarutska’s death. 

However, legislators faced pushback for some of the new rules. For instance, hospital representatives took issue with a requirement for certain criminal defendants — who have undergone an involuntary commitment within three years of their arrest for a violent crime, or who judicial officials believe to be a danger to themselves or others — to be transported “to a hospital emergency department or other crisis facility” for a psychiatric evaluation. 

Hospital leaders said they don’t want the suspects evaluated in emergency departments because they could endanger patients and hospital staff. Hospital leaders said the evaluations should be conducted in jails — a suggestion Reeder incorporated into his bill.

House Speaker Destin Hall, R-Caldwell, created a committee to review the state’s involuntary commitment laws and appointed Reeder cochair. Reeder on Tuesday said his group “realized that we have a lot of questions” and identified “a lot of ways with which to help improve the system.”

“This bill is not the fix of the entirety of the mental health system,” said Reeder, a physician, adding later that the bill “is a step of improving the system to make sure that our citizens are safe.”

Law enforcement officials previously expressed concerns about proposals to require additional mental evaluations in county jails. On Tuesday, Marie Evitt, a representative for the North Carolina Sheriffs’ Association, said sheriffs will support Reeder’s proposal. 

In addition to shifting where some mental evaluations take place, Reeder’s bill would also allow more North Carolinians who are under involuntary commitment orders to undergo mental health treatment outside of psychiatric facilities. “The system as it is currently designed is not set up to do this,” Reeder told WRAL Monday. “We are hoping to update statutes and create a more efficient and effective system for this.”

The bill would also:

• Direct the state Department of Health and Human Services to evaluate the state’s training program for medical providers who are eligible to perform psychiatric evaluations of criminal suspects, and to incorporate additional training where needed. 
• Direct the state-funded regional behavioral health management companies — known as local management entities or managed care organizations, or LME-MCOs — to develop plans to use mobile crisis units in the state’s involuntary commitment process.

• Direct the UNC Health Care System to explore the feasibility of improving services at the state’s psychiatric facilities: Broughton Hospital, Central Regional Hospital, and Cherry Hospital.