Charlotte Light Rail Killing Exposes Gaps In Nc’s Mental Health System

By Rachel Crumpler and Taylor Knopf

In early September, video of Decarlos Brown stabbing 23-year-old Ukrainian exile Iryna Zarutska to decease connected a ray obstruction car successful Charlotte shocked nan country. People from crossed nan governmental spectrum demanded answers: How does a horrific, unprovoked onslaught hap betwixt 2 strangers? What needs to alteration truthful thing for illustration it doesn’t hap again?

Brown’s criminal and intelligence wellness grounds quickly came nether scrutiny. The incident besides fueled caller authorities by North Carolina’s Republican leaders, intended to beryllium tougher connected crime. 

But nan caller measure — passed easy successful some nan authorities Senate and House of Representatives — doesn’t adhd backing for North Carolina’s intelligence wellness system.

Brown, 34, was diagnosed pinch schizophrenia and surviving connected nan streets. Over nan past 2 decades, he’s been arrested much than a twelve times, including respective low-level misdemeanors. In 2015, Brown was convicted of equipped robbery and served much than 5 years successful prison. During his past brushwood pinch rule enforcement successful January, erstwhile he many times called 911, he reportedly told officers that “man-made” worldly was wrong his body, controlling his actions. 

Brown’s mother says she tried to find him psychiatric help. His sister says if he’d received due treatment, nan sidesplitting could person been avoided. Many opportunity Brown should person been locked up — either successful a jailhouse aliases psychiatric facility. The reality is he spent clip successful both, and he didn’t get nan thief he needed. 

People pinch terrible intelligence wellness disorders often rhythm successful and retired of infirmary rooms and jailhouse cells, pinch small to nary intelligence wellness curen successful between. Many besides struggle pinch basal needs — housing, employment, entree to attraction — that, if met, would thief them beryllium productive and unchangeable successful nan community.

Mental wellness experts opportunity they person agelong been acquainted pinch nan fractures and holes successful nan criminal justness and intelligence wellness systems that were exposed by nan Charlotte killing. But nan wide nationalist doesn’t spot them until specified a calamity throws nan gaps into nan spotlight.

“I judge this incident really highlights a systemic failure, not an individual aliases family failure,” said Kate Weaver, executive head of NAMI Charlotte, an statement that supports group pinch intelligence unwellness and their family members. “When group pinch superior intelligence unwellness don’t person accordant care, location are risks.”

If North Carolina is superior astir uncovering solutions, advocates say, it will return resources and willpower to overhaul parts of nan intelligence wellness strategy that aren’t moving and to found an array of services successful nan organization that really support people. 

Those resources person not been forthcoming. 

Falling into chasms 

People often first brushwood nan intelligence wellness strategy during a situation — either done an apprehension aliases an emergency room visit. In some scenarios, rule enforcement officers are typically involved. 

Across nan U.S., jails person go de facto intelligence wellness facilities. The national Substance Use and Mental Health Services Administration estimates that 44 percent of group successful jails and 37 percent of those successful prisons person a intelligence illness. Jails, successful particular, are often ill-equipped to negociate group pinch analyzable wellness needs; nan costs for managing those intelligence wellness issues can beryllium excessively overmuch for smaller region budgets. 

When personification is brought to an emergency room successful a intelligence wellness situation — whether it’s a termination effort aliases a psychotic section — they are often placed nether an involuntary commitment and acquisition forced psychiatric hospitalization. By authorities law, constabulary officers service involuntary committedness tribunal orders and often carrier patients betwixt hospitals, often successful handcuffs and shackles.

The acquisition tin beryllium jarring, and scarring.

“Transitions successful wide for each quality beings are tough,” said Cherene Caraco, head of Promise Resource Network, a intelligence wellness agency based successful Charlotte that is staffed wholly by group who’ve had intelligence wellness struggles. “And past you’re talking astir a modulation into an organization mounting and past retired of an organization mounting wherever you are everlastingly changed erstwhile your authorities are removed.” 

A diligent room successful nan caller 16-bed facility-based situation halfway successful Burlington, a short-term inpatient action for those who request up to a week of psychiatric care. Credit: Taylor Knopf

Caraco said astir group exit psychiatric hospitals, jails and prisons without follow-up support. “You travel retired to nothing,” she said.

Ted Zarzar, a psychiatrist who divides his clip betwixt UNC Health and Central Prison successful Raleigh, said nan play wherever group reenter their communities is high-risk for folks pinch a intelligence illness. Their symptoms tin spiral downward without continued care. 

Many times these group are released from carceral settings without a occupation aliases a spot to live. Some group whitethorn person a azygous outpatient intelligence wellness assignment scheduled and a 30-day proviso of their medications. 

Others mightiness conscionable get handed a database of resources and telephone numbers.

“I deliberation it is nan exception, alternatively than nan rule, that personification goes to a follow-up appointment,” Zarzar said. “At best, they extremity up successful an emergency room aliases inpatient infirmary and get connected that way. But astatine worst, they extremity up either backmost successful jailhouse aliases prison, aliases thing horrific happens, for illustration what happened successful Charlotte.”

Without a nonstop handoff to existent support and services, it is astir intolerable to enactment unchangeable successful nan community, Zarzar said. People often onshore correct backmost successful a infirmary aliases situation compartment successful a frustrating — and costly — rhythm of recidivism for which taxpayers prime up nan tab. Incarceration successful a North Carolina situation runs more than $54,000 a year. The mean costs of a infirmary enactment successful North Carolina is $2,881 per day, according to 2023 information collected by KFF, a nonpartisan wellness argumentation and investigation organization.

“We don’t person cracks successful nan system, we person chasms,” Caraco said. “And erstwhile you autumn into that chasm, it’s not easy to travel retired of that without a batch of support.”

‘Not a casserole illness’

Lately, lawmakers from New York to California have projected to involuntarily hospitalize people who are homeless, to unit them into intelligence wellness treatment. The measure passed by North Carolina lawmakers this week besides seeks to push much group into involuntary commitments.

But galore successful nan intelligence wellness and constituent usage curen organization argue that forced psychiatric hospitalization does not  address terrible and analyzable intelligence illness, and it doesn’t often output affirmative results. These commitments are temporary, and group are often discharged without nan organization support they need. Coerced curen tin besides lead patients to distrust nan system and time off them reluctant to activity thief nan adjacent time. 

Bob Ward is simply a retired lawyer who spent a decade representing group successful involuntary committedness hearings successful Mecklenburg County. Ward said he saw firsthand nan deficiency of curen and timely care. He said civilian commitments of immoderate benignant — adult, minor, inpatient aliases outpatient — are “useless” if nan correct curen and supportive services are lacking erstwhile nan personification comes home.

The continuous emergence successful involuntary commitments — which are intended to beryllium a past edifice for personification who is simply a threat to themselves aliases others — is simply a “sure motion of a grounded system,” Ward said. A NC Health News investigation found that nan number of involuntary committedness petitions revenge successful region clerk of tribunal offices roseate astatine slightest 97 percent betwixt 2011 to 2021. 

Only a fraction of those group extremity up making it done nan full committedness process to a psychiatric inpatient bed, according to a May study by Disability Rights NC. Many who activity pinch group experiencing nan process opportunity it’s riddled pinch problems and needs important reform. 

Weaver, nan NAMI Charlotte leader, said erstwhile it comes to involuntary commitment, it’s “difficult to equilibrium people’s authorities pinch nationalist safety, and it is not against nan rule to person a intelligence illness.” 

Friends and family besides dainty intelligence unwellness otherwise than they do different aesculapian issues, Weaver said.

“If you had a loved 1 pinch a crab diagnosis, your friends would rally astir you, nan casseroles would come, nan section would get trim and you would person continuing attraction pinch a team,” she explained. “When personification successful nan family has a intelligence illness, it is not a casserole illness. People don’t travel rally astir that family, and location is nary continuum of care. 

“There is nary intelligence wellness squad that follows that personification from nan beginning, from unwellness to wellness.” 

Weaver said families struggle to find lasting thief for their loved ones — a business that played retired successful nan lawsuit of Decarlos Brown, nan man accused successful nan Charlotte stabbing.

Brown’s mother said his intelligence wellness had declined importantly aft his five-year situation stay. By this summer, he only had bits and pieces of intelligence wellness support, and he was homeless. 

Lawmakers connected some sides of nan aisle work together that nan strategy grounded Brown. 

“He was grounded because his mother wanted personification to prime him up, and location was not nan willingness connected nan portion of nan strategy to do that,” Republican Senate leader Phil Berger told reporters connected Sept. 22. “[Iryna Zarutska] was grounded because location was a strategy that would let personification for illustration that to grounds nan sorts of problematic behaviors without location being immoderate intervention.”

Berger questioned whether inadequate backing for intelligence wellness resources was astatine fault, alternatively suggesting that group were unwilling to measurement successful pinch already disposable resources. 

Solutions see support, much options

In consequence to nan killing, intelligence wellness experts who said to NC Health News highlighted nan request for transitional support for group leaving jails, prisons and psychiatric facilities. They besides emphasized nan request for money for an array of organization intelligence wellness services that could forestall stays successful jails and psychiatric facilities, which are costly and often nan slightest effective option.

The intelligence wellness strategy is designed to return a faulty attack pinch constricted options, said Caraco, head of Charlotte’s Promise Resource Network.

“You do this, and past you do this, and past you do this. You request a referral. You request an assessment. It is time-limited. You request a diagnosis. You person to comply pinch medications,” she said. “All of nan things that lead group to not being capable to prosecute successful thing that feels meaningful.”

There’s a predetermined group of services and options. Either it useful for people, aliases they locomotion away, she said. 

Caraco said her statement ends up serving galore of those who’ve walked distant from accepted intelligence wellness attraction that they recovered ineffective aliases harmful.

“Our strategy should beryllium group up for illustration a buffet. There are times wherever you want thing but crab legs, and location are times you’re going to eat dessert first, but you person an array of options disposable successful beforehand of you to take from. Because astatine different times, different things consciousness right,” she said. “That array has sewage to beryllium accessible to you.”

Caraco believes that connecting group pinch certified adjacent support specialists astatine hospitals aliases jails would thief span immoderate of nan gaps. Peers tie connected their ain experiences pinch intelligence illness, constituent use, homelessness and/or incarceration, making them much relatable to group navigating nan aforesaid challenges.

Hospital emergency departments already employment group who are often referred to arsenic “sitters,” whose domiciled is to beryllium pinch patients astatine consequence for termination to make judge they are safe. Caraco suggested that hospitals switch sitters pinch community-based adjacent support specialists. 

“They’re sitting successful nan emergency department. They’re interacting, they’re processing plans, they’re getting deeper into nan narration and what’s going on,” Caraco said. “And trying to found that rapport and that narration correct disconnected nan bat.” 

If these group were adjacent support specialists from a community-based organization, alternatively of infirmary employees, that narration could proceed aft nan diligent is discharged. Some psychiatric hospitals usage “peer bridgers” who build relationships pinch group while they’re still inpatients, pinch nan extremity of staying connected erstwhile nan diligent is released and navigating nan organization intelligence wellness system. 

Founder and CEO of Promise Resource Network Cherene Caraco is flanked by adjacent support specialists and section rule enforcement officials, including Mecklenburg Sheriff Gary McFadden, astatine nan 2022 ribbon-cutting ceremonial for nan intelligence wellness agency’s peer-run respite successful Charlotte. Credit: Taylor Knopf

That aforesaid conception tin besides beryllium applied to jails and prisons, Caraco said. 

Peer support specialists and societal workers are being incorporated into intelligence wellness situation responses much often. Initiatives for illustration nan HEART squad successful Durham usage a intelligence wellness situation consequence portion to respond to 911 calls related to intelligence illness, homelessness and constituent use. These specialized teams tin thief steer group to organization support alternatively of emergency rooms aliases jails.

“We request folks who person lived acquisition — not only of intelligence wellness disabilities, but of criminal justness engagement and incarceration, because nary 1 wants to talk to group who can’t subordinate to them,” said Corye Dunn, argumentation head pinch Disability Rights NC.

Bring attraction to wherever group are 

Dunn said there’s besides an opportunity to bolster Assertive Community Treatment teams, which are designed to beryllium community-based, wrap-around services for group pinch terrible intelligence illnesses. She suggested location should beryllium much forensic ACT teams that see adjacent support specialists who were antecedently incarcerated. 

Zarzar said ACT teams break down barriers to accessing attraction by bringing it to group wherever they are — moreover if it’s nether a bridge. 

“It takes nan inpatient curen squad and puts it connected nan outside,” he said. Teams see psychiatrists, nurses, adjacent support specialists and more. They person predominant contacts pinch clients to thief get their basal needs met and scope their individual goals.

Zarzar said he’s seen affirmative outcomes, but it hinges connected a person’s voluntary participation.

Clinical societal worker and longtime intelligence wellness advocator Bebe Smith said it tin beryllium difficult for group to suffice for ACT squad services, arsenic they person to fresh constrictive criteria of a test of terrible and persistent intelligence unwellness positive a precocious utilization of services. 

They must besides person Medicaid and beryllium enrolled successful one of North Carolina’s  “tailored” plans.

According to nan N.C. Department of Human Services, North Carolina operates 87 ACT teams — a number that has remained comparatively unchangeable complete nan past decade. Between 6,400 and 6,800 individuals received ACT services astatine immoderate fixed clip past year. In fiscal twelvemonth 2024, nan authorities spent $8 cardinal successful non-Medicaid costs to screen curen for uninsured individuals, supporting 915 people.

Seven ACT teams service Mecklenburg County, six of which are unfastened to caller referrals pinch nary waitlist, according to DHHS. The Assembly reported that Brown was moving pinch an ACT squad for astatine slightest immoderate of past year, though it’s unclear if he still was getting services astatine nan clip of nan ray obstruction murder.

In fiscal twelvemonth 2025, ACT participants statewide saw a 19 percent alteration successful emergency section usage and a 2 percent simplification successful homelessness, according to information DHHS provided to NC Health News.

However, Smith said that nan value of services tin alteration crossed ACT teams. While it’s expected to beryllium intensive, wrap-around care, sometimes each that is provided to nan diligent is “a little touch aliases medicine delivery,” she said.

Opportunities during reentry 

Many group pinch analyzable intelligence wellness needs extremity up successful nan astir costly settings — hospitals, jails, prisons. 

System experts spot an opportunity to interrupt really group rhythm done them by investing much successful reentry supports that will let group to onshore — and enactment — connected their feet successful nan community. 

Zarzar, nan psychiatrist treating group successful nan organization and successful prison, said he often sees group bounce betwixt those settings.

It’s estimated that that 44 percent of group successful jails and 37 percent of those successful prisons person a intelligence illness, but erstwhile they are yet released galore don’t person nan attraction they need. Credit: Rose Hoban / NC Health News

That’s driven his activity arsenic nan head of FIT Wellness, a programme for group pinch a superior intelligence unwellness leaving nan authorities situation strategy aliases jails. FIT Wellness provides psychiatric and beingness wellness attraction — on pinch connections to organization support for illustration lodging and proscription — to group successful Wake, Durham, Orange and New Hanover counties.

The programme employs formerly incarcerated group trained arsenic organization wellness workers to activity pinch group being released from incarceration. A squad personnel will meet pinch a personification earlier they are released to talk their needs and found a pathway to care. 

“Thus far, we’re having a batch amended occurrence astatine getting group to travel successful to that first appointment,” Zarzar said. “It still tin autumn isolated aft that, but during this high-risk, high-needs play — that first period aliases truthful aft group get retired — we’re doing a amended occupation successful position of getting group to come.”

Along pinch addressing intelligence wellness needs, advocates opportunity finance successful gathering people’s basal needs — housing, food, activity aliases schoolhouse — could thief trim recidivism. Data shows that astir two-thirds of unhoused group besides person intelligence wellness disorders.

“We are responsive aft nan fact, and truthful we’re often consenting to put successful things for illustration harsher situation terms. But again, that’s not going to forestall nan caller personification from engaging successful immoderate act,” Apryl Alexander, head of UNC Charlotte’s Violence Prevention Center, said. “I’m waiting for nan clip that we get invested successful putting our money into prevention. 

“If we return attraction of basal needs, we spot each of this [criminal involvement] reduced.”

The barriers to lodging are many, but groups for illustration Queen City Harm Reduction successful Charlotte are piloting Housing First programs pinch success. These programs thief group navigate nan barriers to lodging — for illustration evictions aliases criminal records — that galore group surviving connected nan streets face. The programme uses lawsuit managers to thief find elastic landlords, way down basal archiving and unafraid a rent deposit. The programme doesn’t require personification to beryllium abstinent from substances to suffice for housing. Program head Lauren Kestner has recovered that galore group who find employment and get housed upwind up reducing their supplier use. 

Mecklenburg County Sheriff Garry McFadden said it costs $198 a time to location personification successful Mecklenburg’s detention center. He contended that those costs mightiness beryllium amended spent connected early involution intelligence wellness curen and reentry support to thief trim people’s recidivism. 

Harold Cogdell Jr., a Charlotte defense lawyer and erstwhile adjunct territory lawyer astatine nan Mecklenburg County District Attorney’s Office, said amended supporting group earlier a crime occurs is simply a amended attack than “paying connected nan backmost end.”

“There is simply a victim, truthful nan harm has been done,” Cogdell said. “If we attraction much connected making a personification holistically patient connected nan beforehand end, that increases nan likelihood that … nan crime whitethorn ne'er beryllium committed.”

‘We person to do more’

“The authorities has an responsibility to build systems that make sense, and this does not make sense,” said Disability Rights’ Dunn. “[The strategy is] very convoluted. It is simply a one-size-fits-all attack that is going to summation request without improving outcomes, connected nan intelligence wellness broadside astatine least.”

For decades, nan authorities shuttered authorities psychiatric hospitals pinch promises to walk nan savings connected community resources that ne'er materialized. Many opportunity this contributed to nan dearth of services seen today. 

A decade aft nan closure of nan state’s largest psychiatric facility, Raleigh’s Dorothea Dix Hospital, an infusion of $835 million into behavioral wellness came from Medicaid description sign-on bonus. That money has allowed nan authorities to drawback up some, raising rates for providers and investing successful intelligence wellness situation services, pre-arrest diversion programs and more.

State wellness officials person allocated $99 cardinal to boost services specifically for group successful nan justness system.  

The further backing has allowed North Carolina to amended immoderate metrics, specified arsenic accrued authorities psychiatric furniture availability, decreased emergency section usage for intelligence wellness holds, and less group successful jails and prisons pinch intelligence wellness diagnoses, according to DHHS.

But, successful a statement to NC Health News, nan authorities wellness section acknowledged there’s much to beryllium done to support group pinch intelligence wellness and constituent usage issues arsenic they time off jails and prisons.

“Upon their merchandise from incarceration, we person to do much to protect some their occurrence and nationalist safety,” nan section said successful a connection to NC Health News. 

The reality, though, is that the measure passed by authorities lawmakers this week successful consequence to Zarutska’s decease did not adhd immoderate backing to bolster nan intelligence wellness system.

That, on pinch uncertainty looming from cuts to Medicaid backing arsenic portion of President Donald Trump’s One Big Beautiful Bill, could put much-desired changes progressively retired of reach.

“We can’t disregard nan truth that we haven’t invested successful intelligence wellness services,” Weaver, nan NAMI Charlotte leader, said. “As a country, we’ve taken distant much and much intelligence wellness support, and pinch nan looming Medicaid cuts coming, arsenic an organization, we’re bracing ourselves for a batch much group being uninsured, incapable to entree resources and struggling moreover more.” 

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