North Carolina no longer allowing police to transport mental health patients

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Handcuffed prisoner in jail by is licensed under Canva
RALEIGH, NC - The state of North Carolina is changing the way mental health patients are transported when having a crisis that the medical provider has deemed dangerous to the patient, like if they believe the patient is a danger to themselves or those around them.

According to reports, the current standard practice in those situations is for the medical provider to petition a judge for an involuntary commitment order, which often require the presence of law enforcement. Involuntary commitments are typically a last resort that mandates the individual get psychiatric care at an inpatient facility for a specified amount of time.

When these commitments are decided, a police officer arrives at the emergency department to transport the patient to an inpatient psychiatric facility that has an available bed. Due to safety protocols, the person is placed in handcuffs and taken in a patrol car or inmate transfer van; this experience can be emotional and traumatic for the patient and their loved ones.

Most sheriffs in North Carolina say that they don't want to be the ones to transfer the patients, stating that it should be done by mental health workers. They also say that driving patients across the state to available hospital beds strains their resources, diverting deputies from responding to crimes and other emergencies, sometimes for hours at a time.

For years, patients and their families have reported being shocked and traumatized by the presence of law enforcement and the use of handcuffs in the course of mental health treatment. State officials and lawmakers have heard the same stories from their constituents and have condemned the policy, as they believe it further stigmatizes mental health. There have been, in the past, some legislative efforts to soften the response to people experiencing mental health crisis, but most largely fizzled out until now.

Out of North Carolina's federal sign-on bonus for expanding Medicaid, state lawmakers allocated $835 million for behavioral health needs in their 2023 budget, including $20 million for a non-law enforcement transportation pilot program for mental health patients under involuntary commitment. In December 2024, the state Department of Health and Human Services released a request for proposals from qualified transportation vendors with a plan to operate the pilot in tow regions out of the state.

Former Secretary of Health and Human Services Kody Kinsley said, "We have been eagerly and desperately trying to decouple these two systems, as are other states, and so we're excited for this pilot." 

According to state law, counties are responsible for the transportation of patients under involuntary commitment, and traditionally this role has fallen to law enforcement. In 2018, North Carolina lawmakers revised the state's mental health laws to allow more flexibility, including alternative means of transportation for patients. 

In 2021, there was a review of the available plans provided by the state health department and found that the majority of counties had opted for minimal to no changes to the practice of using police or sheriff's deputies for the transports. 

Law enforcement transports are the default for patients under involuntary commitment across the country. In October, a report was released that said 43 states have some allowance for non-law enforcement transportation of a committed patient, including North Carolina. However, the study reported that most states largely rely on law enforcement because they haven't established or invested in alternative models.

The report said, "Not only does law enforcement involvement blur the lines between treatment and criminalization of mental illness, people with serious mental illness are also overrepresented in law enforcement use-of-force encounters and law enforcement-related injuries. People with serious mental illness are over 11 times more likely to experience law enforcement use of force and over 10 times more likely to be injured in law enforcement interactions compared to other individuals."

Law enforcement officers across the U.S. have said they should not be the ones responsible for transporting mental health patients. Many believe that the role should be turned over to mental health professionals. Officers often don't have the training or tools to respond to mental health calls. Their presence alone, with marked vehicles, flashing lights, uniforms, and firearms could very well escalate a situation. 

North Carolina is inviting companies to come forward with proposals for how to transport mental health patients differently. The Department of Health and Human Services has set a high bar for this contract and will be paying a premium to get a transportation service that is high quality. 

He said, "We really want to center this on: What does real care and support in transport with the right resources look like?"
 
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Comments

Bruce

Sounds fair to me, but I imagine that if it works similarly to having mental health counselors handle the crazies in the field, the police will have to be nearby. Don’t want the “caring” social workers being injured. OK for the cops, just not them.

Todd

North Carolina wants to be California when it grows up.

thomas

Can't wait till someone gets killed by the crazies

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