Competency to Stand Trial

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The Legal Spotlight: Disability Rights North Carolina vs. North Carolina DHHS

In April 2024, Disability Rights North Carolina and the ACLU-NC sued the North Carolina Department of Health and Human Services, alleging the state delays mental health evaluations and treatment for those unable to assist in their defense. Plaintiffs say such delays, averaging 68 days for evaluations and over five months for treatment, are unacceptable. This case is an example of the U.S. competency crisis, in which increasing court orders for competency evaluations and restoration services have created backlogs that many states cannot adequately manage. Such prolonged delays not only infringe on constitutional rights under the Americans with Disabilities Act, the Rehabilitation Act, and the 14th Amendment but also create cascading effects on the justice and mental health systems. Because limited state hospital beds are tied up for evaluation and restoration, fewer resources are available for general inpatient psychiatric care, driving significant financial and operational strain and underscoring the urgent need for effective, innovative solutions.

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Jails Fill While Mental Health Services Lag Behind

North Carolina lawmakers recently passed “Iryna’s Law,” which toughens rules for pretrial release and requires more mental health evaluations for people in the justice system. But despite the law, it does little to help people with mental health needs because the state still lacks enough hospital beds and community programs. Experts warn that without more funding for community mental health services and state hospital beds, people with mental health conditions will keep getting trapped in jails and emergency rooms. The situation highlights the urgent need for solutions that protect both public safety and access to proper care.

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Smarter Solutions for Justice

The “Competency Crisis” is a multi-jurisdictional challenge that is ongoing and complex. Innovations are critical in that the competency crisis hinders due process and has resulted in painstaking litigation across more than 12 states! Competency restoration services can be costly for jurisdictions already troubled by having limited resources. So, what’s the solution? As with most challenges, the solution to the competency crisis is multi-factored and cannot be fully addressed here. Early detection and classification of barriers to competency, however, is the foremost effective means to reduce the number of individuals requiring services as well as the time needed for restoration. In this technological age, jurisdictions must be open to telehealth services from professionals trained as forensic psychologists—those who have conducted evaluations and have facilitated restoration services. Such professionals are the premier qualified experts and will be able to outline explicitly the specific needs of defendants with mental illness. Forensically trained professionals may be limited in some jurisdictions, and therefore, they choose any licensed psychologist or psychiatrist. Engaging in such is likely wasting critical funds, precious time, and other resources, in ways that legal professionals do not readily understand. Spending more funds on the evaluation process (at the outset) will save thousands when compared to unnecessary, months-long hospital stays prior to a defendant’s adjudication. Contact Dr. Lewis today and learn creative solutions for complex (and seemingly insurmountable) problems.

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