Fractured

Crisis describes North Carolina’s mental health system. It is harder to access mental health care here than most other states, and that affects everyone — particularly the most vulnerable. Like inmates who are too sick to stand trial. They often wait months in custody for the treatment they need just to be well enough to go to court.

For those living with severe mental illness, the chances of becoming homeless can be high. Once homeless, they’re more likely to end up behind bars. Going to jail can start a downward spiral. Many lose jobs or benefits — even health care. Some will cycle between jail and the streets for years — often for minor crimes like trespassing. Last week, WFAE — with support from the PBS series, "FRONTLINE" — examined the problem of inmates who wait in custody for months because they’re too sick to stand trial. This week we focus on inmates who cycle in and out of jail, serving what many in the court system call a “life sentence on the installment plan.”

WFAE — with support from the PBS series, "FRONTLINE" — has been examining the problem of inmates living with mental illness. This week we focus on ways to help former inmates stay out of jail. And the ways the system fails to do that.

WFAE’s "Fractured" series has reported on the struggles of inmates living with mental illness. But it isn’t just inmates who wait. On average, North Carolinians who go to an emergency room in crisis wait 16 days for a state psychiatric hospital bed.

WFAE has been examining North Carolina’s broken mental health system, especially as it affects people in the criminal justice system. This week, we start to look at the impact this system has on others, such as children, who wait for weeks or months in hospital emergency departments because there’s simply no place for them to go. And people who head to emergency rooms in crisis, only to find the average wait for a state psychiatric hospital is more than two weeks.

North Carolina's jails are on the frontlines of the mental health crisis. Jail staff have to tend to inmates with mental health issues, even though they’re not fully equipped to do so. That can take a high toll on those jails — and the people who work there.

The vast majority of violent crimes aren't committed by people living with mental illness. But when people struggling with mental illness are charged with violent crimes, it poses a dilemma. When a defendant receives treatment and improves while awaiting trial in custody, prosecutors must decide whether they'll ask for a prison sentence or allow defendants to be released to the community with no guarantee they'll continue their care.

The more trauma children endure, the more likely they are to develop a host of medical and social problems, including learning disabilities and addictions. They are also more likely to end up in the juvenile justice system and eventually in jail. In this installment of the series "Fractured," WFAE looks at the intersection of childhood trauma and the justice system.

WFAE has been exploring the crisis brewing in North Carolina’s mental health system. That includes a shortage of state hospital beds.

As WFAE has been reporting in our series, “Fractured,” locking up defendants with serious mental illness can make their mental health worse. It’s expensive, and it's often not very effective at reducing crime. If former inmates don’t get treatment when released, they’re likely to get arrested again. But in Miami, Florida, public officials are taking a different approach to the issue — jail diversion.