A report issued by the US Department of Justice in 1999 revealed that 16% of all inmates in state and federal jails and prisons have a severe mental illness. This means that on any given day there are roughly 283,000 persons with severe mental illnesses incarcerated in federal and state jails and prisons. In contrast, there are only 70,000 persons with severe mental illnesses in public psychiatric hospitals and 30% of them are forensic patients. In North Carolina, 23,000 adults with mental illness are under Department of Corrections supervision. About 5,000 are incarcerated in state prisons costing an estimated $117 million, with an additional 18,000 on probation or parole. A Duke University study of persons in North Carolina with severe mental illness found that 20% were arrested within one year following hospital discharge, largely for drug-related crimes or minor offenses such as trespassing, disturbing public order, and public intoxication. Police are becoming front line respondents to people experiencing psychiatric crises in our communities. Prisons and jails are not conducive to effectively treating people with mental illnesses. This trend has occurred because of the inadequacy of community mental health systems and support services. The state could take some immediate actions to reduce the criminalization of people with mental illness. Judges should be given the authority to divert non-violent offenders with mental illnesses away from incarceration and into appropriate treatment. Specialty "mental health courts", now present in several North Carolina communities, should be expanded. The state also should support training for police officers and probate, civil, and criminal court judges and personnel about mental illnesses and legal issues affecting people with these illnesses.

While the state’s current budget situation makes it unlikely that any new programs will be established, a review should be done to determine how to use current resources and federal grant funds to provide training to police and court personnel and to support the expansion of jail diversion and mental health court programs for adults and youth.