Magistrate judge rejects injunction, would allow jail mental health lawsuit to proceed

A federal magistrate judge recommends denying an injunction in a lawsuit blaming state government for delays in providing mental health services to county jail inmates. The judge issued an opinion Thursday that would allow portions of the lawsuit to move forward.

The group Disability Rights North Carolina filed suit in April 2024 against the state Department of Health and Human Services.

The suit alleges that DHHS “is responsible for, but has failed to provide timely and adequate capacity assessments and restoration services to pretrial detainees who are suspected of, or adjudicated to be, incapable to proceed to trial due to mental health disabilities or cognitive disabilities,” US Magistrate Judge Joe Webster explained in his 58-page opinion.

Affected inmates are known as “ITP detainees” because they are or may be incapable to proceed to trial.

DRNC claimed that the department violated “the Fourteenth Amendment’s Due Process Clause, Title II of the Americans with Disabilities Act, and Section 504 of the Rehabilitation Act.”

The lawsuit sought a preliminary injunction against DHHS and an oral argument in the case.

Webster recommended against issuing an injunction or holding an oral argument. He also recommends dismissing the portion of the complaint dealing with Title II of the ADA and the Rehabilitation Act. He would allow DRNC to continue to pursue claims linked to “violations of substantive and procedural due process under the Fourteenth Amendment.”

“Taking the facts as alleged in the Complaint as true, the undersigned concludes that DRNC has alleged a plausible substantive due process Fourteenth Amendment claim that NCDHHS is violating the rights of ITP detainees to be free from incarceration by subjecting them to prolonged confinement in county jails while they await ITP or IVC examinations and/or treatment at a state psychiatric hospital or other appropriate integrated settings,” Webster wrote. “The claim is grounded in a liberty interest in freedom from incarceration, reasonable conditions of safety and mental health care, and timely restorative treatment.”

“The undersigned also concludes that DRNC has alleged a plausible procedural due process claim against NCDHHS,” Webster wrote.

Parties in the case face a June 26 deadline to respond to Webster’s recommendation. A US District judge will make the final decision in the case.

The 2024 lawsuit contended that people with mental health issues sat in North Carolina’s county jails for months before getting required services.

“Under the Fourteenth Amendment’s Due Process Clause, a person with a mental health disability who is charged with a crime and detained ‘solely on account of his incapacity to proceed to trial cannot be held more than the reasonable period of time necessary to determine whether there is a substantial probability that he will attain that capacity in the foreseeable future,’” DRNC lawyers wrote.

“In violation of this bedrock principle, North Carolinians with serious mental health disabilities and other cognitive disabilities are languishing in jails for months, and in some severe cases, years at a time,” the complaint continued. “Their prolonged detention extends well beyond what is reasonable under the circumstances for an evaluation and determination of whether they possess the requisite mental capacity to proceed to trial.”

The lawsuit aimed “to reduce the profoundly harmful and unconstitutionally prolonged detention times.”

DHHS “is systemically violating the Fourteenth Amendment, [Americans With Disabilities Act], and [Rehabilitation Act] by failing to provide capacity assessments and restoration services to pretrial detainees who are suspected of, or adjudicated to be, incapable to proceed (collectively, “ITP detainees”), in a timely and adequate manner,” according to the complaint.

Disability Rights pointed to two main problems. First, people “who have been charged with a crime and had their capacity to stand trial questioned often spend months waiting for a capacity assessment by Local Management Entities/Managed Care Organizations (“LME/MCOs”) or Central Regional Hospital (“Central Regional”).”

“Second, individuals in North Carolina who have been charged with a crime, adjudicated incapable to proceed to trial, and ordered to a state psychiatric hospital to undergo an involuntary commitment examination or capacity restoration services wait months for bed space necessary to receive these court-ordered services,” the complaint alleged.

Detainees “wait an average of two months for their capacity assessment to be completed and nearly five months for treatment at a state psychiatric hospital,” according to the suit.  In contrast, the average wait time for a capacity assessment in Virginia is seven days.

Because of long wait times, some “detainees spend more time in pretrial detention awaiting a capacity assessment and subsequent treatment than they ever would receive as a sentence if convicted.”

The number of state beds for mental health treatment has dropped from 892 to 453 in the last seven years, the lawsuit argued. Of the remaining beds, “about 35% are occupied by individuals who are ready for discharge but unable to leave,” according to the suit. “Most often in these instances, individuals who are ready for discharge are unable to be discharged because of a lack of appropriate services available in the community.”

Disability Rights blames DHHS for failing to ensure “that LME/MCOs fulfill their statutory and contractual duties to develop and maintain adequate provider networks in the community.”

“County jails are intense and stress-inducing environments, generally not suitable for those diagnosed with any kind of debilitating ailment, let alone severe mental health disabilities,” the lawsuit contended. “Prolonged detention in such environments can lead ITP detainees to experience a further decline in mental health, which can result in self-harm and threats to ITP detainee safety.”

“This is a statewide crisis. NCDHHS’s mismanagement and failure to provide essential mental health services on a timely basis exacerbates existing problems and inflicts cruel and unusual pain and suffering on ITP detainees who wait at length for the services NCDHHS is legally obligated to provide,” Disability Rights’ lawyers argued.

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