A state House committee on involuntary commitment of people with mental illnesses began after Iryna Zarutska was killed last year by a man with a long criminal history and a schizophrenia diagnosis.
Now, another death has brought new immediacy to the committee’s work.
At the request of Wake Co. Republican Reps. Erin Paré and Mike Schietzelt, the committee will examine the circumstances leading to the death of Ravenscroft School teacher Zoe Welsh. Ryan Camacho, who has a long criminal history and a diagnosis of schizophrenia, allegedly attacked Welsh in her Raleigh home Jan. 3 .
Weeks before Welsh’s death, a Wake County District Court judge denied a prosecutor’s request to have Camacho involuntarily committed, even after the judge determined Camacho was incapable of proceeding to trial on a misdemeanor breaking and entering charge.
“What additional tools would assist law enforcement and the courts in preventing horrific crimes like this from occurring in the future?” the lawmakers asked in their Jan. 6 letter, which Paré posted to X.
Rep. Hugh Blackwell (R-Burke), a committee co-chairman, said the panel will look at the circumstances surrounding Welsh’s death and determine whether their discoveries will be included in its legislative recommendations.
Last year, the legislature passed Iryna’s Law, which, among other changes, creates new pretrial release procedures and requires judicial officers to initiate involuntary commitment proceedings in certain circumstances.
The House Select Committee on Involuntary Commitment and Public Safety is examining the practice of forced psychiatric treatment with the goal of recommending improvements.
Experts say that people with mental illnesses are far more likely to be crime victims than they are to commit violent crimes, but people with severe mental illness charged in several deaths in North Carolina in the last year have politicians focused on the link between mental health and public safety.
“Despite recent occurrences, these are rare occurrences,” Dr. Marvin Swartz, a professor of psychiatry and behavioral sciences at Duke University, told the committee Wednesday.
“Crafting a policy objective that recognizes that this happens rarely, that it’s almost a needle in a haystack to find the person that’s actually going to commit serious acts of violence, is really tough,” he said.
The committee on Wednesday focused on involuntary outpatient commitment, where civil court orders require people to receive treatment.
It’s been effective in New York, Swartz said. However, it’s unclear how often involuntary outpatient commitment has been used in North Carolina after 2001, when government mental health offices stopped providing treatment and moved to have mental health services offered by private providers instead, he said. The state doesn’t collect that data.
Patients in outpatient commitment can’t be forced to take medications, Swartz said. But most do because it’s a court order.
“Most patients think that they are required to take their medication, and then they do,” he said.
Dr. Carrie Brown, chief psychiatrist at the state Department of Health and Human Services, said involuntary outpatient treatment is suitable for a limited number of adults – those who don’t have insight into their illness, decline voluntary treatment, have repeatedly been hospitalized or arrested, or have repeatedly committed violent acts.
Dr. Carrie Brown, chief psychiatrist at NC DHHS, talks to a House committee about outpatient involuntary commitment on Jan. 14, 2026 (screenshot)Involuntary outpatient commitment is a key to addressing the “revolving door” of repeated arrests, hospitalizations and ER visits, she said.
However, Brown added, outpatient commitment as it operates now has a number of weaknesses, she said. Those include court orders that aren’t specific and a shortage of specialized providers.
Initiatives aimed at helping recently incarcerated people who have mental illnesses, called FACT, or Forensic Assertive Community Teams, are launching in five locations around the state will help, she said.
A team providing centralized statewide oversight is needed in addition to the intensive case management, Brown said.
And judges need to know that outpatient commitment is an option.
“If they’re faced with someone who doesn’t meet involuntary impatient criteria, but requires treatment to be safe in the community, then outpatient commitment may be appropriate,” she said.
Some House members are focused on ways to make more beds in state psychiatric hospitals available. At least 300 beds in state hospitals remain unused because the state does not have enough staff to handle additional patients.
“We know that everybody cannot live outside an institution,” said Rep. Donna White (R-Johnston). “They can be outside of an institution, but they cause havoc for everybody else,” she said.
It’s the state’s responsibility to treat those patients in state hospitals, White said. She asked for ideas for adding qualified staff to state hospitals.
Blackwell said the committee may be in a position to have some recommendations for the legislature to consider in the upcoming short session, but said lawmakers will need additional time to focus on long-term solutions.
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