Under House Bill 1104, psychiatric assessments for suspects in custody would take place in jails, instead of emergency rooms. (File photo: States Newsroom)
A key North Carolina state senate panel approved a bill Wednesday aiming to fix a problem lawmakers inadvertently caused by changing public safety laws in the wake of the 2025 killing of Iryna Zarutska by a person with mental illness.
In the fall, the legislature approved “Iryna’s Law,” a judicial reform package keeping more suspects in custody before their trials and requiring more of them to be taken to hospitals for psychiatric assessments and potential involuntary commitment.
But concerns from stakeholders plagued lawmakers. Hospital leaders were worried about the safety of patients and staff when suspects are evaluated in emergency rooms, saying they’d prefer those assessments take place in jail.
Bill sponsor Rep. Timothy Reeder (R-Pitt), a physician, told the Senate Health Care Committee Wednesday that House Bill 1104 would allow those evaluations to take place in jails instead. He said it isn’t a fix for the shortcomings of the state’s mental health system, but it’s a step forward.
Reeder said he still works in the emergency department.
“I worked there last Friday, and we had no fewer than 30 psychiatric patients in our emergency department,” he said. “You wouldn’t want someone who has a violent history sitting next to your child who’s getting treated for an ear infection.”
Sen. Natalie Murdock (D-Durham) said she went to the emergency room twice in the past six months.
Law enforcement officials are there almost on a daily basis dealing with “all sorts of issues,” she said.
“From my own experience I was concerned about the safety of staff, and could clearly tell some of the issues were mental, which is why they were brought there,” Murdock said.
About 40% of the evaluations for involuntary commitment in emergency departments are already conducted through telehealth, according to Reeder.
“We are going to be using telehealth for the evaluations in jails, which is the primary component of this bill,” Reeder said Wednesday. “We believe that the jails are the appropriate place to do this.”
He said mobile crisis teams — trained behavioral health specialists who travel directly to individuals experiencing a mental health emergency — can be used if telehealth isn’t available.
NC lawmakers weigh changes to involuntary commitment, guardianship under Iryna’s Law
Under Iryna’s Law, criminally violent individuals can’t be released before trial. Sen. Julie Mayfield (D-Bumcombe) asked if H1104 factored in staff issues at jails.
“Does this bill address the current and ongoing problem that we have across the state in terms of overcrowding at our jails, which I hear every sheriff attributing to Iryna’s Law?” she asked.
Reeder said there’s about 300 beds in state psychiatric facilities that aren’t available due to staff shortages, but work is underway to change that. State leaders’ proposed budgets also contain raises for correctional officers.
N.C. Department of Health and Human Services Deputy Secretary Dr. Carrie Brown said DHHS is working on opening “justice units” to house inmates and suspects across the state’s three psychiatric hospitals by Dec. 1.
Brown said they’re working with existing funding to find ways to avoid using contract staff, which would be more expensive.
“We have three postings for each of the hospitals… offering some pretty aggressive graduated sign-on bonuses,” she said. “We are hoping that this will be a very cost-effective way to get full-time staff.”
Reeder also brought up the safekeepers program, which provides more treatment for people with mental illness in jails.
“Some of the challenges in the jails is that they’re not delivering ongoing mental health treatment, which makes it more difficult to take care of those people in custody,” Reeder said. “If we have some availability of resources, we hope and believe that that’s actually going to make it easier to take and deliver some of the services in the current system.”
Ashley Perkinson, an attorney speaking on behalf of the North Carolina College of Emergency Physicians, thanked the committee for their work on the bill.
“This is an issue, of course, that is very important to emergency physicians across the state,” she said. “We look forward to continued partnership to improve the involuntary commitment process across North Carolina.”
The measure could be on the state Senate floor next week.
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