When it comes to mental health funding, NC isn’t that far from the bottom
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- North Carolina ranked 44th in mental health care access in the 2023 survey.
- State mental health funding reached $129.03 per person in 2024, below the U.S. median.
- Recent budget cuts removed $18.5 million from earlier behavioral health allocations.
North Carolina spends less on mental health and offers less access to care than most states — a gap highlighted after a woman was fatally stabbed on Charlotte’s Blue Line by a man with an alleged history of mental illness.
DeCarlos Brown Jr., the man accused of stabbing 23-year-old Ukrainian refugee Iryna Zarutska on Aug. 22, has a reported history of mental health issues that his mother told The Charlotte Observer went largely untreated.
“When people with serious mental health conditions don’t get access to care they need early enough, these are things that can happen as a result,” Danielle Duchaine, director of operations for the National Alliance on Mental Illness in Charlotte, said about the stabbing. “It’s horrific, but early intervention and awareness and the funding around it are all things that we need to focus on as a community so that we can mitigate things like this happening in the future.”
Despite recent state investments, North Carolina still trails much of the country in mental health funding. In 2024, the state spent $129.03 per resident on mental health services, placing it in the lower tier nationally, according to data from the federal Substance Abuse and Mental Health Services Administration. That’s above the lowest spenders, including Florida at $54.10 per person in 2024. It’s far below the highest, including Vermont at $435.08 per person in 2023.
Compared with nearby states, North Carolina is somewhere in the middle of the pack. Virginia spent $138.28 per resident in 2023, Tennessee spent $148.49, South Carolina spent $106.66, and Georgia spent $91.23 in 2024, SAMHSA data shows. North Carolina’s 2023 figure was $109 per person.
North Carolina consistently ranks near the bottom nationally in per-capita mental health funding, Duchaine said.
“What that creates is families often waiting weeks or months to see a psychiatrist or a therapist, and in crisis situations, the ER can mean a 10-plus hour wait,” she said. “Which then creates any community based organizations being stretched thin and people falling through the cracks.”
And when it comes to connecting people with care, North Carolina ranked 44th out of 51 in the latest Mental Health America “Access to Care” index, which considers insurance coverage, treatment availability, cost barriers and workforce size.
What has the state funded?
In 2023, lawmakers approved what state officials called a “once in a lifetime” $835 million behavioral health package, funded through the $1.4 billion given to the state by the federal government after it expanded Medicaid. The money has helped fund mental health crisis centers in the state, prison reentry services and increased pay for health care workers, according to NC Health News.
But this year, a legislative mini-budget cut $18.5 million that had been designated for the state’s Health and Human Services projects that included mental health initiatives.
Mecklenburg County’s own behavioral health plan acknowledges major gaps in care.
Providers say there are too few clinicians, especially bilingual ones, and limited options for people without insurance in the county. Residents report long waits, difficulty navigating fragmented services and transportation barriers that make reaching clinics harder, the plan states.
The county spent $43.4 million in 2024 on behavioral health services. Its behavioral health plan states state and federal programs fall short of meeting community needs.
Duchaine said the biggest gaps to mental health care in Charlotte are capacities and timeliness.
“When individuals aren’t able to receive timely care, then the risk of crises escalates, and that’s when the community is hurt,” she said.
What is DeCarlos Brown Jr.’s mental health background?
A month before the stabbing, a judge ordered Brown to have a mental evaluation. His lawyer said Brown has a long history of mental health issues, the Observer previously reported.
After the stabbing, Brown was been ordered to be evaluated at Central Regional Hospital in Butner after the public defender representing Brown in the stabbing case filed a motion questioning Brown’s mental capacity.
Brown’s mother, Michelle Dewitt, told the Observer her family begged for help in the years leading up to the attack. After he left prison in 2020, she noticed changes as Brown grew withdrawn, began talking to himself, and said that a foreign “object” or “chip” was controlling his thoughts and actions.
He was diagnosed with schizophrenia, she said, but long-term treatment never stuck. Dewitt said she tried to get Atrium Health to admit him for extended care, but was told he could only be held if he threatened to harm himself or others. She eventually filed for involuntary commitment, but he was released after a brief stay.
Police, too, encountered his mental health issues. In January, Brown called 911 to claim that man-made materials were controlling his movements and eating patterns, but officers told him it was a medical matter outside their scope.
Shortly after the attack, Charlotte Mayor Vi Lyles released a statement calling for compassion for those with mental health issues.
“This is a tragic situation that sheds light on problems with society safety nets related to mental healthcare and the systems that should be in place,” she wrote. “While I do not know the specifics of the man’s medical record, what I have come to understand is that he has long struggled with mental health and appears to have suffered a crisis. This was the unfortunate and tragic outcome.”
The statement has been criticized nationally, with many calling it tone-deaf or insensitive to the victim. Lyles has since released another statement in which she called for bipartisan reform of how repeat offenders with mental illness are managed.
