Advocates worry about looming mental health crisis in North Carolina prisons

Samuel C. Wendt suffers from post-traumatic stress disorder, an aftereffect he says was the result of military duty in Iraq and Afghanistan. He is incarcerated at Tabor Correctional Facility and says he still needs mental health care.

“I can tell you from my personal experience that I’m a better person when I can talk about my problems,” Wendt, 43, said during a phone interview from prison. “And prison is not a place where you can cry on other people’s shoulders. It just isn’t.”

I am a better person when I can talk about my problems. And prison is not a place where you can cry on someone else’s shoulder. It just isn’t.

Samuel C. Wendt

Wendt is not alone. A report by the US Department of Justice estimates that more than one-third of people in prison have a history of mental health problems.

In Tabor City, where Wendt is serving a 26-year sentence for a statutory rape conviction, he says there are many people in need of mental health care.

“I can’t stress enough that inmates need mental health care,” Wendt said. “And I’m not just talking about myself.”

But they don’t always get that care, according to interviews WUNC conducted with dozens of inmates and advocates. They say restrictions to prevent the spread of COVID-19, and now staff shortages, mean prolonged lockdowns and isolation. This can make it difficult for prisoners to see psychiatrists. It has even influenced virtual telehealth meetings.

One way this manifests itself is through self-injury. There were 13 inmate suicides in North Carolina last year. That’s the highest annual total since at least 1991, according to data from the NC Department of Public Safety. In total, there were 3,347 events last year that required an assessment of the risk of self-harm. This is an increase from 3,099 in 2019.

NC Department of Public Safety


Suicides in North Carolina prisons by year.

Joseph Williams directs UNC Health’s correctional psychiatry program, which began in 2015. The program now has 15 psychiatrists who provide both in-person and telehealth services. Williams says staffing shortages are also impacting telehealth services because there aren’t enough staff to escort an inmate to the designated virtual care location.

“It deprived some of these incarcerated people of the ability to frequently and easily see their mental health providers just because that would involve movement of incarcerated individuals, and the jail was really trying to reduce that to minimize the spread of the virus,” Williams said.

In 2019, about 31 percent of new inmates were referred for mental health services after their initial screening, according to Department of Public Safety data. This increased to 47% in 2021.

The prison system currently has a 36 percent vacancy rate for licensed mental health clinicians, according to DPS data. Systemwide, the vacancy rate for correctional officers is about 40%. Personnel is the single largest budget item not only for prisons, but for the entire Department of Public Safety. Jail custody and security receives $900 million in state funding, or more than 36 percent of the entire public safety budget.


NC Department of Public Safety


Rate of prison suicides per 10,000 inmates per year.

Prison health and pharmacy accounts for another significant portion of the budget at $288 million. Of that, $41 million is dedicated to mental health. Williams says staffing levels affect both medication evaluation and therapy for inmates.

“People may not make these medication changes quickly enough to be able to deal with worsening mental health symptoms,” Williams said. “And that would contribute to deteriorating mental health.”

Advocates are calling for reduced prison sentences as a solution

Prison reform advocates say that’s another reason to cut more prison sentences. Since its peak in 2011, North Carolina’s prison population has been in steady decline and is now at its lowest point since 1995.

Christy Puckett-Williams is the Deputy Director of Engagement and Mobilization for the ACLU of North Carolina. She’s glad to see population trends, but there are still nearly 30,000 people currently in prison in the state. She wants society to offer better programs to people in need; people like her before she spent time in jail and on probation for theft and drug convictions.

“I was a victim of domestic violence. I needed financial help. Instead of financial aid they offered me [Division of Social Services] to take my children away. They suggested I be locked up,” Puckett-Williams said. “If someone had asked me, ‘Well, what do you need?’ I would have told them that if I had received these things, prison would not even be discussed.”

Puckett-Williams led a weeklong protest in December outside the governor’s mansion in downtown Raleigh. She advocates for various criminal justice reforms, but one of her greatest passions is improving the standard of living in prisons.

“People deserve to be treated like people,” Puckett-Williams said. “And the conditions in North Carolina’s prisons and jails and the penitentiary systems are inhumane. They are excruciating.”

Division of Corrections leadership says it recognizes the need for more mental health care. The prison system is working with the American Suicide Prevention Foundation’s Project 2025, which aims to reduce the annual suicide rate by 20 percent by 2025.


NC Department of Public Safety


Average annual number of prisoners per day. The average population is now at its lowest point since 1995.

Lewis Paper is the jail’s director of behavioral health and says management is addressing the issue “head on.” He says the majority of suicides are among inmates who have not been flagged for self-harm risk assessment. This shows that inmates who see mental health providers are less likely to kill themselves, but also that they are not reaching everyone who needs these services. Pepper says jail staff encourage inmates to speak up if they have a friend who is struggling.

“Everything is available,” Pepper said. “Let’s help each other here.”

In some parts of the North Carolina Legislature, a few lawmakers have begun to pay attention. Sen. Natalie Murdoch represents parts of Durham County and last session introduced legislation to expand the use of a program that allows for early release of medically vulnerable inmates.

“I think it needs to be said that if we don’t think this person is a physical threat to their community, why is he still in prison?” Murdoch said.

Janelle and Leroy.jpg

Janelle Casse and Leroy Wenzel. Wenzel has been released from prison and is serving probation while living with Casse, his daughter, in Pennsylvania.

Her initial legislation won’t apply to many people, but she says it’s a start.

“Especially if you’re elderly and you have family members who say, you know, we’re happy to house our loved one. They can still be monitored in different ways,” Murdoch said.

This exact scenario played out just three days before Christmas.

Leroy Wenzel, who will turn 80 in March, pleaded guilty in 1995 to murdering his daughter-in-law’s husband and was serving a life sentence. He had increasing health problems, and his daughter Janelle Kase, who lives in Pennsylvania, began advocating with the parole board for his release. Late last year, the board agreed. And on a wet and rainy December day, Wentzel returned home with her daughter.

“And when I walked through the gate, I saw my daughter standing there and she was already crying,” Wentzel said. “And we held each other and hugged and kissed. And we still do today. But what a feeling, man.”

Advocates say they want that kind of exemption to be expanded. They say this will not only benefit the person released, but help alleviate problems caused by staff shortages, including lack of access to mental health care.

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