The killing of Iryna Zarutska on the Charlotte light rail has left many people wondering how, or even if, the tragedy could have been prevented. Responses have generally either emphasized the need to get tough on people charged with crimes or the need for more mental health services.
An expert interviewed by WFAE says any potential solution needs to recognize that while people in mental health crisis might need to be in a setting where they take medication whether they want it or not, a well-funded, high-functioning mental health system is needed — not just incarceration.
Decarlos Brown Jr., the man charged in the killing, had 14 prior arrests, served time in prison for armed robbery, and was out on a cashless bond after his latest misdemeanor arrest for misusing the 911 system. He was also homeless and suffering from schizophrenic delusions, according to his mother.
He was not unlike the kind of people that Dr. Evan Ashkin has spent years working with. Ashkin is a family physician and the founder of the North Carolina Formerly Incarcerated Transition Program, which helps former prisoners with mental illness or chronic disease reenter society.
He spoke with WFAE's Nick de la Canal about the case.
Nick de la Canal: The suspect, DeCarlos Brown Jr., had served six years in prison for armed robbery, and his family says that he was in poor mental health when he was released in 2020. How common are cases like this?
Evan Ashkin: Sadly, our mental health system is woefully inadequate. So people with severe mental illness like schizophrenia are actually much more likely to wind up in a jail or prison carceral setting than they actually are in a mental facility. And so by default, our prisons and jails have become the number one provider of inpatient psychiatric care in our state and across the country. And then we underfund jails and prisons who were not set up in the first place to treat people with mental illness.
So, of course, we need to try to support jails and prisons to do better, but the most important thing is to have an adequate, well-functioning community mental health system that can care for people.
De la Canal: Yeah, you know, what I found interesting was that Brown was involuntarily committed by his family in 2023 and diagnosed with schizophrenia, but then released after just two weeks with little follow-up, even as his family wanted him to stay longer. How common is that short-term treatment with no long-term plan, and what would a better continuum of care look like?
Ashkin: That is pretty much the standard, unfortunately, that you point out, that people may begin treatment in an inpatient setting in a psychiatric hospital or in the carceral system, but upon release, often the wheels come off because people are oftentimes unhoused, unsheltered, no access to food, they may or may not have medications upon release or if they're, you know, living on the street, they certainly often lose those meds and then it's very difficult for those folks to wind up actually engaging in psychiatric care post-release.
De la Canal: I want to ask you about this law that North Carolina lawmakers have passed. It's called "Iryna's Law," and it limits cashless bail and makes it easier to have people charged with violent crimes involuntarily committed. Now, in this case, Brown was arrested months before the stabbing for repeatedly calling 911, claiming to have eaten a man-made substance that was controlling him. When a person is experiencing delusions or psychosis, is containment the right approach and is jail the best setting?
Ashkin: Yeah, well clearly, Nick, you know that I don't think jail is the best setting, and oftentimes they're put in solitary confinement, which is also, we believe, even more harmful and causes more psychiatric distress. And then after a couple of weeks, perhaps some type of adjudication has happened and they're released back into the community with very, very thin support.
If we had a system, however, where people were treated appropriately prior to arrest, prior to incarceration, it is highly likely that numerous folks could avoid these types of hospitalizations.
De la Canal: The new law doesn't add new funding for treatment beds or reentry programs. From what you've seen, how big is that need and what difference would funding make?
Ashkin: The law misses the mark and that what we need is a stronger mental health system that is adequately funded. There are arguments to be made in making sure that someone actually gets on meds, whether, at the time, they want them or not, to give them an opportunity to become more clear thinking and treated, and then a decision to be made whether they are competent to then decide to stop taking those medicines or not.
Now this is not a simple decision. It takes a highly functioning mental health system, but that very much could have avoided this type of tragedy that we saw in the case of Iryna's death.
De la Canal: So if lawmakers or city leaders want to prevent another tragedy like this — to protect both the public and people in crisis — what do you think could have the biggest impact?
Ashkin: I think we need to invest in things like ACT teams. I don't know if you've — these assertive community treatment teams. They might have a social worker, a peer to do outreach, a psychiatrist who actually meet people in the community where they're at, because oftentimes these folks are not going to come to the appointment. So they can go if they're on the street or if they're in a shelter, make sure they have their meds, make sure they're getting to appointments, offer them support.
And actually the state is now investing in what we call forensic act teams, which are teams especially funded to care for people post release with serious mental illness, and actually our FIT program — we will be working closely with those teams to try and coordinate that care. So that — building those relationships, better funding those programs, I believe, can be highly impactful.
