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Fractured: Frequently Asked Questions

What is serious mental illness?

A serious mental illness is a mental, behavioral or emotional disorder that substantially limits one or more major life activities. The term is often used interchangeably with “severe and persistent mental illness.” Although definitions differ, it generally describes adults who suffer from prolonged functional impairment from conditions such as schizophrenia, bipolar disorder, depression and some personality disorders.

Broughton Hospital, one of the three psychiatric hospitals in North Carolina, is located in Burke County.
Dana Miller Ervin
Broughton Hospital, one of the three psychiatric hospitals in North Carolina, is located in Burke County.

What does “incapable to proceed” mean? 

North Carolina law and the U.S. Constitution say no one can stand trial if they lack the ability to rationally consult with their lawyer or understand the charges against them. This incapacity must be because of mental illness or what the North Carolina statute terms a “mental defect.” A mental defect can include an intellectual or developmental disability or dementia.

How is capacity to proceed evaluated?

A judge decides whether someone is incapable to proceed, usually after an evaluation by a forensic evaluator and a hearing.

What is restoration of capacity? 

Defendants who are incapable to proceed to trial must be “restored” in order to stand trial. Restoration usually occurs at one of North Carolina’s three state psychiatric hospitals for restoration. Restoration can include medication, various kinds of therapy, and education about the court system. Sometimes that involves watching clips from popular courtroom dramas, like My Cousin Vinny. When forensic examiners determine a defendant has regained capacity, they will inform the court.

The goal of restoration is to enable a defendant to stand trial. It is distinct from ongoing therapy.

What happens if someone can’t be restored to capacity?

If evaluators determine someone can’t be restored, a judge or prosecutor must dismiss the charges. Under North Carolina law, no one who’s incapable to proceed can be held for longer than the maximum sentence for their most serious charge. However, if the defendant remains a danger to either himself or others, he can be involuntarily committed to the state psychiatric hospital after the charges are dismissed.

Are mentally ill people more likely to commit a violent act than others?

The short answer is “no.” Here’s a more complete answer: overall those with mental illness are not more violent than others. Even those with a serious mental illness are more likelyto be victims of violence than perpetrators of it. Some research shows those with an untreatedserious mental illness are slightly more likely to be violent than those in the general population, but researchers have also found that substance abuse is a bigger driver of violence, whether someone is mentally ill or not.

This story is part of a collaboration with FRONTLINE, the PBS series, through its Local Journalism Initiative, which is funded by the John S. and James L. Knight Foundation and the Corporation for Public Broadcasting.

Dana Miller Ervin is a reporter at WFAE, examining the U.S. health care system.