Still here: Cycling between the jail and the mental health hospital
For the last three months, WFAE has been exploring the crisis in North Carolina’s mental health system.
The “Fractured” series began with the story of John, a 32-year-old Charlotte man living with severe mental illness and intellectual disabilities. John was arrested for arson and attempted murder more than five years ago. He’s been in custody ever since, but he’s never had a trial. That’s because a court found he was too sick to understand his charges, and he needed his mental capacity “restored” at a state psychiatric hospital — just so his case could move forward.
But John’s been stuck in a system that isn’t working well, cycling between the jail and the hospital, with no end in sight.
His case isn’t unique. A WFAE investigation found that half of North Carolinians charged with felonies who are incapable to proceed wait behind bars more than 10 months before they can get to a state psychiatric hospital for capacity restoration. All that time, their cases are on hold.
John got better at the hospital once. But he was sent back to jail to await trial — and got so much sicker, he needed to return to the hospital. He even refused to see his attorney.
WFAE accompanied his lawyer to the jail seven times last year, but John refused to see us.
Two and a half years after he left the hospital, John went back. He’s been there since January. His stepfather has been visiting him, but Jason St. Aubin, his lawyer, said that it took months for John to be able to have a meaningful conversation. WFAE was finally able to speak with John a few weeks ago, for the final story in the series, “Fractured.”
‘Try to hang in there’
On July 19, WFAE accompanied John’s stepfather and legal guardian, Eric Witherspoon, to Broughton Hospital, a psychiatric facility. A staff member walked us down a long corridor lined with classrooms that staff call the “treatment mile.” Another brought John to us, then sat outside the open door to make sure we were all OK.
John seemed happy to see us.
“How are you feeling?” I asked.
“Good, good, good, good, good, good,” he replied.
John’s been taking medication for seven months. The newest medicine that doctors are trying is helping, Witherspoon said. John agreed.
John was wearing a blue plaid shirt and had strings twisted into his curly, dark hair. He said it’s a Rastafarian style, like the brightly colored cords some people weave into their dreadlocks. But John’s were plain kitchen strings, and they fell over his forehead, covering the top of his face and most of his eyes.
John has an IQ of 56 and a diagnosis of schizophrenia. Cycling between jails and hospitals for more than five years could have taken its toll. Doctors told WFAE it can be harder, or even impossible, to restore someone with schizophrenia a second time if they’ve been without medication for a long time.
The strings also obscured a dark bruise on John’s forehead. Witherspoon said the hospital told him they recently did a scan of John’s head, but it didn’t reveal significant brain damage. We asked John how he got the bruise.
“I hit my head one day,” he said. “That’s when the scar came.”
“Did you hit your head on the wall or the floor, or do you know?” I asked.
“It was on the thing,” he said. “It was like, was like, was like, I fell.”
Witherspoon has been worried about the bruise, and what happened while John was in jail.
“You weren't in no handcuffs or nothing when you fell, right? ” Witherspoon asked.
“I wasn’t in no handcuffs,” John answered.
But John said it was very hard for him to be in jail. It was confusing. There was too much “stuff going on.” And, he said, too many words were used.
“It's too, like, choice words,” he said. “Like you have to put words in front of people in jail. Which, which, which I don't like.”
The hospital wouldn’t talk to us, but John’s attorney, St. Aubin, said the doctor told them that John is still adjusting to the newest medication. John said he’s still sleeping much of the day. But he said he takes a practice test of mental capacity on Wednesdays. That’s probably part of a class about the legal system — information he’ll need to know before his case can go forward. But John said he doesn’t like what he calls his “court class.”
Witherspoon tried to encourage him. “Just try to hang in there, and just do the best you can do.”
“I will do the best that I can do,” John said.
Witherspoon and St. Aubin both said they’re waiting to see if John can be restored a second time. But it was clear John’s been thinking about his future. He said he’d like to get a job one day. He wants to make his own money.
“I'm not trying to get in no more trouble. No more trouble. I'm not trying to. You know what I'm trying to do? Good. Stay. I still do what I need to do,” he said.
“It’s good you’re thinking that way,” Witherspoon said.
How John got here
Later, Witherspoon and I sat down outside the hospital. He told me that John’s calmer and more talkative than he was a month ago. But he said John’s not doing nearly as well as he’d been after his first hospital stay — almost three years ago. His memory was better then. And he could hold a normal conversation, Witherspoon said.
Witherspoon is glad things are improving, he said, and he’s especially glad he can spend small amounts of time with John again.
Last summer, when he tried to visit John, he was turned away. John was in isolation in the Mecklenburg County Detention Center’s disciplinary unit, where family visits aren’t permitted. He’s charged with multiple counts of throwing feces at guards. At the time, Witherspoon walked back toward his car, furious.
“The system is so messed up,” he told me. “I don't understand how you can put somebody that needs mental care …you can put them in … lock him up like he's in prison.”
John’s legal troubles began in 2018, when he was arrested for arson and attempted murder. He’s accused of setting fire to his group home. He was upset after an argument with another resident, according to St. Aubin.
A court found that John was mentally incapable of understanding the charges against him or assisting his attorney. That made him incapable of standing trial under the U.S. Constitution.
John was sent to a state hospital to get well enough to stand trial. The first time he went, he was thrown out for attacking staff, St. Aubin said. But he was allowed back, and with treatment, he got much better. An evaluator said he was capable of standing trial.
He returned to jail to await trial, but he was isolated because of the pandemic. Prolonged isolation can cause those with serious mental illnesses to deteriorate. And like many with schizophrenia, John didn’t think he needed medication, according to St. Aubin.
By the time St. Aubin, was able to see him, several months had passed.
“And in those several months he had already stopped taking his medication,” St. Aubin told us last year. “You could see visually how he has become disheveled. His hair is unkempt, and his stare more vacant.”
John again became too sick to proceed to trial. But it would be almost two and a half years before he could get back to a hospital. WFAE accompanied St. Aubin to the jail seven times over a five-month period. John refused to see his attorney, or even get dressed.
At one point in May 2022, a detention officer told St. Aubin that John wouldn’t put on any clothes.
“He decided to lay back down on his bunk. He won’t respond at this point to any of our verbal commands,” the deputy said. “We tried our best. We got a new jumpsuit to place on him.”
St. Aubin’s glad John is now doing better, but he’s frustrated that after five years in custody, John’s legal issues are far from resolved.
It’s hard to explain that to John.
“He’s not concerned anymore about staying naked and unclothed or refusing to come out for visits,” St. Aubin said. “But he’s very confused because he’s still in custody. And his question to me repeatedly is, ‘When can I go home?’”
St. Aubin said John can’t understand his answer — not at this point anyway.
“The answer I always have to give him is when the courts say you can, when the prosecutor agrees to dismiss your charges, or when the doctors intervene and say you’re unrestorable,” St. Aubin said. “And that’s tough for somebody in his position to understand.”
No one can predict what will happen, but the outlook isn’t particularly rosy — at least in the short term.
“He’s just in another holding pattern, the third or fourth or fifth one he’s been in since he’s (been) in the system,” St. Aubin said.
Stuck in the system?
John’s case can’t move forward unless and until he’s better. If a patient’s mental capacity can’t be restored, under North Carolina law, a judge must dismiss the charges.
Medical staff could recommend that John then go to a highly supervised group home, according to Beth Guzman, an attorney representing Broughton Hospital patients.
Another option: There’s a chance John could go home with Witherspoon, as long as he has substantial mental health support.
If John can be restored a second time, his case will finally be able to move forward. But if he goes to trial, he could end up going to prison. Although North Carolina’s prison system offers a lot more psychiatric care than its jails, prisons are tough environments for those living with severe mental illness, especially those who are also intellectually disabled. And eventually, John will be released, St. Aubin said.
“It is simply a means of temporarily removing them from society and just waiting until the next volatile moment when they need to be removed again,” St. Aubin said.
He added that he worries a lot about another possible scenario: A prosecutor could offer John a plea deal. If he pleads guilty to the arson, for example, John might be able to be sentenced to the time he’s already served. Then he could go home. But that arson conviction means John will find it very difficult to get housing.
That puts former inmates and their families in a precarious position, St. Aubin said.
“They will depend solely on their family members,” he said. “And if their illness causes them to be estranged from their family members, they’ll be on the street.”
Mecklenburg District Attorney Spencer Merriweather wouldn't comment on John’s case. But he said his office struggles every day with the fallout of poor funding for North Carolina’s mental health system. Underfunding of housing for former inmates is another part of the problem, he said.
“When we put up these barriers, that doesn’t make us any safer,” Merriweather said. “It makes it more likely that someone will reenter our justice system as a defendant. And also, quite frankly, these people tend to be more susceptible as victims when they don’t have to have access to those things.”
But, he added, that’s not a reason to dismiss charges.
“I don't think that our public should have to choose between having someone be held accountable for committing an act of harm against them and having that person have resources at their disposal once they have had some engagement with our justice system,” he said.
Witherspoon’s worried, too. He thinks a plea deal will continue to trap John in the system.
“If he pleads guilty, it’s like he's still stuck, you see what l’m saying,” Witherspoon said. “And then he won't be able to get housing. So, yeah, that leaves a lot of responsibility on me.”
John’s court date just keeps getting rescheduled. His case is on September’s court calendar, but it will almost certainly be postponed yet again. First, John has to get well enough to understand the charges against him a second time.
Robert Benincasa, Mona Dougani and Julia Ingram contributed data analysis to this story.
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.