The Overview

If you or someone you know has ever been held for a psychiatric evaluation against your will in North Carolina, a new law aims to change how that process works. North Carolina's Improve Involuntary Commitment Process and Enhance Public Safety, HB 1104 became law when Gov. Josh Stein (D) signed it July 6. North Carolina used involuntary commitment more than 106,000 times in 2021, nearly double the roughly 54,000 uses recorded in 2011, according to a 2025 Disability Rights North Carolina investigation cited by WUNC. ​

What the Law Does

WRAL reported that HB 1104 includes provisions aimed at moving some mental-health evaluations out of emergency departments and broadening who can conduct them. It also directs state agencies and health-care partners to study and change parts of the commitment process, including jail-based care and behavioral-health beds, according to NC Political News. Specific steps include:

  • The North Carolina Sheriffs' Association must prepare a proposal for a pilot program.
  • The state Department of Health and Human Services (DHHS) and the Sheriffs' Association must develop a plan for using telehealth to conduct initial examinations of people held in county custody.
  • DHHS must establish a working group under Section 8 of the law.

Legislative Status

Reps. Tim Reeder, Hugh Blackwell and Charlie Miller, all Republicans, sponsored the bill, and 20 cosponsors joined them, including Cotham, G. Brown, K. Brown, T. Brown and Budd. The Senate passed an amendment 48-0 on June 30, then approved a second-reading motion 45-3 the same day. The House concurred in the Senate's changes July 1.

North Carolina Health News characterized the law as "heavy on studies, light on solutions."

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