Samuel C. Wendt suffers from post-traumatic stress disorder, which he said was a result of military service in Iraq and Afghanistan. He is being held at Tabor Correctional Facility and says he still needs mental health care.
“I can tell you from personal experience that I’m a better person when I can talk about my problems,” Winter, 43, said in a phone interview from prison. “And prison is not a place where you can cry on someone’s shoulder. It’s not.”
I’m a better person when I can talk about my problems. Prison is not a place where you can cry on someone’s shoulder. But in fact, it’s not.
Samuel C. Winter
Winter is not alone. A report by the U.S. Department of Justice estimates that more than one-third of people in prisons have a history of mental health problems.
In Tabor City, Wendt, who was serving a 26-year sentence for rape, said there were many people in need of mental health care.
“How can I stress that prisoners need mental health care,” Winter said. “And I’m not just talking about me.”
But they don’t always receive that kind of care, according to WUNC’s interviews with dozens of inmates and advocates. Restrictions put in place to prevent the spread of COVID-19 and now staff shortages mean extended lockdowns and quarantines, they said. This can make it difficult for prisoners to see a psychiatrist. It even affected virtual telehealth appointments.
One way this manifests itself is through self-harm. In North Carolina, 13 inmates committed suicide last year. That was the highest annual total since at least 1991, according to the North Carolina Department of Public Safety. Overall, there were 3,347 incidents that required a self-injury risk assessment last year. That’s up from 3,099 in 2019.

NC Department of Public Safety
/
Joseph Williams directs the UNC Health Corrective Psychiatry Program, which began in 2015. The program now has 15 psychiatrists who provide in-person and telehealth services. Staffing shortages can also affect telehealth services, Williams said, because there aren’t enough staff to escort inmates to designated virtual care spaces.
“This deprives some of these incarcerated individuals of the ability to see their mental health provider regularly and easily, as this would involve movement of the incarcerated person, and prisons are really trying to suppress that to minimize spread of the virus,” Williams said.
In 2019, about 31 percent of new inmates were referred for mental health services after their initial prison screening, according to the Department of Public Safety. By 2021, this proportion increases to 47%.
According to DPS data, the prison system currently has a 36 percent vacancy rate for licensed mental health clinicians. Systemwide, the vacancy rate for correctional staff is about 40 percent. Staffing is by far the largest budget item not just for prisons but for the entire Department of Public Safety. Prison Guardianship and Security receives $900 million in state funding, more than 36 percent of the entire public safety budget.

NC Department of Public Safety
/
Prison health care and pharmacies make up another chunk of the budget — $288 million. Of that, $41 million went to mental health. Staffing levels can affect drug evaluation and treatment for inmates, Williams said.
“People may not change these medications quickly enough to address worsening mental health symptoms,” Williams said. “This will lead to worsening mental health.”
Advocates call for less incarceration as solution
That’s all the more reason to shorten more sentences, prison reform advocates say. North Carolina’s prison population has been in steady decline since peaking in 2011 and is now at its lowest point since 1995.
Kristie Puckett-Williams is the Deputy Director for Engagement and Mobilization at the ACLU of North Carolina. She’s happy to see population trends, but the state still has nearly 30,000 people behind bars. She wants society to provide better programs for those in need; people liked her before she went to jail and served probation for theft and drug charges.
“I am a victim of domestic violence. I need financial aid. I am not getting financial aid, I am getting [Division of Social Services] Take my children. Puckett-Williams said: “I was offered to be locked up myself. If someone asked me, ‘So what do you need?’ I would tell them that if I got those things, incarceration would not be on the table.”
In December, Puckett-Williams led a weeks-long protest at the governor’s mansion in downtown Raleigh. She advocated for various criminal justice reforms, but one of her greatest passions was improving the standard of living inside prisons.
“Humans should be treated like human beings,” Puckett-Williams said. “Conditions inside North Carolina prisons and the prison system are inhumane. They are torture.”
Corrections leadership said they recognize the need for more mental health services. The prison system is working with the American Foundation for Suicide Prevention’s Project 2025, which aims to reduce the annual suicide rate by 20 percent by 2025.

NC Department of Public Safety
/
Lewis Peiper, director of behavioral health at the prison, said leadership was addressing the issue “head-on”. Most suicides were not flagged as inmates for self-harm risk assessment, he said. This suggests that prisoners who see mental health providers are less likely to commit suicide and that they do not reach all those who need these services. Prison staff encourage inmates to speak up when they are struggling, Peiper said.
“Everything is being prepared,” Peiper said. “Let’s help each other out here.”
In some corners of the North Carolina legislature, some lawmakers have begun to take notice. Sen. Natalie Murdoch, who represents parts of Durham County and introduced legislation in the last session, would expand access to a program that would allow early release for infirm inmates.
“I think if we don’t think this person is a threat to their community, why are they still incarcerated?” Murdoch said.

Her initial legislation didn’t apply to many people, but she said it was a start.
“Especially if you’re older and you have family members who say, you know, we’re happy to house our loved ones. They can still be monitored in a variety of ways,” Murdoch said.
This exact scene plays out three days before Christmas.
Leroy Wentzel, who turns 80 in March, pleaded guilty to killing his sister-in-law’s husband in 1995 and is serving a life sentence. His health problems got worse, and his daughter, Janelle Kase, who lives in Pennsylvania, began advocating for the parole board to release him. Late last year, the board agreed. On a wet and rainy December day, Wenzel came home with her daughter.
“As I walked through the gate, I saw my daughter standing there, and she was already crying,” Wenzel said. “Then we grabbed each other and hugged and kissed. We still do that today. But what a feeling it was, man.”
Advocates say they want to expand that release effort. Not only would it benefit those released, they said, but it would help ease problems caused by staffing shortages, including lack of access to mental health care.