If a family member is committed to a North Carolina state psychiatric hospital in 2026, that facility will be facing serious staffing shortages.
Each of North Carolina’s three psychiatric hospitals closed out last year with staff vacancy rates at or above 20%. North Carolina still does not have a state budget, and in that underfunded environment, staffing challenges only mount. For the state’s most fragile and at-risk citizens, that translates into an unsettling lack of care.
The NC Department of Health and Human Services operates three psychiatric hospitals across the state: Cherry Hospital in Goldsboro, Central Regional Hospital in Butner and Broughton Hospital in Morganton. Across these facilities, more than 1,000 positions are vacant. Out of 900 total beds across, 350 are not in use at all due to understaffing.
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Still, if one is involuntarily committed in North Carolina, one must be treated in North Carolina. In the current environment of scarcity, this creates disturbing bottlenecks and the potential for unsafe care.
The high vacancy rate translates directly to poorer outcomes for people with mental illness. Over the last decade, the number of reported incidents at state hospitals has risen 65%.
Both the state House and Senate budget proposals include cuts to DHHS, but they don’t align on exactly where the cuts should be made. DHHS can’t move forward under such uncertainty. As a result, more than 700 of the 1,000 vacant positions at the psychiatric hospitals are frozen completely.
And hiring people to fill the 300 non-frozen vacancies is no easy task.
“DHHS is in direct competition with other health care systems to recruit and retain essential staff,” DHHS spokesperson Summer Tonizzo told Carolina Public Press.
“It is imperative to invest in the (DHHS) workforce to shore up an overburdened system that is delivering critical behavioral healthcare that is needed across North Carolina. (DHHS) is focused on using every available tool to recruit and retain the necessary staff members we need to ensure the essential quality care services our facilities provide endure.”
The types of workers DHHS is after for the psychiatric hospitals are in high demand. The private sector often offers higher salaries and other perks. Without a state budget, DHHS can’t ever offer raises, which means that the employees who do actually work there may leave.
DHHS is considering lots of options for strengthening recruitment: job fairs, walk-in hiring, nurse recruiters, flexible scheduling options and bonuses for sign-ons and retention.
But it just got even less attractive to be a state employee. In 2026, health care premiums for the State Health Plan are rising considerably thanks to the plan’s financial woes. They are expected to rise again in 2027.
“DHHS is already in the middle of a major crisis of staff vacancies and having trouble retaining staff,” said Central Regional Hospital social worker Alexandra Fox in a statement last year.
“We cannot afford any increases to our premiums, to our deductibles or cuts to services. We provide face-to-face care for you and your families. DHHS workers keep the hospitals clean, keep patients fed, and do personal, hands-on nursing care, but we can’t afford the care that we give to other people.”
Charles Owens, a health care technician at Cherry Hospital, agreed. “You are gonna increase the cost of our health care so high that we cannot afford to get sick,” he said.
In a state with psychiatric hospitals strained to the absolute max, inpatient mental health care doesn’t look like a good deal for any North Carolinian.
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