By Rachel Crumpler
Key Takeaways:
- North Carolina has launched its first specialized mental health unit for youth in juvenile justice, with 10 beds for intensive treatment.
- Young people awaiting mental health placements can often spend months in detention, usually because other facilities reject them.
- The two-year pilot will test whether specialized treatment can reduce crises and help youth access appropriate care.
Arkevious Armstrong, 45, returned to C.A. Dillon Juvenile Detention Center in Butner on Oct. 12. He had last walked out of the facility 30 years ago.
Armstrong spent four years of his childhood there, from age 13 to 17. This time, though, he came to celebrate the opening of a new behavioral health unit at the facility. The PIVOT unit is designed to provide more timely and intensive mental health care to young people in North Carolina’s juvenile justice system.
Bright blue walls and motivational phrases cover the newly renovated 10-bed unit; the goal is to create a more therapeutic environment than a typical detention facility.
Inside the PIVOT unit at C.A. Dillon Juvenile Detention Center in Butner, which will provide intensive mental health treatment to justice-involved youth with the most acute needs. Credit: New Hope Treatment Centers 
Attendees at PIVOT’s grand opening on Oct. 12, 2026, tour the new 10-bed unit, which will serve young people referred from any North Carolina juvenile detention center or youth development center. Credit: N.C. Department of Public Safety Division of Juvenile Justice and Delinquency Prevention 
Motivational phrases cover the walls of the new specialized mental health unit at C.A. Dillon Juvenile Detention Center in Butner. Credit: New Hope Treatment Centers
“If a place like this was in place when I was there, I would have probably had a different outcome upon my release,” he said.
After his release at 17, Armstrong said he accumulated more than a dozen mugshots and eventually served time in state and federal prisons. He later turned his life around and became a public speaker, author and nonprofit founder. A greater focus on mental health when he was in custody, he said, could have helped him find that path sooner.
Now he’s encouraged by seeing more resources devoted to mental health care and hopes the unit will help more young people get the support they need.
“I think this is definitely a step in the right direction,” said Armstrong, who served as keynote speaker at the unit’s ribbon-cutting event. “I didn’t really get it together, or really get it right, until I was over 25 years old.”
The unit, funded by $3.5 million from the N.C. Department of Health and Human Services for a two-year pilot, is the first of its kind in North Carolina.
“There are certain kids who need both a high degree of safety, security and structure, and a high degree of treatment,” said Matt Simon, chief operations officer at New Hope Treatment Centers, which is partnering with the state juvenile justice system to provide PIVOT’s clinical care. “These youth have been getting mostly just one and not the other.
“What we’re hoping is this proves that if we can find ways to give these kids both, I think we’ll get better outcomes.”
Tremendous need, limited treatment options
Youth in North Carolina’s juvenile justice system have significant mental health needs, and some require a level of care the system just hasn’t had capacity to provide.
A December 2025 point-in-time survey by the state Division of Juvenile Justice and Delinquency Prevention found that 99.4 percent of young people in North Carolina’s youth development centers had at least one mental health diagnosis.
Youth development centers are the system’s most restrictive setting, similar to adult prisons. Young people adjudicated for offenses committed before they turn 18 can be sent there, where they spend an average of 14 months.
On average, youth in those facilities had 4.7 distinct mental health or substance use disorder diagnoses. Some had as many as 12 diagnosable problems, the survey found.
In juvenile detention centers, which function more like adult jails, more than half of young people have been assessed as having mental health needs, according to the division.
Young people sent to these facilities typically stay for shorter periods as they await court proceedings or placement in community-based programs, staying, on average, 40 days.
Of the 2,491 youth admitted to juvenile detention centers from November 2024 through October 2025, 210 — or 8.4 percent — were placed on suicide watch after being assessed by a licensed mental health clinician.
Deputy Secretary William Lassiter, who has overseen the state’s juvenile justice system since 2014, said he’s seen the mental health needs among youth in the state’s 12 juvenile detention centers and five youth development centers grow more complex and more intense.
All told, those facilities housed 576 young people as of Oct. 16, according to data provided to NC Health News.
As the state has reduced the number of young people sent to youth development centers over the past decade, the ones landing there now increasingly have more intensive needs, he said. The average number of diagnoses per young person has increased, according to division data.
“A lot of times when they end up in a [youth development center], it’s because all the other systems have failed — the school system, DSS, the mental health system — and hasn’t been able to either properly identify what is going on with this kid, or it has not been able to be successful with that child,” Lassiter told NC Health News.
Staff regularly conduct health assessments that recommend a higher level of mental health care, Lassiter said, but placement options are scarce. Hospitals and residential psychiatric facilities often reject justice-involved youth because of the complexity of their needs and behavioral histories, which may include aggression, sexualized behavior, gang involvement or running away, he explained.
On any given day, Lassiter said, about 30 percent of North Carolina’s juvenile detention population is in custody awaiting a different placement. Often that’s to a mental health treatment setting, but involvement in the justice system is often a barrier to getting the care they need.
In a sample of 425 detention admissions from 2021 through 2025, youth awaiting behavioral health placement spent nearly three times longer in detention as the average stay of 25 days, according to division data.
For young people recommended for placement in a psychiatric residential treatment facility, fewer than half received that level of care.
Across the five-year sample, just six in 10 kids got the level of care that had been recommended for them, the division found.
Filling a service gap
The new 10-bed enhanced behavioral health unit will serve youth with the most acute needs who are referred from any North Carolina juvenile detention center or youth development center. That includes young people who have been repeatedly placed on suicide watch, who are experiencing psychosis or exhibiting heightened aggression.
Lassiter said the division partnered with New Hope Treatment Centers, which operates a 150-bed psychiatric residential treatment facility for adolescents in Rock Hill, South Carolina. That facility is one of the few in the Southeast that often accepts justice-involved youth who have been rejected elsewhere. The partnership also brings expertise in providing more intensive services, along with highly trained staff.
The unit will start admitting youth in November. New Hope Treatment Centers’ mental health staff and detention facility staff will jointly determine which youth are best suited for treatment there.
Lassiter said the unit will fill a critical service gap. On any given week, he said, two or three youth are transported to the hospital for a mental health crisis that exceeds what the personnel in detention facilities can manage. The hospital trips are resource-intensive, requiring two staff members to accompany each youth to ensure their safety and security — and the youth rarely leave the hospital with a diagnosis or treatment plan that helps them get better.
From November 2024 through October 2025, just four youth were admitted for inpatient psychiatric care, even as 210 youth were placed on suicide watch during that time. In the community, youth experiencing similar crises would end up at a crisis facility, but psychiatric providers rarely admit justice-involved youth who exhibit aggressive behavior for involuntary commitment, according to information provided by juvenile division spokesperson Matthew Debnam.
“This will be a facility where kids can go to that won’t be rejected,” Lassiter said.
PIVOT is designed to provide short-term crisis intervention and stabilization services, helping youth move on to their next appropriate placement and continue their rehabilitation. The goal is for youth to stay for about 14 to 30 days, though the timeline is flexible.
Simon from New Hope Treatment Centers said he hopes the unit can be a way to better serve youth and improve outcomes.
“There are times where there are kids who are actually court ordered and recommended for psychiatric treatment, but because no provider will say yes to them, they basically get stuck in the juvenile justice system [in detention],” Simon said. “That’s not what the system is meant to do.”
He also said that’s not a good reflection on North Carolina’s mental health system.
“What we’re hoping we could do with a young person like that is spend some time in our unit and get our team to really tangibly improve their behavior, improve their functioning, get them on the right medications, get them in the right therapies, but also advocate for them and show that this is a kid who can be served outside of this locked setting,” Simon said.
For a youth awaiting a behavioral health placement, PIVOT may provide a diagnosis and treatment plan that makes another facility more willing to accept them. Some youth may become stable enough to enter a community placement with support at home. Others may return to detention after treatment in the unit once their mental health needs are better managed, allowing them to participate in programming that could accelerate their release.
“If they languish too long in a justice setting that they really shouldn’t be in, they’re going to regress — and they’re going to end up just being as bad as people assumed they were going to be,” Simon said. “But they weren’t going to be that way if we could have intervened earlier.”
Testing a new approach
PIVOT will start with 10 beds, though Lassiter acknowledged that the need among the juvenile justice population far exceeds that capacity. The unit has space for 20 beds, but the two-year pilot funding only covers the cost of operating half.
Lassiter is putting together a funding proposal for the legislature to open all 20 beds and plans to seek more money during the long General Assembly session, which begins in early 2027.
The division will closely track the unit’s outcomes, including, among other things:
- Whether it reduces the number of youth placed on suicide watch at their home facilities
- Reduces the need for off-site hospitalizations
- Reduces the number of assaults on staff
Officials will also look at whether PIVOT helps youth get diagnoses and treatment plans they previously lacked, and reduces wait times for behavioral health placements.
Lassiter also thinks there will be benefits beyond the youth admitted to PIVOT. Moving some of the young people with the most acute needs to the specialized behavioral health unit could free up staff time and resources at other facilities, allowing staff to provide more programming and out-of-cell time for other youth.
If the model is successful, Lassiter hopes the state will set up behavioral health units at other detention facilities to better address the substantial mental health needs among its juvenile justice population.
“We wanted to start small, make sure we get it right, and then hopefully expand from there,” Lassiter said.
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