Winter Wellness: Mental Health for 'Justice-Involved' Older Adults

As winter deepens across North Carolina, state officials and community advocates are emphasizing the mental health needs of "justice-involved" older adults—a population facing heightened risks during colder months marked by isolation, stigma, and limited access to care.

Older adults involved in the justice system often experience compounded challenges, including family rejection and social exclusion. These issues are frequently intensified during winter, negatively affecting emotional well-being and complicating successful reentry, state officials said in an email on Wednesday. Compared with younger individuals, justice-involved older adults are more likely to face chronic medical conditions, cognitive decline, and mental health disorders, alongside systems that are not designed for aging populations.

According to the North Carolina Department of Health and Human Services, older adults in correctional settings experience accelerated aging and higher rates of conditions such as arthritis, hypertension, dementia, and depression. Limited access to age-appropriate care during incarceration can worsen these conditions, while long periods of confinement often weaken family and community ties.

Kelly Crosbie, Director of the Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMH/DD/SUS) at NCDHHS, emphasized the importance of targeted, compassionate support. “Older adults who have been involved in the justice system often carry complex health and behavioral health needs that require coordinated, age-responsive care,” Crosbie said. “When we invest in continuity of mental health services, stable housing, and community-based supports, we not only improve individual outcomes—we strengthen families and communities across North Carolina.”

Housing, Health Care, and Reentry Barriers

Stable housing and continuity of healthcare are widely recognized as critical to successful reentry. Justice-involved older adults face a higher risk of homelessness, and many long-term care options—including nursing homes and assisted living facilities—exclude individuals with criminal records. Employment barriers, age discrimination, and long gaps in work history further contribute to financial instability.

Permanent supportive housing models and Medicaid-funded Home and Community-Based Services (HCBS) can help older adults meet daily living needs while supporting independence. State and local officials say these approaches are especially important during winter, when health risks and isolation increase.

First Lady Anna Stein is a member of the state's reentry council, appointed by Gov. Josh Stein in April 2025. It was created by then-Gov. Roy Cooper on Jan. 29, 2024, by his 303rd executive order. Cooper is now running for U.S. Senate; he has multiple primary election challengers. 

Coordinated Support Across Systems

Effective reintegration depends on coordination among correctional systems, healthcare providers, aging services, and community organizations. Cross-system collaboration allows services to address the intersection of justice involvement, aging, health, housing, and social connection.

North Carolina offers a range of reentry and wellness resources, including community-based treatment programs, Local Reentry Councils, and tools that connect formerly incarcerated individuals with healthcare, housing, and employment assistance, Crosbie said. State leaders note that aligning these efforts helps reduce gaps in care and promotes long-term stability.

Caregivers and Community Networks

Caregivers and community organizations play a vital role in supporting older adults after incarceration. Responsibilities often include medication management, transportation, healthcare appointments, and assistance with daily living. Family Caregiver Support Programs, Area Agencies on Aging, faith-based organizations, and nonprofits provide "wraparound services" that help ease this burden and foster social connection.

It is often unclear what organizations offer what services at the local level, what the programs are, who qualifies, and what the program outcomes are, without doing extensive research. There is no known centralized online database run by the state that is easily accessible to the public to read the information.

As Crosbie noted, collaboration is key. “Successful reentry is not the responsibility of one system alone,” she said. “It requires partnership across health, justice, and community organizations to ensure people can age with dignity, stability, and hope.”

Immediate Support Resources

Help is available statewide for individuals and families who need immediate assistance:

• 988 Suicide & Crisis Lifeline: Free, confidential support available 24/7 by call or text.

• NC Peer Warmline: 1-855-PEERS-NC (1-855-733-7762), a free and confidential line available day or night to speak with someone with lived experience.

State officials encourage anyone concerned about their mental health—or that of a loved one—to seek support, reminding residents that help remains available throughout the winter months.