Mental health, substance use and housing insecurity linked in NC
Free help and resources, and how NC public health is driving change

Did you know more than one in five North Carolina adults experienced mental illness in the past year? About one in 20 had a serious mental illness.

You're not alone. Free, confidential help is available now.

This Mental Health Awareness Month, North Carolina is sharing:

Mental health includes our thoughts, feelings and behaviors. Mental illness can make daily life harder and can affect how you get along with others, keep a job or take care of yourself.

Mental illness, the overdose epidemic and homelessness impact people statewide. This is especially true after natural disasters like Hurricane Helene.

Read more: Mental Health, Substance Use and Housing Insecurity are Connected (PDF)

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Mental health's link to other crises, and how it impacts NC

Suicide is the ninth leading cause of death in NC

In 2023, more than 1,550 people ages 10 and older in North Carolina died by suicide. That's about four people each day.

Suicide is the ninth leading cause of death in the state, and the second leading cause of death for people ages 10 to 40.

Most people who died by suicide had a diagnosed mental health condition like depression, anxiety or bipolar disorder. Some also had alcohol or drug problems. Suicide rates have increased 10% over the past 10 years, and 13% since the start of the COVID-19 pandemic in 2019.

Groups most affected by suicide include:

  • Men
  • White and Native American/Indigenous people
  • People ages 45 to 64
  • Veterans (especially ages 18 to 34)
  • People living in rural areas

Most suicides, about 60% in the past 10 years, involved a gun.

Suicide Prevention Resources

NC Suicide Prevention Action Plan

North Carolina works to prevent suicide by:

  • Raising awareness
  • Providing crisis support
  • Reducing access to lethal methods
  • Making care more accessible

Read more: North Carolina Suicide Prevention Action Plan (PDF)

1 in 4 people who died from overdose also experienced mental illness  

Mental illness and substance use often happen together. In 2023, about one in four people who died from an overdose also had a mental health disorder like depression or anxiety. Most were not in treatment for that mental health disorder when they died.

In 2023, 4,442 North Carolinians died of an overdose, the highest number of overdose deaths in a single year. That’s about 12 people dying each day from an overdose in our state.

Some communities have been hit especially hard. Since 2020, overdose deaths among Black residents climbed and surpassed the rate among white residents. Native American/Indigenous communities have also seen a sharp rise in deaths, up 141% since 2019.

NC Opioid and Substance Use Action Plan

NC's plan to fight the overdose crisis includes:

  • Prevention
  • Harm reduction
  • Support for people with lived experience

Read more: North Carolina Opioid and Substance Use Action Plan (PDF)

People experiencing homelessness are more likely to die from overdose

Homelessness is more than not having a home — it often shows that people are missing support systems or can't afford housing. Many people who are homeless also struggle with mental illness or drug use.

Experts say the best way to help is to offer housing first, without making people stop using drugs or get treatment right away. A safe place to live helps people stay healthy, get jobs and go to school.

People who are homeless are much more likely to die than those who have reliable housing (PDF). Overdoses are the main cause of death among those who are homeless. Rates of suicide, car crashes, pedestrian injuries and gun violence also higher among this population.

In 2022-2023, more than 25% of deaths among people experiencing homelessness were from overdose, according to death certificates and records from shelters in 81 counties.  

North Carolina Strategic Housing Plan

North Carolina's housing plan focuses on creating more affordable, supportive housing for:

  • People with disabilities
  • People who are experiencing homelessness
  • People who are at risk of experiencing homelessness

Read more: North Carolina Strategic Housing Plan

More Information and Resources

Suicide

Overdose

Homelessness

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