In North Carolina's mental hospitals, however, video surveillance technology is used sparingly.

Many older cameras are connected to live monitors, but what is seen on the screens is not recorded. Where newer recording equipment is working, the cameras have sometimes provided evidence of patient abuse.

Naomi Sparkman, a health-care technician at Broughton Hospital in Morganton, was recorded in March 2006 pinching a patient who was strapped down in restraints, according to an investigative report.

At Dorothea Dix Hospital in Raleigh, health-care technician Kumi Ademu-John was recorded picking a resident "up in the air by the front of his shirt, holding him against the wall, and then carrying him to his room, with the resident's feet still being off the floor, and dropping the resident on the floor in his room," according to a state investigation.

Video footage was key in substantiating abuse allegations against Sparkman and Ademu-John. Both lost their jobs, though hospital administrators did not seek criminal charges.

Advocates for the mentally ill have argued that widespread use of cameras could deter abuse and neglect of patients by state employees, especially in the isolation of restraint and seclusion rooms. The archived footage could also be used to clear employees falsely accused.

The News & Observer asked in recent months about the absence of video cameras in the restraint and seclusion rooms at Central Regional Hospital, the new facility nearing completion in Butner.

"The juice isn't worth the squeeze," Patsy Christian, director of the new hospital, said in December about installing cameras. She said using such cameras in restraint rooms could violate the privacy rights of mental patients.

But in a Feb. 7 interview, James Osberg, the director of the state hospital system, said plans are being drafted to install cameras in restraint rooms at Central Regional as well as all similar rooms at facilities where they are not already in use.