A record of problems at Raleigh psych hospital where young patients fled
AI-generated summary reviewed by our newsroom.
- Holly Hill faced 27 violations in 2025, citing patient safety and oversight.
- Adolescent escapes, staff assaults, and unsecured areas raise concerns.
- Advocates say weak community care contribute to challenges.
EDITOR’S NOTE: This story includes a description of self-harm, which some readers will likely find disturbing.
The seven adolescents who managed to flee a locked psychiatric facility in East Raleigh this month are only the most recent patients to do so. The incident marks at least the third time this has happened since 2024, according to state documents and media reports.
Holly Hill Hospital, which treats adults, adolescents and children at two Raleigh locations, has been under scrutiny for years due to potentially vulnerable patients’ unauthorized departures.
Documented problems also include a lack of staff to de-escalate violent situations, hospital staff verbally abusing patients and medication rooms left unsecured, according to a state investigation first reported by NC Health News.
State regulators documented 27 deficiencies at Holly Hill as recently as January of this year. There are still unanswered questions about why problems persist — and what may be contributing to them inside the facility, according to one advocate agency.
“Holly Hill has a troubling history,” Corye Dunn, director of public policy at Disability Rights NC, said in a statement to The News & Observer.
Her organization, North Carolina’s federally mandated protection and advocacy agency, is “very concerned about their apparent inability to address what seems to be a core issue — the culture,” Dunn said
Holly Hill CEO Leigh Holston stressed the hospital staff followed all safety protocols and after the most recent event implemented “enhanced security measures,” in a statement. She did not answer The N&O’s questions about whether conditions inside the hospital could be contributing to patients forcing their way out or if she is concerned that the most recent incident could lead to more state scrutiny.
A ‘troubling history’
Holly Hill Hospital is an inpatient and outpatient psychiatric facility for patients of all ages. Its facility for kids and adolescents is in East Raleigh located near other medical buildings and apartment complexes.
Staff members were left with minor injuries after Sunday’s escape, Holly Hill reported. But state regulators have documented violent encounters between patients and staff, multiple young patient escapes and problems with staff oversight of patients who require close observation, according to the 2025 state inspection report.
The lack of oversight was linked to at least one teen patient with a history of self harm hurting herself, according to the report.
A 14-year-old girl entered Holly Hill last year for different mood disorders. She had started cutting herself with a steak knife, according to the state’s investigation.
Nurses reported she showed up to the hospital with fresh cuts on her arms and needed to be monitored every 15 minutes. Her room searched for contraband — like something she could hurt herself with — twice a day.
After a staff member saw her exit a bathroom “with fresh scratch marks that were bleeding” almost a month into her stay, it was clear the girl had figured out a way to do what staff were supposed to be protecting her from, according to the report.
It turned out that she had pulled the staples out of a worksheet packet staff gave her. State regulators found hospital staff didn’t create an incident report acknowledging and detailing what had happened, as is required.
Unauthorized departures
The seven adolescent patients who forced their way out of Holly Hill earlier this month attacked a security guard, according to Holston.
“While staff were securing the safety of the other patients on the units, the seven patients were able to kick their way through an exterior door and leave the premises,” Holston said in a statement.
In early March 2024, police used drones as they did to find the seven patients this month, but did not find five young men whofled Holly Hill last year. The five boys were found a few days later.
Just a few months after that, another patient ran away from Holly Hill.
When a 16-year-old girl was involuntarily committed there in June 2024 for rapid mood swings and violent ideations, hospital staff noted she was at risk of “elopement,” an official term for escape, in her admission documents, according to the state’s inspection report.
Hospital staff still let the girl through a locked door to the lobby to use the restroom. She pushed a staff member exiting the building and ran out of the front door, according to an incident report included in the investigation.
“I was at the front desk, it was a real busy day, I was working alone with nine patients in the waiting area,” a staff member said in an interview with state regulators, adding: ”she started running to the front door, knocked a lady down and she was out the front door. It happened so fast.”
The hospital reported they called the patient’s mother to notify her that her daughter had left, according to the report from that day. But when state regulators pressed for documentation during their investigation, a staff member said they found “references to talking to family,” but nothing else.
A violent event before Christmas
A group of adolescent girls staying at the hospital late last year “breached” — or entered without permission — the nurse’s station a few days before Christmas.
The situation escalated, resulting in some patients pulling computer monitors off of desks and smashing them. Others started throwing phones and i-Pads at staff members.
One patient “swung from the ceiling,” knocking tiles off — only to fall back down onto the nurses’ station later.
Four of the same patients made it inside the medication room — through a door that was propped open, according to the inspection report.
They smashed the screens on medication cabinets and two grabbed syringes and vials of medication, with one leaving the room with two syringes and needles, according to the report.
Surveillance video shows another patient attempting to stab a staff member in the neck with a needle, the report notes. When the police arrived, they put four patients in handcuffs.
Five patients were transferred to the local hospital “for evaluation due to possible medical ingestion,” regulators reported.
More resources needed
North Carolina has a well documented shortage of psychiatric treatment facility beds — especially for young patients, Dunn at Disability Rights NC said. But no number of beds will solve the problem if they “provide poor quality care.”
Worsening the problem is the lack of community-based mental health services for people who likely don’t need intensive treatment an inpatient facility offers, but do need more than what’s currently available outside the hospital.
Those services include outpatient therapy, supported employment, intensive in-home programs for kids and “other modalities that help folks heal and maintain without being locked in a hospital,” Dunn said.
Young patients in conflict with staff at Holly Hill may be sending a signal, she said.
“In the behavioral health world we often say that ‘behavior is communication’,” Dunn said in a statement to The N&O. “I think a lot about what these kids are communicating with this behavior. What would it look like for them to feel safe and supported?”
