Joonu-Noel Andrews Coste

The Project

Joonu-Noel’s project worked to end the PRTF-to-Prison Pipeline by addressing the overreliance of the State of North Carolina on commitment to Psychiatric Residential Treatment Facilities – Institutions – to deliver mental health services to youth.

Youth are harmed when Psychiatric Residential Treatment Facilities (PRTFs) deny them their rights under the law. These include the right to due process for continued admission, the unrestricted right to call a parent or guardian, and the right to be free of abuse and neglect. Youth placed in PRTFs are disproportionately minority, economically disadvantaged, and have disabilities in addition to a mental health condition or addiction. After being away from their home communities for many months or years, these youth struggle to reintegrate into the community with little or no community mental health services and often end up in trouble with the law or readmitted to a residential facility. Parents want tools to advocate on behalf of their children. Community organizations want to build capacity to strategically bring their concerns about extremely limited numbers of community-based treatment options for their youth to local leaders and lawmakers.

Many autistic individuals have difficulty communicating verbally and are dismissed as having nothing to say. As a mother to three children, two of whom are autistic, Joonu-Noel has experienced stigma and many challenges while advocating for her children. That experience inspired her to attend law school to elevate and amplify marginalized voices, work to eliminate stigma and advance disability rights.

Fellowship Highlights

Ms. Coste integrated work conducted by DRNC over the last decade and advanced it by identifying additional potential areas of abuse, neglect, exploitation, and other civil rights violations of clients and tracking reported and observed violations in order to remedy individual violations and address systemic causes. The project confirmed that youth placed in PRTFs are disproportionately minority, economically disadvantaged, and are involved with the child welfare and/or juvenile justice systems. Specific highlights include the following: (1) Created data management system to identify trends in licensing and client rights violations used to provide technical assistance to the NC DHHS rule-making committee during the recent revision of licensing rules for PRTF; (2) Forward 36 complaints and requests for an investigation to the State licensing agency, all of which were substantiated and several of which directly contributed to the suspension of admissions and/or licenses of facilities; (3) Represented nine individual clients to obtain appropriate community-based services and exit or avoid PRTF commitment; (4) Contributed to the National Disability Rights Network’s upcoming national report on PRTFs.

Next Steps

The work of the fellowship project has been folded into priority work of the P&A within Target 5 and will continue to inform ongoing advocacy efforts involving children’s mental health more broadly. Ms. Coste is transitioning in her role to continue leading this work as Target 5 co-leader and Staff Attorney at DRNC.


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