Purpose: The deinstitutionalization of mental health and the failure of community-based care has resulted in more individuals with mental illnesses receiving treatment in the criminal justice system than in the mental health system. This is referred to as the criminalization of mental illness. The purpose of this study is to examine and determine if the number of individuals suffering from a mental illness receiving treatment in the criminal justice system has increased or decreased from 2004 to 2016. That is, has criminalization increased or decreased?Methods: Data from the 2004 and 2016 Survey of Prison inmates gathered by the Bureau of Justice Statistics is utilized to compare 2004 and 2016. Bivariable analysis compares incarceration for those with and those without a mental illness. The confounding variables included in the data are race, substance abuse, crime type (drug, property, violent), and homelessness.Findings: There was a significant decrease in the number of incarcerated individuals suffering from a mental illness in 2016 compared to 2004. It was found that the number of violent offenses increased significantly from 2004 to 2016 regardless of mental health status. In regard to race, the race of the individual was not a significant indicator of incarceration among individuals with a mental illness. However, blacks not suffering from mental illness were more likely to be incarcerated. It was also found that in 2016 the number of black individuals in a system already overrepresented by blacks also increased. Blacks without a mental health diagnosis represented the largest increase, with blacks suffering from mental illness representing the largest decrease in incarceration. In addition, while blacks were significantly more likely to be charged with a drug offense, they were not significantly more likely to suffer from substance abuse.Implications: The criminalization of mental illness in North Carolina may be decreasing. However, the number of violent crimes increased significantly. Further study is needed to understand why.Originality: While national research has looked at the criminalization of mental health, little research has focused on the state level, specifically in North Carolina.