Jan272026
Guardianship Q&A Series

How do I get guardianship over my adult child who has serious mental health and substance use issues and can’t safely live alone? – North Carolina

Short Answer

In North Carolina, guardianship for an adult usually starts with filing a verified petition asking the Clerk of Superior Court to declare the adult “incompetent,” followed by a hearing. If there is an urgent safety risk while the case is pending—such as leaving inpatient treatment early—North Carolina law also allows a request for an interim guardian with a fast hearing timeline. If the clerk finds the adult is incompetent, the clerk can appoint a guardian (of the person, the estate, or both) with powers tailored to what is needed.

Understanding the Problem

In North Carolina guardianship cases, the key question is: can a parent ask the Clerk of Superior Court to appoint a guardian for an adult child when the adult child’s mental health and substance use issues make it unsafe for the adult child to live independently or make safe decisions? The process typically turns on whether the adult child meets North Carolina’s legal standard for “incompetence,” and whether immediate court intervention is needed while the case is pending.

Apply the Law

North Carolina uses a two-step framework: (1) an incompetency case to decide whether the adult legally lacks capacity, and (2) if incompetence is found, a guardianship appointment to decide who will serve and what powers the guardian will have. These matters are handled through the Clerk of Superior Court in the county connected to the adult (often the county of residence or where the adult is located for care). When there is an urgent risk of harm before the incompetency hearing can be held, North Carolina law allows the clerk to appoint an interim guardian with limited, short-term authority.

Key Requirements

  • Proper filing to start the case: A verified petition must be filed with the Clerk of Superior Court requesting an adjudication of incompetence for the adult.
  • Proof of incapacity tied to safety/decision-making: The evidence must show the adult cannot manage important personal decisions (and/or finances) in a way that keeps them safe, not just that the adult has a diagnosis.
  • Right-sized guardianship powers: If the clerk appoints a guardian, the appointment can be limited to the person (care/placement/medical-type decisions), the estate (money/property), or both, depending on what the evidence supports.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The facts describe an adult child with significant mental health conditions and substance use issues who is on an involuntary inpatient hold and repeatedly tries to leave treatment early. Those facts often support (1) filing an incompetency petition with the clerk and (2) considering a motion for an interim guardian because leaving treatment can create an imminent or foreseeable risk of physical harm. If the evidence shows the adult child cannot understand or weigh decisions about treatment and safe living arrangements, the clerk may be more likely to consider a guardian of the person (and possibly limited powers focused on care and placement), rather than a broad guardianship that goes beyond what is necessary.

Guardianship is not automatic just because someone has a diagnosis or is in treatment. The case usually succeeds or fails based on practical proof: recent behavior, inability to meet basic needs safely, inability to make and communicate stable decisions, and the concrete risks that follow (for example, repeatedly attempting to discharge against medical advice and returning to unsafe conditions).

Related reading that may help frame the decision-making: declared incompetent and whether guardianship can help prevent leaving inpatient treatment early.

Process & Timing

  1. Who files: Typically a parent or other interested person. Where: The Clerk of Superior Court in the appropriate North Carolina county. What: A verified petition to adjudicate incompetence, and (if urgent) a verified motion requesting an interim guardian. When: As soon as there is a pattern of unsafe decision-making or a current crisis that requires immediate court authority.
  2. Interim guardian (if needed): The clerk must set a hearing promptly, and the hearing must be held as soon as possible and no later than 15 days after the motion is served on the respondent. If granted, the interim guardian’s powers must be limited to what is necessary, and the interim appointment is short-term under the statute.
  3. Incompetency hearing and guardianship appointment: If the clerk adjudicates the adult child incompetent, the clerk can then appoint an appropriate guardian (person, estate, or both) and issue letters/authority documents reflecting the scope of powers granted.

Exceptions & Pitfalls

  • Diagnosis alone is not enough: The clerk generally needs evidence of functional incapacity and real-world risk, not only medical labels.
  • Overbroad requests can backfire: Asking for broader powers than necessary can create resistance and delay. A narrowly tailored request (for example, focused on care/placement decisions during a crisis) is often more consistent with how the clerk must limit interim authority.
  • Confusing guardianship with involuntary commitment: Guardianship can help with decision-making authority, but it does not automatically replace the separate mental health commitment process. The safest approach is often coordinating the guardianship strategy with the current inpatient legal status and discharge planning.
  • Service and notice problems: Interim relief has strict service and timing requirements. Delays in serving the respondent or missing required parties can push the hearing out and undermine the urgency argument.

Conclusion

In North Carolina, getting guardianship over an adult child generally requires filing a verified incompetency petition with the Clerk of Superior Court and proving the adult child cannot make or carry out safe decisions. When there is an urgent risk—such as repeatedly trying to leave inpatient treatment early—North Carolina law allows a request for an interim guardian with a fast hearing schedule, and the clerk can grant limited short-term powers to address immediate safety needs. The next step is to file the incompetency petition (and, if appropriate, an interim-guardian motion) with the clerk promptly.

Talk to a Guardianship Attorney

If a family is dealing with an adult child who cannot safely live alone and keeps trying to leave treatment early, our firm has experienced attorneys who can help explain options, prepare the filings, and track the timelines in the Clerk of Superior Court. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

Category: Guardianship Q&A Series

Author: Pierce Law

Pierce Law Group is a North Carolina law firm focused on probate administration, real estate partition matters, and surplus funds claims across North Carolina. We know these situations often come with stress, family dynamics, and time-sensitive decisions—so we prioritize clear communication, steady guidance, and a practical plan from day one. Our goal is to make a complicated process feel manageable, while protecting what matters most to you.