Carrie Brown, MD’04, HS’04-’08, MPH, credits her first clinical rotation as a Duke University medical student at John Umstead Hospital, a former psychiatric inpatient facility in Butner, North Carolina, with planting the seed for her future psychiatry career.
“That experience opened up a whole new world for me,” she said. “I was drawn to working with people with psychotic disorders and other serious mental illnesses.”
That path eventually led her to the North Carolina Department of Health and Human Services (NCDHHS), where she now serves as chief psychiatrist and deputy secretary for facilities, behavioral health, and intellectual and developmental disabilities.
Following opportunities
Brown has always had a passion for science. As a child, she dreamed of becoming an astronaut, and she started college at Princeton planning to study astrophysics. Although she found research measuring cosmic background radiation fascinating, she discovered that what she enjoyed most was building relationships with people. Seeking to improve people’s lives through science, she changed her major to molecular biology and shifted her focus to a career in medicine.
Brown charted an unconventional path in medical school: she took a year off to conduct clinical research in oncology and, in her third year, pursued a master’s degree in public health at the University of North Carolina at Chapel Hill. After completing her MD, she stayed at Duke for her psychiatry residency, which she completed in 2008.
“In medical school, I learned flexibility and creativity, and I gave myself permission to be flexible and creative in my career, which ultimately led to me being much happier,” Brown reflected. “I came to my current job without any intention of ending up here, but it’s a perfect fit. It was all about following opportunities that arose, rather than having a predetermined pathway.”
Those opportunities have included a five-year stint as a psychiatrist at Central Regional Hospital and a faculty role at UNC, where she conducted research and started a program to help people with serious mental illness thrive in the community. She also provided psychiatric care for patients at Central Prison in Raleigh and has held an adjunct faculty appointment in Duke’s Department of Psychiatry & Behavioral Sciences since 2008.
Brown joined NCDHHS in 2018 as the chief medical officer for the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. Although the role was a massive career change, Brown says it was a logical next step, given her breadth of experience in health services research, clinical research, and both inpatient and outpatient care. It also spoke to her strong interest in shaping systems and public policy.
A year later, she took on an additional role as the chief medical officer for NCDHHS’s Division of State Operated Healthcare Facilities, which serve adults and children with mental illness, developmental disabilities, substance use disorders, and neurological conditions. She was promoted to her current position in 2026.
‘The Stars Lined Up’
One of Brown’s most notable achievements — in collaboration with the governor’s office, the North Carolina General Assembly, and many others — was helping to secure $835 million of the federal funds the state received as part of its Medicaid expansion in 2023. So far, NCDHHS has spent more than 75% of these funds to enhance behavioral health care across the state and broaden access to services.
“This was a unique opportunity where all the stars lined up,” Brown said. “There were dollars available, there was bipartisan support for behavioral health, and after the pandemic, everyone was talking about mental health, substance use, and trauma.”
With the funding, Brown has partnered with various entities to expand mental health care in primary care settings, raise Medicaid reimbursements for behavioral health services, overhaul processes for people with mental illness facing legal charges, and bolster the behavioral health crisis system.
While these initiatives have substantially moved the needle on behavioral health care in North Carolina, there’s still much work to be done. Top priorities on the horizon include continuing to develop North Carolina’s behavioral health crisis system, investing in the behavioral health of justice-involved populations and foster care youth, and ensuring state-operated health care facilities can meet statewide needs.
And Brown is up for the challenges: “I’m one of those people who likes to work on impossible problems,” she said.
This story originally appeared in the Spring 2026 print edition of Magnify Magazine.