Williamson “Billy” Royal

Chapel Hill

“Billy” Williamson Royal of Chapel Hill died at 4:45 am, Dec. 12, 2025 at the age of 98. He died peacefully at home with his wife of 46 years, Nancy Earl, and several of his children around him.

Billy was born in Salemburg on July 20, 1927, to Ranby and Carrie Royal. He was the fifth of six children, Ranby Jr., Helen, Ammie Lee, Kenneth, Billy and Joe. He was the last of his siblings to pass.

Salemburg and its surrounding community of Sampson County were at the core of Billy's identity. He worked in his family's general store on Main Street during the Depression era. One of the most formative events of his childhood was when the family house burned down, and they escaped with nothing but their underwear (and glasses). Billy frequently referenced this event, noting that even though they lost all their possessions, the core of what was important, his family, remained intact.

During World War II, Billy joined the US Navy as a medical corpsman in Bethesda, Maryland. He then completed college at Wake Forest and found his way to medical school at Bowman Gray School of Medicine in Winston-Salem. There, he met his first wife, Lilian Butner, a nurse. They had four children, Philip, Sharon, Fredric and Pamela.

After his initial medical training, Billy completed a residency in psychiatry at the University North Carolina at Chapel Hill. He made his home in Chapel Hill from that point forward and took up several leadership positions in the community, including serving as president of the North Carolina Psychiatric Association and as a faculty member with the UNC Psychiatry Department working on medical education and the ethical review board for research.

After a foray into private practice, Billy saw the need for community-based mental health care. To that end, he applied for and was awarded a presidential grant to build and develop the Edgecombe-Nash Mental Health Center in Rocky Mount, which he ran for many years. He also flew to rural areas of North Carolina to bring psychiatric services to people who wouldn't have otherwise been able to access care. (He earned a pilot's license and purchased a propeller plane to facilitate these far flung commutes, and he flew his family on joy rides around the state using railroads and highways to guide him).

Later in his career, Billy became interested in forensic psychiatry and began working with patients at Dorothea Dix, the North Carolina state mental hospital in Raleigh. Much of his attention during those years focused on the legal consequences of mental illness and complex questions of culpability and competence in the justice system. He was frequently in the position of defending a mentally ill perpetrator against capital punishment. Billy was subsequently recognized for his significant contribution to mental health care in North Carolina with the state's highest civilian honor, the Order of the Long Leaf Pine, under Governor James B. Hunt Jr., joining other distinguished recipients such as Maya Angelou, Andy Griffith and John Hope Franklin.

In 1980, Billy married Nancy Earl. He and Nancy, a neurologist, later had a daughter, Emily.

In retirement, Billy enjoyed the bounty and variety of North Carolina life: independent newspapers, WUNC, Carolina Playmakers, the American Dance Festival, and the Red Clay Ramblers. His love of culture extended beyond North Carolina, and he faithfully recorded the Metropolitan Opera on the radio every Thursday afternoon for years. He loved good stories, especially ones about family and history, and delighted in bringing people together to find commonalities and connections. He embraced the good in our world, counseled those in need, and chuckled at the absurd. Most of all, he was uniquely and authentically human and recognized and valued the humanity in others. He was deeply loved.

He is survived by his wife, Nancy Earl; five children and their spouses (Philip Royal and Geri Siebert; Sharon Royal; Fredric and Linda Royal; Pamela Royal; Emily Earl-Royal and Andrew King), eight grandchildren, and one great-grandchild. He also leaves behind a large extended family of cousins, nieces, nephews, in-laws, and friends.

A graveside burial will take place at 1 pm on Sunday, May 3rd at the Sunrise Memorial Gardens Cemetery in Salemburg, NC. All are welcome to attend.

Memorial gifts may be made to the National Alliance on Mental Illness (NAMI) North Carolina or the Southern Poverty Law Center. 

Services entrusted to Butler Funeral Home, 401 W Roseboro, NC 28382.