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Long Waits for Montana Jail Detainees Needing Competency Restoration Services

As of June 30, 2023, an unnamed detainee at Montana’s Flathead County Jail (FCJ) had been held over nine months on a burglary charge, though she was not scheduled for trial. Instead the woman, who suffers from mental illness, was waiting for space to open at Montana State Hospital (MSH), the only place where she can be forced to take psychiatric medications that might restore her competency to stand trial—medications she refuses at the jail.

It’s a story repeated in jails across the country. But the problem is particularly acute in Montana, where 70 people were on the waiting list for one of the MSH’s 54 beds. Just six of those beds are available for women, whose waits are usually longest. The detainee at FCJ spent her months waiting atop a bed, refusing to take showers or go outside for recreation.

“They just deteriorate in our facility,” said FCJ Commander Jen Root.

State judges, who make the decision to send arrestees for competency restoration, have begun to lose patience with officials at the state Department of Health and Human Services (DHHS), who run MSH, threatening to hold them in contempt or levy other sanctions. DHHS attorney Chad Parker said he wanted state lawmakers to give judges other options, such as treatment in other mental health facilities.

“There’s room for community care to be ordered,” he said. “It is underutilized, if rarely utilized, through the court ordering process.”

But state District Court Judge Amy Eddy said that wasn’t an option for those who need medication they refuse to take.

“If someone needs to be involuntarily medicated, which the vast majority of people do in order to stabilize, the only place that can be done is at the state hospital,” she said.

Meanwhile detainees like the one at FCJ are stuck in limbo.

“Probably my biggest frustration with our whole system is the mentally ill,” Root said, “and having people in here that should not be criminally charged. Yes, they broke the law. Yes, they’re not safe to be out in the public. But being in jail is not the answer for them, either.”  


Sources: KFF Health News, NPR News

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