Wait for Competency Restoration Averages 14 Months in Missouri Jails
By late January 2025, a critical shortage of providers had stranded 418 detainees waiting for competency restoration in Missouri jails an average of 14 months each. The number wait-listed for the services had jumped from 300 a year earlier, when state Department of Mental Health (DMH) Director Valerie Huhn warned lawmakers at a February 2024 House Budget Committee meeting that “it’s probably going to be 1,000 individuals long before we’re at 100 individuals.”
The Sixth Amendment guarantees the right to a “speedy” trial. But the Fifth and Fourteenth Amendments also guarantee the right to a trial that is “fair.” The rights conflict when defendants are deemed incompetent to stand trial (IST); in that case they are involuntarily committed to a state mental hospital for treatment—usually medication and therapy—to restore their competency. This process can take months, if not years, but it can’t even get started until a treatment bed opens up. The limited number of those leaves IST defendants waiting in jail.
State Supreme Court Chief Justice Mary Russell warned in her 2024 State of the Judiciary speech that “concrete cell blocks are not conducive for treating mental health or addiction issues.” The problem has gotten so bad that state Public Defender Mary Fox said a dozen people had been jailed longer waiting for competency restoration than the maximum sentence they faced for their charged crimes.
DMH spokesperson Debra Walker said that admissions for treatment were following “the order in which the court order is received,” though they “are triaged based upon clinical acuity.” But the increasing number of court referrals has ballooned the number of jail detainees waiting for competency restoration nearly 50-fold since August 2013, when there were just 10.
State lawmakers budgeted a new $300 million psychiatric hospital in 2023, but it won’t open before 2028 or 2029. Meanwhile DMH was authorized to provide jail-based competency services under another 2023 measure that provided $2.5 million for pilot programs in five jail systems. Of those, only three signed contracts. The program in Clay County then lasted less than three weeks before its only clinician quit in November 2024. The Jackson County program wasn’t expected to begin before spring 2025. The one in St. Louis County had three participants.
Green County Sheriff Jim Arnott rejected the funds and the pilot in his jail, even though a detainee there has waited 450 days for competency restoration to stand trial for a misdemeanor with a maximum one-year sentence. “I’m not going to participate in a warehousing contract of people that are mentally ill that shouldn’t be in the jail in the first place,” he insisted.
Fox agreed that jail is “not a healthy setting for anyone, let alone someone with a mental health issue.” She estimated that two-thirds of those on the IST waitlist, like the detainee waiting so long in Arnott’s jail, are charged with misdemeanors and could be safely released to community treatment centers.
Source: Missouri Independent
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