Competency Crisis in Missouri’s Jails
by Douglas Ankney
The cover story of the June 2025 issue of PLN reported that “[d]espite years of litigation, injunctions, consent decrees, and contempt fines ranging into the hundreds of millions,” the State of Washington had “consistently failed to provide timely competency evaluations and restoration services to defendants facing criminal charges.” Now this woeful state of affairs has also been uncovered in Missouri, resulting in mentally ill detainees languishing in jails, untreated, presumed innocent, yet unable to stand trial or resolve the charges against them.
Generally, where there is evidence to suggest that an accused person lacks the competence to assist in his or her own defense, a judge may, sua sponte or on motion of any party, order the accused to undergo a competency evaluation. Doctors conducting the evaluation will then provide evidence at a competency hearing and opine whether they believe the accused is competent or incompetent. But it is the judge who determines whether the accused is competent or incompetent to stand trial.
While laws vary among the states, an accused, broadly speaking, is incompetent to stand trial when they lack the “capacity to understand the nature and object of the proceedings against him [or her], to consult with counsel, and to assist in preparing his [or her] defense.” See: 18 U.S.C. Section 4241.
If the judge determines the accused is incompetent, the criminal case is paused until doctors are able to opine, and the judge finds, that the person has been restored to competency. In Missouri, mental health officials estimate that about 80% of patients are restored to competency within four to six months of treatment in a state facility. Those persons not restored to competency are usually placed under civil commitment or guardianship.
But according to the Missouri Department of Mental Health (MDMH) the average wait time for a person deemed incompetent to be admitted into a specialized state facility for treatment to restore competency has increased from eight months to 14 months in just the past two years. As of October 21, 2025, there were 489 people waiting in line to be admitted—up from 252 in July 2023 and a mere ten in 2013. Worse, there are about 200 accused people, presumed innocent, waiting in line to get in line, i.e., waiting for a competency evaluation after a court has ordered one.
MDMH Director Valerie Huhn testified to state lawmakers that mental illness grows worse for those waiting in jail—and the longer the wait, the harder it is to restore to competency.
The accused also often suffer other ill effects not normally associated with criminal justice. For example, Megan Jolly, 52, has been held at the St. Charles County Justice Center since early 2024 for allegedly unlawfully entering a family member’s home and biting the family member. Jolly was deemed incompetent and her case stalled. In January 2025, Jolly was still awaiting hospital admittance to have her competency restored when her home was auctioned off on the courthouse steps across from the jail where she is confined.
Timothy Beckman, 64, had been held in a Kansas City jail for eight months, waiting for admittance to a treatment facility after being found incompetent. Beckman was schizophrenic and had lived in several nursing homes because, according to court records, he was “unable to care for himself.” He was jailed after breaking into a home and eating a burrito. In May 2025, Beckman accidentally choked to death on food at the jail. “He was really lost,” said Annie Legomsky, director of client advocacy for the Missouri Public Defender. “When you look at everyone else who’s on the competence wait list, they’ve also been lost.”
To address the backlog, the MDMH received $3.2 million in fiscal year 2023 to add 25 beds and staffing at the St. Louis Forensic Treatment Center-North, which is one of only three state hospitals that offer competency restoration. Soon thereafter, another $2.5 million went to a pilot program to offer competency restoration services to people waiting inside five of the biggest jails in Missouri. But the pilot program is off to a slow start with just 33 people participating at four of the jails as of October 2025. Green County, the fifth jail, isn’t participating at all. Green County Sheriff Jim Arnott has refused to participate in a “warehousing contract” of people with mental illness that Arnott says should not be in jail.
An additional $1.7 million was allocated to two forensic mobile teams, prompting former Marion County jail administrator Kevin Coates to say in an interview: “Thank God, finally, they’re going to start coming into our facility; they’re going to start seeing feces on the wall, the urine being thrown.”
Source: The Marshall Project
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