Latest news with #MissouriHouseHealthandMentalHealthCommittee
Yahoo
07-05-2025
- Health
- Yahoo
Hundreds of Missourians continue to languish in jail waiting for mental health services
Valerie Huhn, director of the Missouri Department of Mental Health, speaks to reporters after being appointed to the job on Dec. 29, 2021 (photo courtesy of the Missouri Governor's Office). There are 430 Missourians across the state in jails waiting to be moved to state psychiatric hospitals, up from around 300 at this time last year. The average time those people wait in jail before receiving treatment has held steady at 14 months, according to Missouri Department of Mental Health data. Those individuals were arrested, found incompetent to stand trial and ordered into mental health treatment designed to allow them to have their day in court — a process called competency restoration that generally includes therapy and medication. Those being held in jail are sometimes incarcerated for longer than they would be if they'd received the maximum sentence for the crime they were charged with. Testifying before the Missouri House Health and Mental Health Committee earlier this week, Valerie Huhn, the state mental health agency's director, called the issue the 'most critical' of the department's various waitlists for services. 'I just wanted to make everybody aware of some of the risks that we know we're taking on because we can't get these individuals from jail into our state operated hospitals,' Huhn said. 'Obviously their illness is worse, and as their treatment is delayed, that makes it harder for us to turn them around.' The state also faces potential lawsuits, Huhn said. 'We also know that there are federal lawsuits in five states for inappropriate detention and imprisonments, and there are federal lawsuits in 10 states for violation of due process,' she said. 'So there are a lot of risks for us not being able to address the needs of these populations.' State Rep. Kent Haden, a Republican from Mexico, said county jails are ill-equipped to hold individuals awaiting psychiatric treatment for so long. 'My sheriff continually tells me, 'I am not prepared to handle mental health issues in my jail.' And he had a suicide,' Haden said. 'He said: 'We were not prepared to handle this situation.'' The waitlist peaked in February and March, when the average stood at 440 people per month, and has since declined to 430 as of May 1. Huhn attributed the slight decline to the launch, over the last few months, of a handful of pilot programs that were signed into law two years ago. These jail-based competency restoration programs are designed to bring treatment to jails, rather than require individuals be transferred to psychiatric facilities. 'That program was slower starting than we wanted to see, but it is now open,' Huhn said. It has a capacity of 40 people, she said, and currently is serving 19. Those programs are in the Jackson, Clay and St. Louis County jails, Deb Walker, the spokeswoman for the department, told The Independent. In 2023, the state legislature approved $300 million to build a psychiatric hospital in Kansas City, which will add 150 beds. That is estimated to open in 2029, Huhn said, which is 'not soon enough' to ameliorate the issue. The legislature that year also worked to increase outpatient competency restoration, which has been slow to get off the ground, to treat those who can be safely released in their communities. Huhn said the agency is working to bolster that, including with money in the budget for community behavioral health liaisons to work between the agency and court. Outpatient treatment efforts will be targeted for those charged with low-level offenses, meaning misdemeanor charges and parole violations. More Missourians are in the pipeline who will need competency restoration. There are 80 people awaiting court orders and 230 more in open pretrial evaluations, of which the department estimates around half will be found incompetent. The waitlist is a result of limited bed capacity, workforce, and a lack of community placements, Huhn told lawmakers, as well as a surge in the number of court-ordered competency evaluations. There has been a 48% increase in the last five years in those evaluations. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
17-02-2025
- Health
- Yahoo
Missouri lawmakers raise concerns about long waits in jail for court-ordered mental health care
Annie Legomsky,who runs the state public defense system's holistic defense services program, testifies to the Missouri House Health and Mental Health Committee on Monday as Mary Fox, the director of the Missouri State Public Defender system, looks on (Tim Bommel/Missouri House Communications). Leaders of Missouri's public defender system urged lawmakers on Monday to take action to reduce the growing number of people languishing in jails across the state who are in need of mental health treatment. As of last month, 418 people were in Missouri jails waiting to be transferred to a state mental health bed, up from around 300 at this time last year. The average wait time was 14 months, with some held longer than the maximum sentence for the crime for which they were charged. These are Missourians who were arrested but found incompetent to stand trial and ordered into treatment designed to restore their ability to have their day in court. Competency restoration generally includes medication treatment and therapy. Missourians waiting in jail for court-ordered mental health care reaches all-time high The Missouri House Health and Mental Health Committee spent most of an informational hearing Monday addressing the Department of Mental Health's competency restoration program, with a presentation by Mary Fox, the director of the Missouri State Public Defender system, and Annie Legomsky, who runs the state public defense system's holistic defense services program. 'When somebody sits in a jail unmedicated and uncared for,' Fox said, 'their mental health can get worse and so bad that they can never be cured.' Legomsky and Fox urged changes to state law to increase court referrals to community-based treatment, instead of holding those charged with nonviolent, low-level offenses in jail for months. 'If we could figure out a way to take care of more of these folks in the community,' Fox said,'we're not only saving the state money in the competence restoration process, but we're setting them up for success when they return to the community.' The state can't create beds overnight, Fox said. 'And until we can either create the community restoration and let folks receive the treatment that way or create the beds, we don't have a quick solution to the problem,' she said. Many of the public defender's office's clients who are found incompetent have schizophrenia, intellectual disabilities or are on the autism spectrum, Fox said. The legislature in 2023 passed a law giving the department the authority to provide treatment on an outpatient basis if the person could be safely released and wasn't charged with a dangerous felony. But the department told The Independent last month that only two people have participated in the program so far. The state also passed a law giving the department of mental health the ability to treat people within jails. The programs have been slow to get up and running, and three counties are in their early days of getting the programs started, the department told The Independent. Legomsky said Monday that solution is 'not ideal' since 'the jail is not a therapeutic environment.' The hearing was designed to inform lawmakers, not to discuss any particular legislation. Several of the legislators serving on the committee expressed concern with the waitlist. 'We just don't have enough beds, that's the answer,' said state Rep. David Dolan, a Republican of Sikeston 'We don't have enough beds, and restoration within county jails is very hit and miss.' State Rep. Tony Harbison, a Republican of Arcadia, said small counties are footing the bill, since counties are responsible for paying for jail stays. 'Fourteen months — we're already spending a lot of money,' he said. Legomsky estimated that the state would save around $480 in savings per day to do community-based competency restoration as opposed to the hospital setting, not to mention the cost savings for counties currently housing those individuals in jails. One client, Fox said, was a 78-year-old woman with dementia who tossed lit matches in a laundromat waste basket — but was held in jail for a year, waiting for a mental health bed. State Rep. Jo Doll, a Democrat of St. Louis, responded: 'Where's the common sense part of that? How does someone, how do you all these people see this person day after day and let someone sit there for a year?' A handful of lawmakers asked about the potential for a public-private partnership, and whether private hospitals could be included. The public defenders said that would be a question for the department of mental health. Others asked about states that do things better. Legomsky said Washington state limits the wait time to 14 days, and recommended time limits be established in Missouri statute. 'Even closer to 30 days would be a huge improvement over 14 months,' she said. Other recommendations included increasing funding for community crisis care, housing and substance use disorder treatment — wraparound services to help people become competent and remain healthy, Legomsky said. The state could also make community-based treatment the presumption for those charged with low-level, nonviolent offenses. She said the public defenders estimate around 80% of those on the waitlist are charged with low-level, nonviolent offenses, and could be treated on an outpatient basis. 'We're on the same side as the prosecutors, the sheriffs, the courts,' Legomsky said. 'I think we all just want to find a solution.' SUPPORT: YOU MAKE OUR WORK POSSIBLE
