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Oct. 12, 2023 |  By: Clara Bates - Missouri Independent

260 Missourians are waiting in jails for mental health services

mental health

By Clara Bates - Missouri Independent

There are currently 260 people in Missouri jails waiting to be transferred to a hospital for mental health treatment — a slight uptick from last month, as state officials work to develop plans for the “jail-based competency restoration” program approved by the legislature this year.

Those 260 people were arrested, deemed unfit to stand trial and ordered into mental health treatment. 

They are supposed to receive rehabilitative mental health services that allow them to stand trial, a process called competency restoration. But they languish in jails, often for months, without having been found guilty of any crime because there are no hospital beds available to transfer them to.

The monthly update came from Nora Bock, director of the Missouri Department of Mental Health’s Division of Behavioral Health, during a mental health commission meeting Thursday.

Last month, there were 253 awaiting treatment and the wait time was eight months. The Department did not provide an updated wait time Thursday. 

The state has long struggled to transfer people from jails into mental hospitals once they are found to be incompetent to stand trial, in part because of a lack of hospital beds, staffing issues within the department of mental health and an increase in referrals. 

Bock said many of the agency’s staffing issues persist, noting that “our vacancy rates are better, but we still have significant turnover. 

That, Bock said, means “training over and over.”

Vacancy rates for social workers in particular “are very, very high, with 70% (licensed clinical social worker)  positions either vacant or they’re filled with a non-licensed mental health professional,” Bock said.

And more people in need of treatment are in the pipeline: The department will add 55 people who have been evaluated and determined incompetent to stand trial once they receive the court’s order to do so. It expects around 136 people with open pre-trial evaluations (half of the 273 evaluations open) will be found incompetent to stand trial and need treatment, Bock said.

“So that makes it very important that we are launching and getting ready to launch the jail-based competency restoration along with community outpatient competency restoration,” Bock said.

A law passed this year gives the agency the authority to treat arrested people within jails, called jail-based competency restoration, or on an outpatient basis if the person can be safely released and treated. 

“We continue to develop the curriculum and connect with the jails that are designated for that,” Bock said, “And we’ll continue to get that up and moving.”

This year’s budget set aside $2.5 million for the jail-based competency programs to be established in jails in St. Louis, St. Louis County, Jackson County, Clay County and Greene County.

Services in jail-based competency restoration will include room and board, along with medical care for 10 slots at each jail, contracted staff from a local behavioral health organization, and psychiatric care from DMH’s “mobile team practitioners.” The agency hopes to reduce wait times through the program. They have not provided a timeline for when it will be up and running.

Elsewhere, there have been recent high-profile lawsuits against long wait times in jail for those needing mental health services in states including Indiana, Kansas and Pennsylvania, arguing that long wait times are unconstitutional because they deprive people of due process.