Missouri state lawmakers are advancing multiple bills to address a growing backlog of people awaiting mental health services while housed in jails. In October, the average number of people on the waitlist for the Missouri Department of Mental Health reached 487, according to state officials—a new high for people who have been charged but not convicted of crimes and found incompetent to stand trial due to mental health disorders or cognitive disabilities.
Proposed Legislative Solutions
Several bills filed ahead of the 2026 legislative session target different aspects of the problem. State Rep. Jeff Vernetti, a Republican from Camdenton, filed legislation requiring the department to reimburse jails for housing people on the waitlist at $200 per person, per day, plus medication costs. State Rep. Brian Seitz, a Republican from Branson, proposed a bill imposing a 45-day deadline for the department to conduct court-ordered evaluations and another 45 days to transfer people to a hospital. Seitz’s bill would also require annual reports to the General Assembly on competency restoration.
State Reps. Aaron Crossley of Independence and state Sen. Maggie Nurrenbern of Kansas City filed a Democratic bill establishing guidelines for court-ordered involuntary outpatient treatment before criminal charges are filed, aiming to help people access treatment earlier and reduce waitlist growth.
Challenges with Current Approaches
A 2023 law authorized jail-based competency restoration services and outpatient treatment options, with four pilot programs launched in St. Louis city and county, plus Clay and Jackson counties. However, results have been mixed. The Clay County Sheriff’s Office announced it is terminating its pilot agreement in January, reporting that the number of people awaiting hospital placement stayed steady at 7-8 during the pilot and compensation from the department did not cover costs. Cape Girardeau County Jail Administrator Richard Rushin estimated his agency’s two mental health pods cost $7.5 million of a $54 million jail project.
Department Deputy Director Dr. Jeanette Simmons told The Independent in October that the waitlist grows because courts are requesting more competency evaluations while the department maintains a static number of hospital beds. The department’s fiscal year 2027 budget request showed it takes an average of 75 days to complete evaluations, exceeding the state law requirement of 60 days. One inmate in Taney County has waited over 14 months for hospital care after being ruled incompetent.
Lawmakers and jail administrators emphasized that addressing underlying causes requires investment in workforce wages and accountability in departmental spending, with some warning that people facing misdemeanor charges are experiencing delays of 18 months to two years or more due to the backlog.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.newsfromthestates.com/article/missouri-lawmakers-vow-tackle-mental-health-backlog-hundreds-languish-jails