Jefferson City, Mo. – Plaintiffs filed a motion for a preliminary injunction, seeking intervention from the court to compel the Missouri Department of Mental Health to remedy the ongoing harm from failing its legal duties to provide treatment to people living with serious mental illness and disabilities during pretrial detention after having been deemed incompetent to stand trial or awaiting an evaluation of their competency. The motion was filed in an existing case, Darrington, et al. v. DMH, et al., which was brought in Western District’s Central Division by the ACLU of Missouri, ArchCity Defenders, and the MacArthur Justice Center in November 2025.
DMH and the state have failed to respond reasonably and adequately in the face of the worsening waitlist problem. Despite the department’s admission before the Missouri House Committee on Health on February 5, 2024, that the waitlist for competency evaluation and restoration would grow beyond the 297 individuals at that time, Director Valerie Huhn declined to ask for adequate fiscal appropriations to mitigate the growing crisis. As the situation deteriorated further and the waitlist ballooned to over 500 individuals, Governor Mike Kehoe proposed a meager increase in the 2027 fiscal budget for only 50 additional individuals to be treated in community-based programs.
The ACLU of Missouri, ArchCity Defenders, and MacArthur Justice Center issued the following statement:
“These extended wait times are a direct result of DMH’s failure to follow the law. Worse, the situation is rapidly deteriorating. In just three years, the average wait time has doubled from an already unacceptable and illegal duration. In some instances, people are unconstitutionally held in a detention center while waiting to receive treatment for a longer period of time than the maximum sentence available for the crimes alleged. The court must intervene and order DMH to remedy this crisis.”
While average wait times for evaluation and restoration treatment have surged, so have the waitlists for these services. In 2013, the waitlist to enter a facility for restorative treatment was ten names long. In July 2023, the number had risen to 252, a twenty-five-fold increase. By September 2025, the average number was 492, nearly doubling in a two-year span. In January 2026, the waitlist reached an all-time high: 528 people had been found incompetent to stand trial and were on a waitlist for restoration services, while another 200 individuals were waiting to be evaluated in the first instance.
Plaintiffs seek a preliminary injunction requiring Defendants to file a detailed proposal for complying with the terms of the injunctive order within 21 days of the order indicating their plan to:
- ensure that DMH completes all currently pending court-ordered capacity evaluations for all Plaintiffs still on the waitlist within 60 days of the order;
- ensure that all future court-ordered capacity evaluations are completed within 60 days of a judicial order directing such evaluations;
- ensure that the defendants provide mental health services and competency restoration treatment to all relevant individuals within a constitutionally appropriate time, not to exceed 30 days, following a commitment order, said treatment to be provided either in a DMH facility or another suitable and the most integrated setting possible (e.g., in a hospital or community-based treatment center) and, in any event, not in a jail setting.
This requested relief is necessary and narrowly tailored to remedy the ongoing violation of Plaintiffs’ rights while more comprehensive and sustained solutions are developed in this litigation.
In support of their motion, the plaintiffs provided preliminary reports by two experts. Dr. Terry Kupers, a board-certified psychiatrist, Institute Professor Emeritus at the Wright Institute, Distinguished Life Fellow of the American Psychiatric Association, and an expert on correctional mental health issues, discussed in his declaration the harmful effects of long waits in jail on individuals like the six named plaintiffs. A second expert declaration was provided by three nationally-renowned forensic psychologists, and provided a critical analysis of the current state of Missouri’s competence evaluation and restoration system. That declaration also details certain best practices for managing competency evaluation and restoration systems–information which might shine a light on a path forward for the state.
Read full motion for preliminary injunction, supporting suggestions, and exhibits.
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