JEFFERSON CITY, Mo. – A coalition of civil rights organizations has filed a federal class action lawsuit alleging Missouri officials are illegally leaving people with serious mental illness to deteriorate in jail without court-ordered treatment.
According to a press release from the ACLU, the MacArthur Justice Center, ArchCity Defenders, and the ACLU of Missouri filed the lawsuit against the Missouri Department of Mental Health (DMH), arguing the agency has failed to meet its legal obligation to provide mental health treatment to pretrial detainees living with serious mental illness and disabilities.
The lawsuit, filed in the Western District’s Central Division, focuses on individuals who have already been deemed incompetent to stand trial but who nonetheless remain held in county jails without treatment.
According to the ACLU press release, Missouri state law requires competency evaluations within 60 days of a court order, but “it often takes approximately six months for someone to be evaluated.” The press release reports that nearly 500 detainees, all of whom have already been assessed as incompetent to stand trial, are “languishing in jail” while waiting for DMH to transfer them for treatment.
The press release further notes that, on average, affected individuals wait 14 months before receiving treatment intended to restore their competency, with some people detained longer than the maximum sentence they would face if convicted.
Amy Malinowski, co-director of the MacArthur Justice Center’s Missouri office, criticized the agency’s handling of competency services, stating, “DMH continues to fail hundreds of Missourians living with serious mental illness, leaving them to languish in county jails without access to treatment, where they stand a heightened risk of decompensating or worse.”
In addition, the press release notes that DMH Director Valerie Huhn said the waitlist is a “critical issue,” yet the numbers have continued to rise. DMH testified before the Missouri legislature that the waitlist for competency services has increased by “a third since September 2024 and almost 88% since September 2023.”
As of May 2025, 230 people were waiting in jail just for an initial DMH assessment, while 430 others who had already been found incompetent were still detained awaiting treatment. By October 2025, the number awaiting restoration treatment climbed to nearly 500 people.
Gillian Wilcox, Director of Litigation at the ACLU of Missouri, emphasized the state’s legal responsibility, stressing, “The state has a statutory and constitutional obligation to assess and treat all individuals that courts have deemed incompetent to stand trial in a timely manner. The current status quo leaves some people who experience mental illness or disabilities trapped in judicial limbo and languishing in jail while the state fails to provide the necessary care to allow the detained person to advance through the judicial system.”
ArchCity Defenders also condemned the situation. Maureen Hanlon, the managing attorney for civil rights litigation at the organization, said, “There is something deeply wrong with a state that always finds money to keep people in jail but cannot find money to provide the basic mental health treatment that our most vulnerable citizens are constitutionally entitled to.”
She followed the statement with a further reprimand, emphasizing, “True public safety would be providing care and support to families like those of our plaintiffs who are desperate to get their loved ones the treatment they need.”
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