Missouri Lawmakers Propose Bills to Reduce Jail Mental Health Backlog

Jefferson City, Mo. (KFMO) - Missouri lawmakers are advancing several proposals aimed at reducing a growing backlog of people jailed while awaiting mental health services needed to move their criminal cases forward.

The individuals have been charged but not convicted and were found incompetent to stand trial due to mental illness or cognitive disabilities. In October, the average statewide waitlist for services from the Missouri Department of Mental Health reached a record 487 people. Bills filed ahead of the 2026 legislative session would impose new deadlines on the department, require reimbursement to county jails for housing people on the waitlist, and expand options for treatment outside of jail.

One proposal would require competency evaluations and hospital transfers within set timeframes, while another would mandate payments to jails to help offset housing and medication costs. Lawmakers say the measures are intended to increase accountability and encourage collaboration on long-term solutions. Other legislation would establish clearer guidelines for court-ordered outpatient mental health treatment before criminal charges are filed, with the goal of intervening earlier and easing pressure on jails and state hospitals. State officials have acknowledged the backlog and cited increased court referrals and limited hospital bed capacity as contributing factors.

While the department has launched pilot programs and mobile clinician teams, some counties report mixed results, underscoring continued concerns about due process, costs, and access to timely treatment.