Court orders California to move severely disabled defendants into treatment within 28 days

A man is detained and placed in handcuffs while Los Angeles police officers search the car he was riding in.
A man is detained and placed in handcuffs in Los Angeles. An appeals court has set a deadline of 28 days for the state to move mentally ill and intellectually disabled defendants into hospitals or treatment programs after a court has found them too impaired to stand trial.
(Genaro Molina / Los Angeles Times)

A state appeals court has ordered California to move disabled inmates found mentally incompetent to stand trial out of jails and into treatment.

A three-judge panel of the 2nd District Court of Appeal in San Francisco set a deadline of 28 days for the state to move mentally ill and intellectually disabled defendants into hospitals or treatment programs after a court has found them too impaired to stand trial. Those defendants now often spend months in jail, where lawyers say they have died of suicide or suffered abuse while awaiting medical attention.

The decision by the state court, handed down late Tuesday afternoon, largely upheld a ruling by an Alameda County judge who oversaw hearings in a suit filed by the ACLU Foundations of Northern California and Southern California and family members of disabled defendants.


The trial judge phased in the 28-day deadline over 30 months, beginning with a 60-day deadline within 12 months of the court’s order and ending with the final deadline at the end of this year.

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Experts who testified in the case found that a lack of available state hospital beds was primarily responsible for the delays, followed by inefficiencies in the admission process. The average wait in jail for mentally ill defendants was 86 days.

Justice J. Anthony Kline, writing for the court, said unconstitutional delays in providing treatment “have continued for many years.”

“Too many of these defendants’ due process rights continue to be violated due to lengthy waits in county jails,” Kline wrote.

The number of defendants found mentally incompetent to stand trial has been rising sharply in California and across the nation.

Michael T. Risher, who worked on the case for the ACLU, said many experts believe the rise reflects a lack of community treatment options with more and more untreated people ending up in the criminal justice system. Some also believe the numbers have risen because of growing homelessness.

About 4,000 people a year in California are placed in jails after being found mentally incompetent to stand trial, the vast majority of them because of severe mental illness. These defendants generally return to trial courts after five to seven months of treatment.


During the pandemic, the waiting list for admission to state hospitals soared to more than 1,600 people — a 500% increase since 2013, according to the ACLU.

Criminal defendants in California who have been deemed incompetent are committed to the state Department of State Hospitals or the state Department of Developmental Services until they are able to understand and participate in their court cases.

Risher acknowledged that state waiting lists for hospital beds have been long but argued that California could resolve the shortage by sending more defendants to community-based programs for treatment.

“We have a huge over-reliance on state hospital beds and not nearly enough use of community-based treatment options,” he said.

In a letter to state legislators this month, several civil rights groups said funding needed to be at least doubled for counties to house and treat mentally ill defendants.

The state can appeal the decision to the California Supreme Court.

State Atty. Gen. Rob Bonta’s office, whose lawyers argued the case, referred a reporter to the Department of State Hospitals for comment. “The state is in the process of reviewing the court’s decision and considering next steps,” the department said in an emailed comment.