Missouri Department of Mental Health left man found incompetent to stand trial in county jail for years awaiting treatment bed

On August 24, 2026, The Marshall Project published an investigation, republished by the Missouri Independent two days later, revealing that the Missouri Department of Mental Health left Carl Henry Louis -- a man found incompetent to stand trial -- confined in the Clay County jail in Liberty, Missouri for roughly two and a half years while he waited for a state psychiatric hospital bed to begin court-ordered competency-restoration treatment.

Louis was arrested in Kansas City in mid-2021 on robbery and armed-criminal-action charges. A state evaluation in August 2022 found him competent to stand trial, but a second evaluation -- ordered by his public defender and completed roughly ten months later -- found him incompetent. The Department of Mental Health sent him back to the Clay County jail to wait for a treatment bed. In August 2023, a judge suspended Louis's criminal case and ordered him committed for treatment; without an available bed, the jail kept holding him. The department did not take custody of Louis until January 2024. Jail incident reports, video and internal emails reviewed by The Marshall Project documented Louis's mental state deteriorating during the wait, including repeated forcible cell extractions, use of a restraint chair and chemical agents, and Louis smearing feces on his cell walls; jail leadership repeatedly told the department it needed help and got none.

Louis's case illustrates a statewide pattern: Missouri's own figures show the number of people waiting for court-ordered mental-health evaluation or restoration statewide grew from 27 in 2016 to 549 by July 2026, and at least two people have died in Missouri jails while on that waitlist since May 2025. A federal class-action lawsuit filed in November 2025 by the ACLU of Missouri, the MacArthur Justice Center and ArchCity Defenders alleges the department routinely misses the state's 60-day statutory deadline for evaluations and the "reasonable time" standard for taking custody of people found incompetent to stand trial.