Tulsa County Sheriff Vic Regalado sees it every day. Dozens of people sit inside his jail not because their cases are moving forward, but because they can’t. They’ve been found incompetent to stand trial. Courts have ordered them into mental health treatment. But instead of being transf erred to care, they remain in custody, waiting. “On average, we’ll have anywhere from 45 to 60 people in our jail awaiting that treatment,” Regalado said. “These are people that are in limbo.” They are not well enough to face trial. And they are not receiving the level of treatment they need to get there. “They’re not at a point where they can be a part of their defense,” he said. “And they’re also not getting potentially the mental health treatment that they need outside of the jail.” Across Oklahoma, that limbo has become the norm even after a federal court ordered the state to fix it. A System Under Court Order In March 2025, Oklahoma entered into a federal consent decree aimed at ending long delays in its competency restoration system, the process used to treat defendants with serious mental illness so their criminal cases can proceed. The plaintiff in the lawsuit styled Briggs v. Slavonic argued that defendants were being held in county jails for months without treatment after courts determined they were incompetent to stand trial, a violation of their constitutional rights. Under the agreement, the Oklahoma Department of Mental Health and Substance Abuse Services was required to reduce wait times, expand treatment capacity and improve coordination across the system. But a year later, federal court monitors and a U.S. district judge said the state is still falling short. Court-appointed consultants reported that hundreds of defendants remained in county jails awaiting treatment months after the decree took effect, many experiencing severe psychiatric symptoms, including psychosis and suicidal thoughts.  In a February 2026 ruling, U.S. District Judge Gregory Frizzell agreed, finding that the state had not met key requirements and had fallen short in implementing the reforms. The judge affirmed the consultants’ finding that the department had not used best efforts, the standard required under the consent decree, to implement key reforms, including developing an in-jail competency restoration program. The Numbers, and What They Miss Even measuring the scope of the problem has been a challenge. Consultants overseeing the case found conflicting data across agencies, with estimates of defendants waiting for treatment ranging from about 130 to as many as 250 at a given time.  After reviewing the available information, they estimated approximately 180 people were awaiting restoration services in May 2025. Wait times were equally troubling. The average delay reached approximately 215 days — more than seven months — meaning many defendants spent extended periods in jail after courts had already determined they needed psychiatric treatment.  More recent figures suggest some improvement, with average waits closer to three months, or about 95 days. But that still falls far short of the roughly three-week target envisioned under the consent decree. And even those numbers come with a warning. Consultants found inconsistent reporting across agencies, incomplete datasets and gaps in tracking that made it difficult to determine exactly how many people were waiting — or how long they had been there.  The result is a system that is not only struggling to meet court-ordered benchmarks, but one that may not be fully able to measure its own performance. How the System is Supposed to Work, and Where it Slows Officials familiar with Oklahoma’s system said the competency process follows a defined sequence, but delays can emerge at nearly every step. First, a judge raises the question of competency and orders an evaluation. That evaluation must be scheduled and completed. That process that can take weeks depending on provider availability. If the defendant is found incompetent, the court orders restoration treatment, typically through the Oklahoma Department of Mental Health and Substance Abuse Services. At that point, the person is placed on a waiting list for a treatment bed, most often at the Oklahoma Forensic Center in Vinita. That is where the system slows most dramatically. Because the number of beds is limited, defendants often remain in county jails until space becomes available. They must then be taken to the facility, where treatment can begin. Each stage — evaluation, placement, transport — introduces potential delay. But the wait for an available bed has become the most significant bottleneck, often stretching for months.  The process also depends on coordination among courts, jails, transportation providers and mental health officials. Breakdowns in communication or scheduling can add additional delays.  What is designed as a short-term clinical intervention can instead become a prolonged holding pattern that compounds at each step. Why the Delays Matter The delays are not just a logistical problem; they raise constitutional concerns. Attorney Paul DeMuro, who represents plaintiffs in the class-action lawsuit, said the issue centers on due process. Once a defendant is found incompetent to stand trial, the state has an obligation to provide treatment aimed at restoring competency. Holding that person in jail for extended periods without care undermines that obligation. “A jail is not a therapeutic environment,” DeMuro said. Sheriff Vic Regalado Defendants who wait months for treatment often deteriorate, he said, making restoration more difficult and prolonging the process even further. In some cases, individuals are effectively detained without meaningful progress toward resolving their cases. The longer the delay, the more the system risks turning temporary incompetency into long-term confinement. The Human Cost For defendants, the consequences can be severe. Debbie Maddox, executive director of the Oklahoma Indigent Defense System, said people charged with relatively minor offenses can end up waiting longer for competency evaluation and treatment than they could legally serve if convicted. “The most they can serve is one year in the county jail,” Maddox said. “Most of the competency evaluations involving misdemeanor charges take longer than a year.” In some cases, she said, defendants wait months just for an evaluation, followed by an additional nine to 12 months for restoration services. “By the time you put all of this delay on someone, they could do two to three times the maximum sentence requirement that they’ve been charged with,” Maddox said. Many of those defendants suffer from chronic mental illness and are charged with low-level offenses tied to untreated conditions. “These are red flags that signal to us early in the process that we need to be diverting these people,” she said. “We don’t need them in our county jails.” Inside those jails, conditions can worsen. “They’re scared to death, and they can’t make sense of what’s going on,” Maddox said. Even when warning signs are clear, diversion does not always happen early. In many cases, defendants enter the system through local law enforcement, where officers must make quick decisions about arrest, release or referral to services, often without access to immediate mental health resources. Once charges are filed, the legal process can move faster than the mental health evaluation system, leaving courts to identify competency issues only after a defendant is already in custody. By that point, options narrow. Without sufficient community-based treatment capacity or pretrial diversion programs, jails become the default holding place even for people whose primary need is medical, not criminal. Maddox said that dynamic reflects a broader gap in the system. “We’re trying to fix it on the back end, instead of catching it on the front end,” she said. Jails as the Default Mental Health System For sheriffs and jail administrators, the backlog has effectively turned detention facilities into front-line mental health providers. In Tulsa County, Regalado said approximately 30% of the jail population is prescribed psychotropic medication, a sign of how deeply mental illness is embedded in the system. The county opened a dedicated mental health unit in 2017, with more than 100 beds designed to provide structured care. But Regalado said it’s a stopgap, not a solution. “Mental health treatment and addiction treatment should not be occurring in a jail,” he said. “That’s kind of where the state of Oklahoma has dropped the ball.” The reality inside the jail reflects that mismatch. A dorm-style cell at the David L. Moss Criminal Justice Center in Tulsa. (Rip Stell/Oklahoma Watch) Defendants awaiting restoration may spend weeks or months in a setting designed for custody, not treatment, sometimes cycling through isolation, crisis intervention or suicide watch as their conditions fluctuate. Staff members are forced to adapt. Deputies and detention officers are increasingly expected to identify and manage mental illness, often without the training or resources available in clinical settings. “A deputy has to become not only adept at enforcing the law, they also now have to be experts in identifying and dealing with people with mental illness,” Regalado said. The longer the wait, the more the jail becomes the system itself, not a temporary holding place, but the default environment for people who need psychiatric care. The problem is not limited to Tulsa. In Cleveland County, jail officials say they regularly house defendants awaiting competency restoration services, sometimes for weeks or longer. Those delays create operational challenges related to supervision, housing and coordination with medical providers, according to the sheriff’s office.  Jeremy Walker, communications director for the Cleveland County Sheriff’s Office, said county jails are not designed to function as long-term mental health facilities. “At any given time, the detention center may have several individuals in this status,” Walker said. “When individuals remain in custody while awaiting restoration placement, it can create operational challenges related to supervision, housing considerations, and coordination with medical and mental-health providers.” Ripple Effects Across the Justice System The delays affect more than defendants and jail staff. Prosecutors said stalled competency cases slow the entire criminal justice system. “It’s at least a few months,” Chuck Sullivan, district attorney for Pittsburg and Haskell counties, said of typical wait times. “And it’s just hard to call delayed justice justice sometimes.” Tulsa County District Attorney Steve Kunzweiler echoed those concerns in a written statement. “The delays in getting these individuals the help they need to deal with their criminal cases impacts our ability to secure justice for victims of crimes in a timely manner,” he said. When defendants cannot proceed, cases remain frozen, leaving victims, families and attorneys waiting indefinitely for resolution. A System Trying to Catch Up State lawmakers said they are investing new money to address the problem. Senate Appropriations Chairman Chuck Hall said the Legislature plans to allocate $17 million in the upcoming fiscal year to help the mental health department meet consent decree requirements and avoid court-imposed fines.  That follows a $9.4 million appropriation in the current year. Lawmakers expect the funding to support expanded treatment capacity, including additional inpatient beds and infrastructure projects such as the Oklahoma City Behavioral Health Campus and expansion of the forensic center in Vinita. “Anything less than that would fall short of the Legislature’s expectations,” Hall said. What Happens if the State Falls Further Behind The consent decree is not just a set of goals. It is a court order. If the state fails to meet its requirements, it could face additional enforcement actions, including potential sanctions or fines designed to compel compliance. Court-appointed monitors have already raised concerns about missed benchmarks and delayed implementation timelines, and the February ruling signaled that patience may be limited. In similar cases in other states, prolonged noncompliance has led to escalating judicial oversight, stricter reporting requirements and, in some instances, financial penalties tied to each day a defendant waits beyond court-ordered limits. For Oklahoma, the risk is not only continued delays, but a system increasingly shaped by court intervention rather than policy design. Progress — and Persistent Problems There are signs of improvement. Consultants noted increased effort and some progress following leadership changes within the mental health department. But they also concluded that, more than six months into the consent decree, the state had failed to meet many required benchmarks and timelines. Still Waiting In Tulsa County, Regalado sees the consequences of those delays in human terms. People cycle through the jail with untreated mental illness. Cases stall. Staff stretch to meet demands they were never designed to handle. Until the system changes, he said, jails will continue to fill the gap. “It’s backwards,” Regalado said. “But it’s where we are.” And for the people waiting inside — unable to stand trial, unable to access treatment — that reality has no clear end date. Stephen Martin is an Oklahoma City-based journalist and contributor to Oklahoma Watch. Contact him at [email protected]. The post Still Waiting: Oklahoma’s Mental Health System Leaves Defendants Waiting in Jail Despite Court Order to Fix Delays appeared first on Oklahoma Watch. ...read more read less