MONTGOMERY, Ala. (AP) — Fernando Clark spent the last 10 months of his life in a jail cell, waiting for psychiatric treatment a court ordered he undergo after he’d been arrested for stealing cigarettes and some fruit from a gas station.
He died while waiting for the treatment that never arrived, found unresponsive in his jail cell.
Clark was just one of hundreds of people across Alabama awaiting a spot in the state’s increasingly limited facilities, despite a consent decree requiring the state to address delays in evaluating and providing care for people suffering from mental illness who are charged with crimes.
Seven years since the federal agreement, the problem is only worse. The waitlist for the state’s sole secure psychiatric facility is almost five times longer than when the decree was issued, according to court documents released in September.
Sometimes arrestees are waiting years for placement in a facility designed to treat their illness and ensure they are healthy to go to court, a problem faced by many states around the country.
In Alabama, that means people charged with less serious crimes, like Clark, “spend more time waiting for a bed than if they had just pled guilty,” said Bill Van Der Pol, a lawyer with the Alabama Disabilities Advocacy Program, which won the federal consent decree.
Delayed progress
In 2010, the Department of Mental Health had its budget cut by $40 million in the wake of the recession. At least 10 state-run psychiatric facilities have closed over the past three decades, leaving only three inpatient facilities with 504 total beds, and just one where men facing criminal charges can receive treatment to restore them to competency.
The lawsuit that led to the consent decree was filed in 2016, alleging delays at every point in the process that violated constitutional due process.
The 2018 consent decree gave the state two years to complete all mental health evaluations and reports within 60 days of a court order. A man deemed incompetent for trial should go to Taylor Hardin within 30 days after that.
However, the state was also required to expand the number of beds for more permanent care if someone cannot be rehabilitated. Taylor Hardin’s waitlist has grown to 273 men, according to an August court filing, up from approximately 60 men in 2017. The average wait is well over a year, and more than 30 people on the list have languished more than two years. The state is still in mediation with the plaintiffs.
A national issue
Nationally, the number of state hospital beds for adults with serious mental health issues reached a historic low in 2023 with 36,150 beds, more than half of them occupied by people committed to the hospital through the criminal legal system. That’s a 17% decline in beds from 2017, according to the nonprofit Treatment Advocacy Center.
“There really isn’t any state where this hasn’t become an increasingly visible problem — and it’s actually expanding in scope rapidly over the last decade,” said Lisa Daly, the executive director of the Treatment Advocacy Center.
In Nevada, for example, one county was ordered to pay $500 per day because defendants did not receive timely treatment. Officials estimated that the payout would be $3.6 million for fiscal years 2026 and 2027, based on the current caseload and wait times.
The worsening trend reflects an intractable paradox, as courts are better identifying mental illness as a factor in arrests, while the infrastructure has not adjusted to meet growing demand.
Noticeable improvements
Alabama has taken steps to address the bottleneck, with construction underway to add 80 beds to Taylor Hardin. However, there is a significant staffing shortage, and the added beds will only be usable if proper staffing is obtained.
The department has trained 94 people for competency restoration programs in jails to relieve the burden on Taylor Hardin. Alabama has also spent $175 million over five years to build six crisis centers with 180 beds across the state, providing more appropriate alternatives to incarceration for people suffering a mental health crisis.
Impossible to get out
Jennifer Tompkins, an Alabama criminal defense attorney, emphasized that it can take decades to get released from Taylor Hardin, creating a perception that mentally ill people are guilty simply for being mentally ill and poor.
Clark, who had a long history of petty crimes and severe mental health issues, found himself in a frustrating cycle as he awaited treatment. His tragic death prompts urgent questions about the treatment of mental illness within Alabama’s judicial and correctional systems.
