Texas is asking a federal appeals court to pause an order requiring the state to admit mentally incompetent jail detainees to psychiatric hospitals within 21 days, a mandate a district judge imposed after finding the current wait times unconstitutional.
State attorneys have asked the Fifth U.S. Circuit Court of Appeals to postpone the process of setting compliance benchmarks, according to court records reported by The Texas Tribune. Their argument is that the 21-day requirement would force the Health and Human Services Commission to begin what they describe as irreversible work rebuilding part of its system on a court-set schedule, and to spend unrecoverable funds on a remedy the appeals court may ultimately find the Constitution never required.
If the stay is granted, the injunction is suspended during the appeal. If it is not, the deadline structure stands, and people continue moving toward hospital beds on the court's timeline rather than the state's.
The Numbers Behind the Ruling
As of June, about 1,626 people were on the state hospital waitlist, according to Thomas Vazquez, a spokesperson for the Health and Human Services Commission. Of those, 447 were waiting for a bed in a maximum-security unit, with an average wait of seven months. Another 1,179 were waiting for a lesser security bed, with an average wait of more than five months.
Earlier figures were worse. As of August 2025, the average wait for transfer to a maximum security unit was 202 days after a person was deemed incompetent to stand trial. At the ten-year peak in December 2022, the wait for a maximum-security bed reached two years.
U.S. District Judge David Ezra issued the injunction in July in a class action filed by Disability Rights Texas in 2016 on behalf of people charged with a state crime who spent more than 21 days in jail after being found incompetent. He gave the commission four years to reach compliance with the 21-day standard, ordered the agency to identify compliance benchmarks within 45 days, and directed the parties to submit a joint proposed schedule for benchmarks, monitoring, and reporting within 60 days, KXAN reported.
"Wait times beyond twenty-one days are not constitutionally permissible in this case," Ezra wrote, reasoning that longer waits destroy the reasonable relation between the nature and duration of confinement and its purpose, as Houston Public Media reported.
The System the Case Is About
Competency restoration is a specific legal process, not general mental health treatment. When a judge finds a criminal defendant incompetent to stand trial because of mental illness, that person cannot be prosecuted until treatment restores their ability to understand the proceedings and assist in their own defense.
Texas law requires the state to provide that care. The bottleneck is capacity: there are not enough state hospital beds for the volume of court orders, so people wait in county jails on a first-come, first-served list.
The state has tried to shorten it. The commission has used funding from the Legislature, jail-based competency programs, and diversion initiatives, but Ezra found those efforts had not reduced the number of detainees waiting and noted that commission leadership had told lawmakers the state still would not have enough beds by the end of next year. A Texas court imposed a 21-day deadline on the agency once before, in 2012; that order was paused soon after, though Ezra wrote that the agency was able to comply at the time.
Jail is not a treatment setting. Melissa Shearer, mental health division director at the Travis County Public Defender's Office, has described the Travis County Jail as having one full-time psychiatrist for a population in which an estimated 40 to 50 percent of people need psychiatric help. An attorney for the plaintiffs told the Tribune that jails are, to say the least, not appropriate places for people with mental illness.
The Consequences That Accumulate During a Wait
The harms documented in the litigation are concrete. The plaintiffs argued that extended jail time worsens symptoms, leads to medical complications, and in some cases, death, and that the delay damages detainees' criminal cases while keeping them in jail longer than they otherwise would be, particularly on misdemeanor charges.
Some people wait so long that they serve the maximum possible sentence for their charge in jail and are released without ever being tried or restored to competency. That outcome serves no one, including the public.
Families absorb much of this. A parent who calls 911 hoping to get an adult child into psychiatric care can find that the call routes into a criminal case and then into a months-long wait, with limited ability to influence either.
Counties absorb the cost. Dallas County sued the commission over the same backlog, and while that state court suit was dismissed, Ezra cited the county's arguments in finding that long waits do not preserve state resources but instead shift the financial and administrative burden to counties.
"This is a significant victory for the thousands of people with mental illness," Beth Mitchell, lead counsel for Disability Rights Texas, said of the ruling in a statement reported by KERA News.
The Paths Available Regardless of the Appeal
Advocates have pointed out that several remedies do not depend on the outcome in the Fifth Circuit. Those include expanding community diversion programs, bringing currently unused inpatient capacity online by addressing staffing and maintenance issues, increasing contracts with private psychiatric facilities, and using step-down programs so people who no longer need inpatient care can be discharged promptly, freeing up beds.
Families with a relative on the waitlist should stay in contact with the defense attorney handling the case, as counsel can raise issues of medication access and deterioration with the court. County jail medical staff can be asked directly about continuity of psychiatric medication, which is often where the immediate risk lies.
Anyone in crisis, or worried about someone in crisis, can reach the 988 Suicide and Crisis Lifeline by call or text. Local mental health authorities in Texas operate crisis lines and may be able to connect a person to services before a criminal charge becomes the entry point to care.
A ruling on the stay request will determine whether benchmark-setting proceeds this year or waits for the appeal, according to KSAT.
Key Questions Answered
What is Texas appealing? A federal injunction requiring the Health and Human Services Commission to admit jail detainees found incompetent to stand trial to state psychiatric facilities within 21 days of a court order. The state has asked the Fifth Circuit to postpone benchmark-setting while it appeals.
How long are people waiting now? As of June, about 1,626 people were on the waitlist. Average wait times were seven months for maximum-security unit beds and more than five months for other beds.
What is competency restoration? Treatment that restores a criminal defendant's ability to understand court proceedings and assist in their defense. Texas law requires the state to provide it, and prosecution cannot proceed without it.
Why does waiting in jail matter medically? Jails have limited psychiatric staffing and medication access. The litigation argued that extended waits worsen symptoms, cause medical complications, and in some cases lead to death.
What is the state's argument? Complying with the 21-day requirement would commit the agency to irreversible system changes and unrecoverable spending on a remedy the appeals court might find was never constitutionally required.
What can families do while a case is pending? Stay in contact with the defense attorney, who can raise issues of medication access and deterioration with the court, and ask jail medical staff directly about continuity of psychiatric medication.
Where can someone in crisis get help now? The 988 Suicide and Crisis Lifeline is available by call or text. Local mental health authorities in Texas also operate crisis lines.
