Champaign County Sheriff’s Capt. Karee Voges, superintendent of the Champaign County satellite jail, is shown in front of the roster of people in custody. The jail can hold a total of 186, but 140 to 150 were housed out of county in the past year due to capacity restraints exacerbated by mentally ill inmates who wait months to be transferred to a state hospital.
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CHAMPAIGN — Later this month, a psychiatrist will issue a report to the Champaign County courts on whether the man charged with fatally shooting the manager of a downtown bar earlier this year was insane when he allegedly pulled the trigger.
In ruling that Fidele G. Tshimanga, 25, of Urbana must await his pending trial in jail in the Feb. 8 death of Brandon Hardway, 45, a Champaign County judge said initial evidence showed Tshimanga was suffering from delusions in the days leading up to the shooting.
Depending on the psychiatrist’s evaluation, Tshimanga may be found “mentally unfit,” a legal condition that indicates someone is unable to understand what they are doing or assist their attorney in their defense.
While Chief Public Defender Elisabeth Pollock said most unfit defendants are not charged with serious violent crimes, she, along with Champaign County sheriff’s Capt. Karee Voges, superintendent of the Champaign County jail, and Dr. Lawrence Jeckel, the county’s lead forensic psychiatrist, all said they’ve witnessed the number of severely mentally ill people entering the criminal-justice system increase in recent years.
The professionals attributed this rise to a lack of accessible treatment. So as not to deprive them of their rights, those who are mentally ill and charged with crimes must first be restored to “fitness” by the Illinois Department of Human Services before their cases can resume.
But an apparent lack of resources in state hospitals means mentally unfit individuals are waiting months in jail to be transferred out to begin treatment, delays that result in safety risks, cell shortages and potentially more time spent in custody than these defendants would be ordered to serve from a sentence — an issue that those interviewed said is not unique to Champaign County or even Illinois.
Psychiatrist Dr. Lawrence Jeckel, one of two who conduct all the mental-fitness evaluations for the Champaign County courts, said the number has increased since he first started practicing in 1983, attributing the hike to the emptying of state mental hospitals at the end of the 20th century.
The fitness process
Under state law, all defendants are presumed to be mentally fit when they are charged with a crime. But a prosecutor, defense attorney or judge may request that a defendant be evaluated by a forensic psychiatrist after they become aware of concerning behavior.
These front-end evaluations are conducted by county clinicians, not IDHS personnel. Just two people — Jeckel and Dr. Joshua Camins — currently conduct all mental-fitness evaluations in Champaign County.
Camins said fitness evaluations serve three main purposes: To protect defendants from incriminating themselves, to keep court proceedings from being disrupted or mocked, and to ensure that a guilty conviction is not later overturned in the event a mentally ill defendant pleaded guilty or went to trial when they should not have.
“If they are very mentally ill at the time, they may make decisions in their current state that are going to make perfect sense to them, but really are not in their best interest,” Camins said. “That could be something like talking to a prosecutor, or a defense strategy going against what their attorney is recommending for no good reason.”
“The appellate court has really been, very much, making sure the lower courts take care of mental illness,” Jeckel said. “They do not want people who are psychotic going to trial. You are depriving them of their rights.”
It is usually “pretty evident” if a defendant cannot process what is going on around them, Jeckel said, but he’ll interview them in person and review information about their psychiatric history and behavior reported by their family, attorney and jail clinician.
Notably, fitness differs from insanity, which is determined retroactively if a defendant shows they could not substantially appreciate the criminality of their conduct during the time they committed an offense. In Champaign County, the two evaluations are often ordered together.
Jeckel conducted 68 fitness evaluations for Champaign County and surrounding counties in 2022. Jeckel and Camins together conducted a total of 95 in 2023.
Jeckel said the national average is 25 percent of evaluated defendants are deemed mentally unfit. He estimated that between 40 to 50 percent of his evaluations result in an unfit opinion, as Champaign County “seems to have an inordinate number of untreated psychiatrically ill individuals.”
Once a judge accepts Jeckel’s or Camin’s opinion that a defendant is mentally unfit, the case against that person is effectively put on hold and a timer begins. The defendant is supposed to then be evaluated by IDHS personnel within 30 days to determine what kind of treatment they need.
If the state decides that the defendant requires inpatient treatment, that individual is supposed to be transported to a state hospital within 60 days and that facility has one year to return them to fitness and send them back to court.
Hospital referrals on rise
Voges said the Champaign County satellite jail houses, on average, eight to 10 inmates at a given time who are waiting to be picked up by IDHS. These inmates can easily wait between four to five months in a cell before they are transported, she said.
Pollock added that it varies case by case, but she sees clients wait anywhere from two to six months in jail before they are finally moved.
IDHS spokeswoman Rachel Otwell said the department “has no control over how many referrals” for mental-health treatment it receives, as intake levels depend on outside decision made by local law-enforcement agencies bringing charges, state’s attorney’s offices moving forward with prosecution, and psychiatrists and courts issuing evaluations.
IDHS has just five state hospitals. They’re located in Alton, Chester, Choate, Elgin and McFarland. Together, they have a total of 1,365 beds, but only 798 are for forensic purposes, the rest are designated for civil cases.
That means every single one of Illinois’ 102 counties must compete for those 798 beds, each bed only becoming available for someone found newly unfit or insane after another patient has been discharged.
“Bed availability is a combination of the increase in the number of referrals we are experiencing statewide and the time it takes for some courts to order treated consumers who have been returned to fitness back to jail custody to proceed in the criminal-justice process,” Otwell said.
“Those numbers continue to increase, from 40 to 50 referrals per month before the pandemic to over 100 each month now.”
Besides its booking center, the Champaign County satellite jail in Urbana lacks any dedicated single-occupancy cells. The downtown Urbana jail had a number of individual units, but it was shuttered in 2022 due to dilapidated conditions.
‘Jail is not therapeutic’
Champaign County’s satellite jail has three contracted mental-health clinicians dedicated to suicide prevention and crisis intervention, but mentally ill inmates need 24-hour supervision, Voges said.
That’s because these defendants — who may be self-harming, easily manipulated and unable to speak — often pose a risk to themselves and others. In extreme cases, Voges said inmates have been found playing with their own feces. Another individual bit themselves and spit blood on a corrections officer.
“There is not a jail that has been built to manage those that are severely mentally ill,” Voges said. “They’re meant to be in a therapeutic environment, and a jail is not therapeutic. We understand that, but we also understand that the biggest concern that we have is to keep them safe.”
Voges said the jail will isolate acutely mentally ill inmates in cell units separate from the rest of the general population for their own safety, the safety of the general jail population and that of corrections officers.
However, besides the cells located in its central booking, Voges said the county jail lacks any dedicated single-occupancy cells. The jail in downtown Urbana, which contained a number of individual units, shuttered in 2022 due to dilapidated conditions.
That means the satellite facility must make individual cells out of existing rooms designed for two or more inmates, effectively cutting in half how many the jail can hold in certain wings. The building’s capacity is 186, but 40 of its double-occupancy cells, on average, are used to house individuals, Voges said.
Giving up total capacity in order to isolate inmates is not a practice unique to housing the severely mentally ill, as the jail also often separates inmates who have been charged with certain crimes, like murder or the sexual assault of a minor, from its general population.
But the length of time mentally unfit inmates spend waiting to be transported out by IDHS exacerbates the facility’s existing capacity issue and contributes to why approximately 140 to 150 inmates from Champaign County have been housed in out-of-county jails over the past year.
Some 88 Champaign County inmates are currently housed in Kankakee’s Jerome Combs Detention Center alone. That creates a challenge to public defenders and defense attorneys who must make a two-plus-hour round trip to speak with their clients in person.
Further, the distance creates barriers to local family members seeking to visit their loved ones, and requires Champaign County sheriff’s deputies to shuttle those housed out of county to and from their Urbana court hearings multiple times a week.
The delays the mentally unfit experience in jail ultimately means that those who are charged with misdemeanors, first-time offenses or lower felonies often end up serving more time in detention than they would otherwise be remanded to serve from a prison or probation sentence, Pollock said.
“Imagine being in a schizophrenic mental break and you’re in a room alone for months,” Pollock said. “It’s like cruel and unusual; it’s really unfortunate.”
Treatment turnarounds
Once an unfit defendant is brought to a state hospital, IDHS is supposed to provide status updates regarding treatment every 90 days, and those updates are supposed to be delivered to the presiding judge and attorneys seven days prior to periodically scheduled court hearings. That way, a patient’s defense attorney can take necessary actions.
But Sixth Judicial Circuit Chief Judge Randy Rosenbaum said he typically receives reports from IDHS seven to 10 days after a defendant’s status hearing has already taken place. Pollock said she understands the delay is likely caused by staffing shortages at the department.
Pollock said in her experience, IDHS often falls short of even completely restoring defendants to full fitness. She emphasized that there are two main aspects to the legal definition of fitness: whether a defendant can understand the “nature and purpose of the proceedings” and whether a defendant can assist their defense.
IDHS tends to put more weight on the first condition and neglect the latter, Pollock said. As a result, the public defender said she sometimes gets clients returned to her who are still suffering from the same delusions they had when they entered a state hospital.
“If a person knows what a judge is and knows what a jury is, but says ‘I didn’t commit a crime because I’m a robot and I’m here from Mars,’ then they really can’t help me with their case,” Pollock said.
One of the reasons fitness might not be fully restored is because it’s rare for IDHS to force medication — a time-consuming and expensive process that Pollock said is typically only reserved for defendants who pose a risk of danger to themselves or others.
If a person is discharged from a hospital and a judge agrees the individual is still not fit to participate in a trial or contribute to their defense, that person is sent back to the state hospital and the one-year timer begins all over again.
Doing ‘best they can’
This summer, Champaign County is scheduled to complete construction on an addition to the satellite jail that will create a 48-bed general-population housing pod and a 26-bed pod for “special management” cases.
Voges said the new building still isn’t big enough, but the individual cell units in the special pod will help the jail more efficiently house inmates who must be isolated, and allow inmates in Kankakee to return to Champaign County.
Pollock said one of her goals this year is to help reinstate a mental-health court in Champaign County — an alternative-justice model similar to drug court in which defendants are connected with a team of legal and social-service specialists instead of being given a prison sentence.
Champaign County’s previous existing mental-health court dissolved about 10 years ago. A revival would require a judge to volunteer to add mental-health cases to their call, as well as a new prosecutor, public defender and probation officer, Pollock said.
A mental-health court would also mean having a treating psychiatrist and a dedicated partnership with local inpatient and outpatient service providers in order to provide defendants with intensive regiments.
Champaign County State’s Attorney Julia Rietz said it’s always better to have more tools at the court’s disposal, but defendants would only be eligible to participate in a mental-health court after they’ve been restored to fitness.
Further, she said there’s no benefit to creating the program without local providers stepping up to participate in it first. Delays in inmates getting transferred to state hospitals is not a new problem in Champaign County or unique to the state, she added.
“From my perspective, until there is a service provider saying, ‘This is what I can and will do as a part of a mental-health court team,’ I don’t believe we are going anywhere,” Rietz said.
Notably, Sangamon County’s sheriff filed a lawsuit against IDHS in 2022 over the agency’s delays in notifying the county of which state hospital its mentally unfit inmates were going to be transferred to. A judge ruled that the department violated the law, but the state legislature took action in 2023, passing a bill that allows IDHS to renew its hold on inmates, keeping them in jail, every 30 days.
In other states, what Illinois refers to as fitness is known as “competency,” Camins said.
Previously tasked with evaluating mental incompetency at a hospital in Wisconsin, he said he saw people wait six to eight months before they were finally evaluated. This is a sign of what Camins said experts in the field call a “competency crisis,” as rates of defendants found mentally incompetent increase across the country.
Voges added that housing mentally unfit inmates in jail has been a challenge her entire career, but she’s noticed an increase of unfit individuals entering the facility in the past 10 to 12 years.
The captain attributed the rise to the fact that few people in crisis have timely access to the treatment, so they end up using drugs to self medicate or committing offenses that introduce them to the criminal justice system.
“I don’t necessarily know if the average citizen realizes that 25-plus years ago, they closed a whole bunch of mental-health hospitals,” Voges said. “I’m not sure what they thought would happen, when the individuals on the streets and the family members and families that need to get help can’t get the help.”
Jeckel said he’s also seen the number of forensic evaluations he conducts has increase since he first started practicing psychiatry in 1983, and attributed the hike to the emptying of state mental hospitals at the tail end of the 20th century.
While that means more people have become criminal defendants instead of civil patients, and are therefore stuck waiting in jail for IDHS treatment, Jeckel said the prevalence of fitness evaluations in Champaign County is testament to the fact attorneys here are more aware of and sensitive to how mental illness should be handled in the courts.
“I believe there’s a real difference when you go to other counties, where they don’t really care as much about the mentally ill. And that’s not the case here,” Jeckel said. “It humanizes people rather than just seeing them as thugs and just garbage, to see people as human and struggling with mental illness.”
Otwell said IDHS has added more than 81 new beds to its forensic capacity since July 2022 through a combination of increased staffing and converting civil beds to forensic.
As it stands, the creation of more individual jail cells or a mental-health court may improve Champaign County’s ability to house and rehabilitate the unfit, but persisting delays in transporting inmates out indicates that the state needs to expand its capacity even further if it’s going to reduce the amount of time those individuals spend in detention — each one waiting to receive treatment, resolve their case and resume their lives.
“I think that everybody locally does the best they can,” Rosenbaum said. “The lawyers raise the issues as quickly as they can. The local doctors are doing the evaluations as quickly as they can. And I think our jail is doing what they can to get people sent to DHS as quickly as they can.”
“But I think unless the law changes or there are more resources for DHS, I don’t know when the current problems may disappear.”
