DECATUR — Chris Amero started worrying about his client’s mental fitness shortly after taking on the case in late August. 

His client, Ricardo Q. Holloway — known around the Amero law office as “Ricky” — was facing felony charges of aggravated domestic battery and strangulation, in addition to a domestic battery misdemeanor. 

It was far from the first time he’d been in trouble with the law. 

According to Macon County court records, Holloway, 34, of Decatur, has a criminal record that includes felony offenses of criminal trespassing, obstructing justice, manufacturing and distributing a look-alike substance, resisting or obstructing a peace officer, unlawful restraint, possession of a controlled substance, domestic battery and more. 

Holloway was charged with his latest offenses in March 2022. Amero requested a fitness hearing in October, and prosecutors did not object to the motion. On Dec. 16, a judge ruled Holloway was unfit to stand trial and should be committed to custody of the Illinois Department of Human Services.  

Amero notified the state agency immediately, as ordered by the court. But for Holloway, nothing changed. 

Holloway is just one of dozens of Central Illinois inmates who’ve been declared unfit to stand trial but are stuck in county jails for months as they await critical, court-ordered psychiatric care from the state. Lee Enterprises last month spoke to law enforcement officials across the region, with several reporting wait times over 100 days. 

IDHS did not provide a comment for the initial story, but provided answers to a list of questions after it was published. In it, an agency spokesperson said it was working to address challenges attributed to both increased demand for services and staffing shortages. 

“IDHS takes seriously its duty to expeditiously house individuals who have been remanded to its custody and its obligation to defendants to begin the restoration process quickly,” the spokesperson said.

Amero and his office are attempting to push their client off of the growing waiting list while dealing with what they say has been a severe lack of communication from IDHS. 

Sydney White, a receptionist at the Amero office, said she spends much of her time fielding calls from Holloway and his mother, calling mental health facilities to check on bed availability, and attempting to contact the state. Many of those attempts have been unsuccessful. 

Handling Holloway’s case has left White and Amero feeling like they’ve taken on the responsibilities of a social worker in addition to their normal job requirements. 

“The problem that we’ve been having right now is communication,” White said. “I will say, we’ve gotten a lot better communication because somebody new has stepped into the (caseworker) role there. So the person that we were contacting before, she wasn’t responding to emails, wasn’t calling anybody, wouldn’t talk to his family, wouldn’t talk to us. And we were just trying to move the process along a lot quicker than it’s been going. Like I said, he’s been in there for about seven months for no reason, just sitting.”

Holloway’s new IDHS caseworker was able to provide White with a vital piece of information: Per their most recent update, Holloway is No. 13 on a list of 34 individuals in the region awaiting a bed at McFarland Mental Health Center in Springfield.

Holloway has been waiting for a bed for nearly 170 days.  

During that time he’s been rejected by at least one behavioral health center, The Pavilion in Champaign, because of his inmate status. 

“He would have had to (have) been out of jail in order to go into that facility,” White said. “But because he’s an inmate, he couldn’t go there.”  

The state-operated facilities that accept inmates unfit to stand trial or declared not guilty by reason of insanity include Alton Mental Health Center, Chester Mental Health Center, Chicago-Read Mental Health Center, Choate Mental Health and Development Center, Elgin Mental Health Center, Madden Mental Health Center and McFarland Mental Health Center. However, the Pavilion is not one of the main behavioral health facilities to which IDHS admits patients from county jails.

But White and others in Amero’s office have reached out to as many other behavioral health facilities as possible in hopes of finding any location that could treat Holloway immediately. 

They also hope to meet a request from Holloway and his mother to find a treatment center where his children would be allowed to visit him. 

Most other treatment options are for profit and have stricter admission protocol, such as inmate status.  

IDHS notably rejects the use of the term “inmates” to describe individuals like Holloway, who per court orders have been remanded into IDHS custody and cannot leave the jails in which they’re being held. 

“Note: These are not inmates, but individuals either found unfit to stand trial, who IDHS/DMH restores so that they can continue in the criminal justice process,” IDHS said, as part of a response to questions from Lee Enterprises.

But Amero and his employees say Holloway’s case refutes that distinction. 

“They are inmates,” Amero said. “Because if Ricardo was out — see, I don’t want to get into this soapbox thing, but it just shows you the disparity between rich and poor. If he were able to post bond, he’d be in The Pavilion right now getting treatment.

“But because he can’t post bond, now he’s got to be drugged through the (expletive) mud. Because his family can’t afford to bond him out. So now he’s got to do this. Whereas, you know, if you get someone who just bonds out, it’s not even an issue.” 

In a statement issued to Lee Enterprises reporters, IDHS attributed long inmate wait times to staffing shortages and a post-pandemic mental health crisis. 

That statement came after publication of an initial examination of the issue by Lee Enterprises reporters last month.

“Two things are happening at once — the number of people experiencing mental illness and being involved in the criminal system has significantly increased … and the number of people available to fill open mental health sector jobs has decreased,” a department spokesperson wrote in an email. 

According to the department, Illinois has seen a more than 20% increase in forensic placements by the courts since the pandemic began. In October, IDHS Division of Mental Health received over 90 forensic referrals. This was a record number for just one month, the department said.  

“There is not a pool of unused, staffed, empty beds that could otherwise be filled,” the IDHS spokesperson wrote. 

But the department still attributed many of its issues to a “nationwide workforce crisis,” which IDHS officials hope to combat by investing in hiring efforts, hosting job fairs, enhancing marketing efforts and raising starting salaries for some mental health care jobs. 

IDHS confirmed it has a patient prioritization system that ranks inmates awaiting care based on a few key factors. 

“IDHS/the Division of Mental Health prioritizes admission by clinical need, so that people in the most urgent mental health crisis can get appropriate access to treatment,” the department said. “There are also criteria for expedited admission based upon presentation at the jail.” 

IDHS did not elaborate on criteria for how it defines the most urgent crises.

Aside from the most severe and demanding cases, inmates are admitted to proper care facilities in order of date on their respective court orders.  

Holloway is not the first of Amero’s clients to experience months-long wait times for psychiatric care. 

Amero also represents Matthew L. Keith, 38, of Decatur, who faces a felony charge of domestic battery and violating an order of protection. He has been in a state treatment facility for nearly a year. 

Keith waited roughly three or four months last year before being transferred, but White said that process was still smoother than Holloway’s. 

Nobody knows exactly how long Keith will need to stay in treatment before a psychiatrist deems him fit to stand trial, or how long Holloway will have to wait to finally be placed in a treatment center. 

In the meantime, the justice process is on pause. 

“The state will have to make a determination as to whether or not to proceed with the charges,” Amero said. “Just because Ricky, (with) these domestic violence cases, just because he’s unfit doesn’t mean the case just goes away. He’ll go get his treatment. And then if the state wants to proceed with it, when he’s done, they’ll proceed with it. And then they can still theoretically send him to prison.”

Years-long delays and drawn-out trials also mean higher court costs and an undue burden on taxpayers, Macon County Sheriff Jim Root said last month. 

“We’re limited on our mental health resources, and it is a burden on the local taxpayer and is counterproductive to the people that need these services outside of our facility,” Root previously told Lee Enterprises.  

The state says it’s taking action to decrease wait times and speed up the justice process. 

“Despite challenges due to referral volume and staffing, IDHS has taken many steps to increase bed capacity and availability and to address the length of time that defendants are waiting in the county jails for admission,” the agency spokesperson said.  

Cited steps include repurposing existing bed space; entering a hospital partnership with University of Chicago Ingalls Memorial Hospital to create dozens more medium and minimum secure beds; increasing the number of outpatient restoration services across the state; making improvements at a currently unused building at Alton Mental Health Center also to create more beds; and working with public health partners to admit some eligible individuals to community care, making room for new forensic admissions.  

IDHS said it has added more than 90 beds since July 2022 between the state mental health centers in Springfield, Elgin, Chicago and Alton. 

Under the Mental Health Inpatient Facility Access Act signed into law last year, DHS’ Division of Mental Health was required to develop a strategic plan that would propose ways to improve access to inpatient psychiatric beds in state-operated mental health facilities.

The report should include the development of benchmarks to ensure that individuals unfit to stand trial or not guilty by reason of insanity are admitted to a state facility within the 60-day window set forth by the Code of Criminal Procedure of 1963.

Although the strategic plan was supposed to be finalized and made publicly available by May 27, DHS officials have indicated that the report may not be accessible for another few weeks.