It’s not often that Menard County Jail has a detainee who has been found unfit for trial.
The jail, just north of Springfield, is small. With a census that can hover around 10 people or less, and just a few correctional staff on a given shift, mental health care is limited. In 2024, the man who was declared unfit refused to shower and spread feces throughout his cell.
“He needed the help,” said Sheriff Mark Oller. “We didn’t know what to do.”
Oller drove the man to Kankakee County where he became one of the first defendants to participate in Kankakee’s pilot program to house unfit detainees from other counties who are awaiting a bed at a state psychiatric hospital.
The program aims to provide relief to smaller jails, offer detainees from smaller facilities better access to treatment and medication, and, ideally, combat wait times, according to sheriffs and Illinois Department of Human Services officials.
Illinois, in recent years, has seen a steep rise in the number of times people are being found unfit for trial, resulting in long wait times due to the limited number of state hospital beds. In 2022, tensions reached a high between jails and IDHS when a handful of sheriffs sued the state for not transferring defendants quickly enough.
The legislature then changed the law, giving the department 60 days to transfer a person and the ability to extend that time.
Data from the progress reports show the Kankakee program has had some initial success – more than a dozen people have been found fit while at the jail, and others have received mental health care while waiting to go to a state hospital.
“It’s gone better than I think anybody ever imagined,” said Kankakee County Sheriff Michael Downey. McHenry County Jail launched a similar program this summer.
Kankakee County Jail has about 20 beds dedicated to the program. IDHS funds the pilot programs at both jails.
Downey said the jail meets with IDHS every week to discuss current detainees and review those who could be transferred to Kankakee. The Iroquois Mental Health Center is contracted to provide mental health care, which Downey said has benefited the entire jail.
Now, more Kankakee detainees have better access to mental health professionals who can prescribe medication, the sheriff said. In the past, he said, few medical professionals who worked at the jail were able to do this.
Fitness restoration is not seen as mental health treatment, since it’s more narrow in scope and focuses on an individual understanding the legal system and helping their lawyer craft a defense.
Some defendants in the pilot program have been able to regain fitness as a result of the jail’s mental health access.
As of June 30, 2025, 185 people have been recommended for the pilot program with 90 being transferred and admitted. About 20% of those people have regained fitness in jail, according to performance reports, which Illinois Answers obtained through a Freedom of Information Act request.
Others have had access to psychiatrists, medications and weekly treatment, according to the data.
McHenry County Jail, which can house up to 12 people in its pilot program, has had 14 participants so far, nine of which came from outside counties, said sheriff Robb Tadelman. Two have been restored to fitness and another six have been transferred to a state hospital.
An IDHS spokeswoman said the department’s goal for the program is “to provide defendants with mental health services while they are waiting for an IDHS inpatient restoration bed.”
Yet to the sheriffs, restoring fitness has emerged as a priority.
“For the individuals that are brought in,” Tadelman said, “I think if we can restore them in house and get them back to stand trial, and, you know, be prepared for that next step of their life, I think that’s the ultimate success.”
According to the National Conference of State Legislatures, 14 states have different variations of jail based restoration programs. Arizona and New Jersey authorize these programs to occur in jails with few regulations on how they should operate.
Texas has more detailed requirements, including that the program employs only licensed mental health professionals, including at least one psychiatrist. Decade-old research of similar programs conducted in Colorado and Arizona show that a majority of the people admitted were generally successful at restoring people to fitness in jail.
But some have expressed hesitation.
Susan McMahon, a professor at University of California Irvine’s School of Law, previously worked in Arizona and has written about restoration. She said many in Arizona find jail-based restoration to be “successful” since it has kept costs and delays down, while being efficient.
Yet McMahon said many psychiatrists and psychologists believe jail is “not a therapeutic environment.”
“If we all think it’s a valid thing for us to be spending a lot of time and resources getting people competent so that the criminal system can work, then I think jail-based restoration is an efficient way to do that,” she said.
“But if instead we want to be thinking more long term and do we want to help these people become well, then jail based restoration is not an effective way to do that at all.”
Amanda Antholt, managing attorney at Equip for Equality – an Illinois watchdog group that monitors for abuse and neglect of people with disabilities – said she would prefer to see the pilot program be a “temporary bandaid and not a long term solution.”
“It’s not a substitute for the larger care needs that can be addressed by a mental health treatment provider, whether community based, private or public,” she said.
“It’s still a jail.”
Tadelman, the McHenry County sheriff, said he isn’t “blind” to concerns some in the mental health field have about jail-based restoration. But he said he would rather have these individuals restored in a jail than wait to be transferred to a facility.
“We’re talking about human beings here, and some of them are in a really bad spot,” he said. “The more time it takes to get them to a facility, that’s more time away from … their lives.”
In Kankakee County, Downey, the sheriff, said the jail could take in as many as 50 out-of-county detainees. But he also knows the jail has its limits.
“The unfortunate part about jail restoration is, we don’t know the follow up once they’re released from jail,” Downey said. “We don’t know what’s going on.
“In a perfect world, those who are in need of mental health treatment would be able to get that at a place adequate for what they need, as opposed to having to come to jail to get it.”