Pam Grillo points to a photo of her son, Kevin Mock, as a young child in a family album at her home in Greenwood, Ind., on Thursday, April 10. Kevin spent months in the Johnson County Jail awaiting a court-ordered competency evaluation. (Farrah Anderson / Side Effects Public Media)
Kevin Mock couldn’t even remember his own name in one of his first court appearances for charges of battery of an officer. He had to be strapped into a restraint chair just to make it through the hearing.
It didn’t take long for Johnson County Superior Court Judge Douglas Cummins to acknowledge what was obvious — the 43-year-old needed a “competency evaluation.” But that didn’t mean a quick resolution.
“He’s gonna stay in jail until I get the evaluations done. If I can get them done quicker, I’ll bring him back quicker, but it does take a while, unfortunately,” the judge said, according to a court transcript.
Competency evaluations are court-ordered assessments by mental health professionals to determine whether a defendant can understand the charges against them and assist in their defense.
If a defendant is found competent, the case proceeds. If not, they are ordered into competency restoration treatment — usually in a state psychiatric facility — until they meet the legal standard to stand trial. It’s a mental health treatment process not specifically aimed at recovery and typically involves educating the person about the legal system and the charges against them.
Despite the judge ordering the evaluations on Oct. 2, 2024, they hadn’t been completed by the time Mock’s mother, Pam Grillo, and his stepfather, Robert, arrived at the Johnson County Courthouse for Mock’s third hearing on Nov. 6. In the meantime, Mock — who was diagnosed with schizophrenia and is also on the autism spectrum — remained in jail, waiting. And waits like Mock’s are not unusual.
A Side Effects Public Media investigation found that in 2024, people in Indiana jails waited just over two months on average to get the two court-ordered mental health evaluations done — down from more than seven months in 2018. That’s according to an analysis of the state’s judicial branch data on all requests for competency evaluations during that time period.
While that improvement suggests the system is moving faster, people with serious mental illness still spend weeks — sometimes months — in jail without proper treatment. Advocates and mental health experts say incarceration often worsens psychiatric conditions.
“The competency eval would help, but it’s going to be a long way down the road,” the judge said during Mock’s third hearing. “There’s only so much I can do. Because it doesn’t do any good to let him out if we’re going to have another problem — then that’s just compounding the issues.”
Outside the courtroom, Grillo spoke with Mock’s public defender, Drew Eggers.
“His situation is never going to be fixed,” she said. “Yeah,” Eggers replied. “The court system just isn’t set up that way.”
In the United States, individuals like Mock who have psychotic disorders, including schizophrenia, are incarcerated at especially high rates. Among all incarcerated individuals, 10% of federal prisoners, 15% of state prisoners, and 24% of local jail inmates report symptoms consistent with a psychotic disorder.
Their struggles with the criminal justice system date back decades.
In 1968, Theon Jackson, a mentally disabled Indiana man, was charged with stealing $9 — the equivalent of around $80 today when accounting for inflation. Because he was deemed incompetent, he was committed indefinitely with no clear path to restoration. His case set a national precedent after the U.S. Supreme Court ruled in Jackson v. Indiana that indefinite confinement was unconstitutional, though it left it up to states to define what constitutes a “reasonable period of time” for competency restoration.
Until today, many individuals with mental illness spend more time in jail awaiting competency evaluations than they would have if convicted — sometimes even exceeding their potential sentences, according to a report prepared by the nonpartisan nonprofit The Council of State Governments Justice Center. Experts say it’s a reflection of a nationwide systemic failure.
In Indiana, that timeframe is capped at no more than the maximum sentence a person could serve for their charges.
Mock sat in a cell, waiting nearly three months to complete the evaluations before he was found incompetent. His wait time was longer than the state average that year — and, according to his mother, it pushed him deeper into psychosis, leaving him almost unrecognizable to her. She says he never received the treatment he needed while in the jail — including the antipsychotic medications Invega and Zyprexa.
Despite rules requiring jails to provide mental health care — including necessary medications — Dr. Bob Trestman, a national expert on psychiatric needs in correctional settings, said it's common for individuals not to receive their prescribed medicine.
Side Effects requested access to Mock’s medical records, but the jail denied the request even with authorization from his mother. They said Mock himself had to authorize the release.
The Johnson County Sheriff’s Office did not comment on Mock’s specific case, but told Side Effects that jail staff do not force inmates to take prescribed medication. Mock’s mother said he frequently refused his injections and often had to be restrained to receive them when he lived with her, with family members, or at group homes.
A system that leaves people waiting
Since the COVID-19 pandemic, public defenders, prosecutors, and mental health professionals have seen a nationwide surge in demand for competency evaluations. Recent studies estimate that at least 130,000 evaluations are conducted throughout the U.S. each year, even as many jurisdictions admit they lack adequate data on evaluations and their outcomes.
In Indiana, referrals for competency restoration have jumped more than fivefold — from 123 in 2013 to 615 in 2024. That’s happening as the state grapples with a shortage of mental health professionals, who can conduct the evaluations and provide services, leading to a backlog.
In 2023, state lawmakers passed a law aimed at reducing wait times. It expanded who could perform competency evaluations beyond psychiatrists to include certain medical professionals — like registered nurses and physician assistants — for people charged with misdemeanors or the state’s lowest-level felonies. The law also allowed judges to accept a single evaluation for low-level felonies, although courts can still order more.
“If you're spending 348 days before you've ever been evaluated, you might as well plead guilty to begin with,” said Republican Indiana Representative Wendy McNamara, the main author behind the 2023 legislation.
However, the law does not address other issues with Indiana’s competency system, including inconsistencies in data tracking. While records of competency evaluation requests exist across counties, they’re not uniformly maintained and monitored, making it difficult to understand disparities in wait times and outcomes across the state, according to officials familiar with the issue.
The law also does not address the additional delays some people face for a hospital bed after they are deemed incompetent. In some cases, people wait in jail even after restoration is complete.
It has led the Indiana Protection and Advocacy Services Commission to sue state officials in May 2022 over delays in psychiatric services. The lawsuit was eventually dismissed after wait times for psychiatric restoration beds at state facilities went down.
McNamara noted that waits for psychiatric hospital beds for restoration have gone down since the legislation passed, though she did not provide specific numbers. The Division of Mental Health and Addiction did not respond to multiple requests from Side Effects for comment about the current state of the competency evaluation and restoration process, including questions about current wait times, access to restoration beds, and whether the state seeks civil commitment for people whose competency can’t be restored.
Shannon Scully, Director of Justice Policy and Initiatives at the National Alliance on Mental Illness (NAMI), said that while states like Indiana have dedicated more resources to expediting competency evaluations, they also need to invest in proactive solutions — such as increasing access to mental health care before people get caught up in the legal system.
“The competency restoration process is really just a symptom of our reliance on the criminal justice system for people with mental health conditions,” Scully said.
Until that changes, the criminal justice system will be the first line of defense, Eggers said, and people like Mock will continue cycling through it for charges or crimes that are often a symptom of their mental illness and lack of long-term, wraparound care.
‘He wants to live his own life’
Grillo first noticed something was wrong with her son, Mock, when he was a baby.
But at 18, his struggles worsened. One day, he came home from high school convinced people in the halls were talking about him. The voices weren’t real; they were the first signs of schizophrenia.
Still, Mock was determined to keep his job at a pizza place and earn his driver’s license, which he eventually did. He took pride in owning a car and getting around on his own.
“He wants to live his own life,” his mom said.
Mock was born into a family with a history of the illness. His father and grandfather both had schizophrenia, and his father’s violent outbursts eventually forced Pam to leave. Now, she sees history repeating itself.
Grillo tried to get Mock the care he needed. He was involuntarily admitted to three psychiatric facilities over recent years. But he was discharged because they said his time had run out. Dumped onto the streets, his mom eventually found a group home, a setting she thought would help him. But last fall, Mock ran away from the group home and was off his medication, wandering around looking for food. He was arrested on Sep. 13 after an employee at Walmart in Greenwood reported him for shoplifting a package of cheese, and he started struggling with the guard in the store.
When officers tried to detain him, he allegedly shoved and spit on one of them. He was arrested, charged with battery to a public safety officer, and booked into the Johnson County Jail. And that marked the beginning of his months-long wait as he navigates the competency evaluation and restoration system.
Indiana restores competency through state psychiatric hospitals, jail-based programs in select counties, and private inpatient facilities. While most cases go to hospitals like Logansport and Evansville, some jails provide treatment to ease backlogs. But prolonged incarceration in jails can be devastating to mental health, often making competency restoration even harder.
“For those left waiting in custody, simply returning to their previous baseline — or even reaching the legal standard of competency — can be a significant challenge,” Trestman said. “The brain isn't a simple mechanism, and recovering to a previous level of functioning becomes much harder after someone has been off medication for an extended period of time.”
For people with psychotic disorders like schizophrenia, jail can be especially dangerous. Correctional environments put vulnerable individuals at risk — whether by exposing them to exploitation or forcing them into a constant state of fear and unpredictability.
“Helping people recover is harder if you're in an environment that, by design, encourages paranoia,” Trestman said.
‘Mom, take me home’
For now, Mock remains at the psychiatric facility for competency restoration, still awaiting a path forward. And despite the medication and treatment, Pam says he remains in active psychosis, barely able to remember his own name — let alone hers. His cheeks have hollowed, and his glasses are still at the jail, leaving him unable even to watch TV, she said.
“He told me, ‘This is prison, Mom. I can't read. I can't watch TV, nothing. So I just lay on my bed,’” Grillo recalled from her last visit with Mock at the end of February. “And then, all of a sudden, he reaches over, touches my hand, and says, ‘Mom, take me home with you.’”
After more than four decades of caring for her son, Grillo — now in her 70s — has lost faith in a system she said has failed him at every turn. Each delay, she said, pushes Kevin deeper into crisis. And if he’s ultimately declared competent and released, she fears he’ll be left without the consistent, supervised care only medical professionals can provide.
Judge Amy Jones of the Marion County Superior Court frequently sees people cycle through the system because they don’t meet the legal thresholds for care — and the state doesn’t track how often that happens.
“The biggest issue is that you're either sick enough to be committed to a state hospital under a civil commitment, or you're not sick enough and can maintain community-based treatment,” Jones said. “But there’s a big group in the middle — people who can’t consistently manage on their own yet don’t meet the criteria for a civil commitment.”
Mock’s family fears he will fall into that gap.
They’ve struggled to find a facility that will accept him for long-term care due to long waitlists and facilities not wanting to take him due to behavioral issues.
“Nobody seems to understand, or nobody seems to be working towards the goal of we need to commit this guy and keep him probably for the rest of his life,” Grillo said.
Robert, Mock’s stepdad, added: “Unless he's in jail or in trouble, nobody really offers him any real services.”
“Everybody just washes their hands of him.”
Farrah Anderson is an investigative health reporter with WFYI and Side Effects Public Media. You can follow her on X at @farrahsoa or reach her at fanderson@wfyi.org.
