McHenry County is piloting a new program to provide specialized psychiatric care for jail inmates deemed unfit to stand trial while they wait for a bed in a state mental health facility.
Since July, the initiative—the second of its kind in Illinois—has aimed to ensure that inmates with severe mental illnesses receive timely treatment, addressing a “critical statewide backlog” that grew after the COVID-19 pandemic. According to the Illinois State Police, delays have left many inmates “waiting months in county jails unequipped to provide specialized psychiatric care.”
Licensed social worker BreeAnn Kaczmarczyk, who leads the program in partnership with Thresholds in Woodstock, said finding a bed in an Illinois Department of Human Services (IDHS) facility can take weeks or even months. During that time, a defendant’s mental health can worsen due to isolation, inadequate medication, or frustration—sometimes resulting in further legal trouble.
“People with severe mental illness often can’t advocate for themselves,” Kaczmarczyk said. “Providing treatment in the jail not only helps the individual, it also ensures they can eventually stand trial, which is important for justice to victims and their families.”
Thresholds provides mental health care alongside WellPath, which delivers medical services. Kaczmarczyk has recently worked with five McHenry County inmates and also treats detainees transported from other counties.
“This program is incredibly important,” she said. “I see real change in each person we treat. Helping even one individual make better decisions can have a lasting impact on their future.”
She added that when inmates approach mental fitness, they can begin relapse prevention, which motivates them to avoid returning to the correctional system. Most inmates she treats are not violent offenders. Many are unhoused and have mental health conditions that lead to minor crimes like retail theft or trespassing.
However, Kaczmarczyk has also treated detainees charged with more serious offenses, such as aggravated battery or unlawful use of a weapon—often committed during a psychotic episode. For many, jail is their first encounter with the legal system, often linked to untreated mental illness or substance use disorder.
Early treatment in jail also eases pressure on staff and helps prepare inmates for transfer to IDHS facilities, program supporters said. The pilot program, which has 12 beds, is funded by a $442,000 grant and is a partnership between the McHenry County Sheriff’s Office, IDHS Division of Behavioral Health and Recovery, and Thresholds.
“Safety and compassion aren’t opposites,” said McHenry County Sheriff Robb Tadelman. “In McHenry County, they walk hand in hand.”
Similar initiatives are underway elsewhere in Illinois. In Kankakee County, WellPath provides mental health care for inmates waiting for IDHS beds. Franklin County in southern Illinois is setting aside 10 to 12 beds with Centerstone providing services, according to the Illinois State Police.
Defense attorney Brian Stevens said 10% to 15% of his clients over the past year could have benefited from earlier intervention. He described a former U.S. Marine with PTSD who was charged with aggravated battery of a child. “He really needed help, but because he didn’t get specialized care, he ended up in more trouble,” Stevens said.
IDHS spokesperson Daisy Contreras said the program’s main goal is to prevent inmates’ mental health from deteriorating while they await a bed. While restoring fitness isn’t its primary aim, about 20% of participants have reached fitness while in jail.
Kaczmarczyk provides therapy, including talk and art therapy, monitors medications, and educates inmates about courtroom procedures so they can understand their trial and participate fairly.
“The minute someone is found unfit, they receive daily support,” Kaczmarczyk said. “We start easing their symptoms right away and guide them toward recovery and stability.”
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