Defendants held on Rikers Island while they wait for a psychiatric hospital bed to open up will no longer sit in legal limbo for months without a judge checking on their case. Starting in October, Queens Criminal Court began requiring judges to reevaluate these defendants' mental competency every 30 days, a shift aimed at catching cases where jail-based treatment has already worked.
The initiative targets defendants who have been committed for mental competency treatment but remain stuck on Rikers while they wait for a bed at a state Office of Mental Health facility, according to Queens Daily Eagle. Under the new rules, if a defendant shows signs of improved competency during one of those check-ins, their case will be quickly moved back into Criminal Court rather than left to languish on the jail's waitlist. Administrative Judge Michelle Johnson unveiled the details at a stakeholder meeting with the Queens County Criminal Bar Association, per the outlet.
Queens is not the first borough to try this approach. The reevaluation initiative began as a pilot program in parts of Manhattan and Brooklyn before expanding to Queens Criminal Court this month, the outlet reports.
How a 730 Exam Decides Fitness for Trial
The process hinges on what's known as a 730 exam, which requires two psychiatrists to examine a defendant and determine whether they are fit to stand trial. When someone is found unfit, the Office of Mental Health designates a hospital and places them on a waitlist, but the same report notes that commitment orders have often lacked any built-in protocol for reevaluating a defendant's competency while they wait.
That gap matters because treatment defendants receive on Rikers can sometimes restore their competency before a state bed ever becomes available. Johnson said as much, explaining that the treatment that they're receiving actually restores them to fit, according to the same account. Defense attorneys often argue that their clients' mental capabilities have improved, and without a regular check-in schedule, those arguments previously had no clear pathway back into Criminal Court.
Ira Margulis, who oversees many cases that involve 730 exams, said he has seen rare cases of defendants regaining competency while waiting on Rikers, and that doctors sometimes find a defendant fit after a new examination, the Eagle reports. Margulis also believes these competency-restoration cases have become more common in recent years.
Months-Long Waits Fuel a Federal Lawsuit
The new check-in rule arrives against a backdrop of lengthy waits that advocates say can stretch far longer than 30 days. Defendants found unfit to stand trial can spend upwards of six months waiting on Rikers Island for a bed in an upstate hospital, per the Eagle's reporting, and in the meantime they receive little to no contact with a judge about their case.
The Legal Aid Society has sued over those delays. A 2025 federal class-action complaint brings due-process claims against the state Office of Mental Health and its commissioner over failures to transfer detainees to psychiatric facilities after a judge has ordered it, and names city agencies in connection with Americans with Disabilities Act and Rehabilitation Act claims, according to Legal Aid Society's complaint. The filing states that the median wait time in jail prior to transfer to Office of Mental Health custody was 81 days in 2024, while the Eagle separately described that same 81-day figure as an average; Gothamist has reported a different average of 79 days as of the prior fall. The complaint also states that 130 New Yorkers waited more than 100 days for transfer in 2024, and that eleven people waited more than six months for competency-restoration services over the two years before the lawsuit was filed.
Legal Aid has argued that timely restoration services should mean treatment within seven days, not the five to six months some detainees have experienced, the complaint states. Gothamist has also reported that the number of people found mentally unfit to stand trial citywide has more than doubled since 2020, while available treatment beds have increased by less than 10%. Separately, the Office of Mental Health has pointed to a substantial and sustained uptick in referrals from the state's court system since 2019, according to amNY.
Advocates Say the Fix Is Limited
Elena Landriscina has said the new 30-day check-ins could help some defendants but does not resolve the systemic causes of prolonged detention on Rikers, per the Eagle's reporting. She noted that most people still require therapeutic restoration services that Rikers simply cannot provide, and she expects the initiative to affect only a small number of people even as it may chip away at the waitlist. Landriscina has said meaningful solutions will require state investment in mental health facilities and restoration programs.
The stakes of prolonged waits have drawn scrutiny beyond the courtroom. Among people who have died in Department of Correction custody since 2021, about half had mental health needs, and five of those who died required competency restoration while incarcerated, according to the Eagle's reporting. Long waitlists increase the risk of further harm and worsening symptoms for incarcerated people with mental illness, the outlet notes.
State Lawmakers Have Also Acted
The Queens court initiative follows action in Albany. The state legislature passed reforms in June establishing new definitions and policies for court restoration services, the Eagle reports, which require psychiatric examiners to submit a report on whether restoration services are highly likely to restore a defendant's competency within a reasonable time. Under those reforms, a judge must issue an order committing the defendant to an appropriate facility for up to 90 days if restoration has a strong probability of success.
Separate proposed legislation in the state Senate would go further, establishing a program that lets counties opt in to jail-based competency-restoration services, according to a New York State Senate bill amendment. Under that proposal, a defendant who has not been restored to fitness after 90 days but is believed restorable with additional treatment would be transferred without unnecessary delay to the first appropriate available facility. Related measures have also received legislative approval, including one addressing referrals to Supreme Court under the Mental Hygiene Law.
