A Georgia man on trial for an unsolved 1988 murder case has his chances dependent on access to mental health care. A new law could help – WABE

Across Georgia, people in need of mental health treatment can be held in jail for months — sometimes years — before they are convicted or even tried for a crime.

James Michael Coates is one of those people.

In 2021, Roswell police arrested Coates on the grounds that new DNA evidence linked him to the unsolved 1988 murder of 8-year-old Joshua Harmon. Records show he had already been convicted twice of child abuse – among other charges – for crimes committed in 1990 and 1993.

“This was a tragedy that no family should have to endure,” Roswell Police Chief James Conroy said at a press conference. “The death of Josh and the fact that his killer walked free for so long is unimaginable. I hope this arrest gives your family some sense of closure.”

But more than three years later, Coates' trial remains pending.

At least two independent psychological evaluations ordered by the court have found the man, now 60, to be mentally incompetent to stand trial. His case cannot proceed until he has undergone a “recovery of competency” so that he can understand the charges against him and defend himself.

Patients often must complete the process in a state mental hospital, where the average daily cost of inpatient treatment for a person is $945.51, according to Medicaid cost reports for fiscal year 2023.

However, Kevin Tanner, commissioner of the Department of Behavioral Health and Developmental Disabilities in the US state of Georgia, says that the agency faces the problem of creating a treatment plan because there are rarely beds available for these patients in state psychiatric hospitals.

“We only have about 300 beds that we can actually use for restoration services,” Tanner said, sitting in his office with his back to the golden dome of the Georgia Capitol. “I have 700 people waiting for a bed, so at some point we're going to have to find a way to increase our capacity.”

Tanner expects only about half of the state's total number of beds to be used, as the other half are occupied by people who have been “found not guilty by reason of insanity.”

“So these people aren't going anywhere,” Tanner said. “We have a lot of people who have been there for over 20 years.”

Because of the lack of beds, people can spend longer on the waiting list than the maximum sentence for the crime they are accused of. According to the department, the average wait time for a man is 339 days and for a woman is 184 days.

And unlike Coates, many of them are charged with offenses that carry a maximum sentence of 12 months in prison and a maximum fine of $1,000.

“They don't commit serious crimes,” Tanner said. “What they do is urinate in public, trespass, commit property damage and other things that bother them and keep putting them in the system because they're just so sick.”

“This is a wrong thought process. We are just warehousing individuals instead of providing services.”

-Fulton County Sheriff Pat Labat during a recent tour of the Fulton Jail

In May, Tanner said, the waiting list for a bed was 40 percent longer than at the same time last year. In addition, there were about 1,300 people in prison who had not yet reached that point because they were still waiting for an assessment of their eligibility.

Tanner said the backlog of people waiting for mental health evaluations existed before the COVID-19 pandemic, but the problem became worse when the department lost more than 1,200 employees. Since then, only about half of the lost jobs have been restored. That means it also takes longer to “restore” someone.

Georgia State Senate Bill 533 is part of a new initiative to help people who are in jail because of long wait times for a mental health facility. It allows the state's Department of Behavioral Health to work with the local sheriff's office to get into a jail and provide treatment.

Attorney Derek Johnson-Gage specializes in criminal and probate matters involving mental illness.

“It's not a panacea,” he said of the legislation, “but it's a significant step forward.”

While Johnson-Gage acknowledged that prison is a dangerous place and the environment can exacerbate a person's mental health issues, she said prison rehabilitation programs are a good option.

“At least no one is sitting in jail for 12 months waiting for an evaluation and hospitalization, only to then endure another nine to 12 months of treatment in a closed facility,” Johnson-Gage said.

During a tour of the Fulton County Jail this summer, Sheriff Patrick Labat and his staff walked through the facility's white-brick hallways to several apartment blocks undergoing renovations, pointing out problems they say cannot be fixed.

“This is a wrong thought process,” said Labat. “Here we are just warehousing individuals instead of providing services.”

The sheriff disagrees with county authorities that renovations and a new “special facility” for inmates with severe mental health problems could be enough to improve prison conditions.

However, both parties agree that more mental health resources are needed, as evidenced by the 2022 death of Lashawn Thompson in the prison's psychiatric unit. Thompson's death led to a federal and state investigation into possible civil rights violations.

Natalie Ammons, spokeswoman for the Fulton County Sheriff's Office, said Emory University currently provides aptitude testing and mental health treatment for men in the prison, but only for women, and she was not aware of any agreement with the state's Department of Behavioral Health to expand those services.

As for Coates, he is not expected to be transferred to a state psychiatric hospital in the near future.

In recent years, he has repeatedly pleaded not guilty to the charges against him and claimed in court documents that the state is using “false and fabricated evidence.”

He has also filed dozens of requests to have his public defender dismissed so he can represent himself, and has sent handwritten letters to the Fulton County Court Clerk requesting copies of court decisions he believes could help secure his release.

Both Coates' lawyers and prosecutors expressed concerns about his mental health.

“The defendant (Coates) was present at numerous trials where the swabs obtained during the autopsy of the minor child JH were explained in detail,” prosecutors wrote to the judge overseeing the case last November. “Notwithstanding, the defendant does not appear to recall this statement in his most recent plea. These statements are repeated over and over again in almost every plea entered by the defendant.”

Coates is scheduled to attend a status conference in February to find out where he stands on the waiting list for treatment.

Meanwhile, Roswell Police spokesman Tim Lupo said the team working to solve the alleged Coates case has remained in regular contact with the Harmon family.

“The men and women of the Roswell Police Department have worked diligently on this investigation for more than three decades and have now entrusted this investigation to the next link in our criminal justice system,” Lupo said.