State officials are calling it a crisis as the demand for competency restoration has grown rapidly. According to the Indiana Family and Social Services Administration, referrals for competency restoration increased by 477% between 2013 and 2025. By the end of 2025, more than 709 people were under competency restoration orders, and state officials projected that number would surpass 800 in 2026. State officials said about 70% of patients currently in Indiana's state psychiatric hospitals are patients in the criminal justice system, known as forensic patients, while 30% are civil commitments. "You're always operating in scarcity," Goff said, describing shortages that stretch from county jails to community mental health services and state psychiatric hospitals.