(The Center Square) — The court-appointed monitor in the U.S. Department of Justice’s lawsuit against the Mississippi Department of Mental Health says the state is making progress toward a community-based care system for the mental ill, but challenges remain.
“Mississippi has made substantial progress in improving care,” Dr. Michael Hogan, the court-appointed monitor, said in the report. It’s the fourth issued by the monitor and covered the period from March to August.
Among those challenges are staffing as the state agency tries to transition from a system of institutionalization for the mentally ill to a community-based plan conceived by Hogan that is compliant with the 1999 U.S. Supreme Court decision, Olmstead v. L.C.
The decision says individuals with mental disabilities have the right to live in the community under the Americans with Disabilities Act rather than be institutionalized.
The U.S. Department of Justice sued the state on those grounds in 2016, won in a verdict handed down by U.S. Judge Carlton Reeves and is fighting an appeal in the 5th U.S. Circuit Court of Appeals in New Orleans. Oral arguments were held in October before the 5th Circuit and a decision is forthcoming.
The report also says the practice of holding the mentally ill in jail awaiting a bed in one of the state’s mental hospitals was made worse during the COVID-19 pandemic due to a reduction in capacity. The report also says the waiting times for state mental health services have been reduced, but “problems persist.”
Hogan’s report also details issues with the community mental health centers, some of which were combined into larger regions due to funding issues.
The mental health expert also praised the Legislature for passage of House Bill 1222 this session, which expanded the state agency’s crisis intervention teams (mobile teams of care providers that help those with serious mental illness in a crisis situation), provided funding for liaison personnel and mandated data reporting requirements for chancery courts.
He also praised the state Department of Mental Health for changes to its crisis stabilization units, which are small in-patient facilities with eight to 16 beds designed to stabilize those undergoing mental crises. He detailed the agency’s goal of imposing a mandate on community mental health centers that they maintain diversion rates (keeping the mentally ill out of the state hospitals) of 85%.
Patients can be diverted to institutions due to staffing shortages at the community units or because the staff there can’t handle the most violent patients.
The monitor also found that the state’s two types of mobile intervention teams of care providers that help keep the mentally ill out of institutional care was well below 50% of the funded capacity.
“We do not know whether the low enrollment is due to staffing problems or a failure to enroll people in the program, e.g., when they leave the state hospital or a CSU,” the report says. “Levels of hospitalizations, and patterns of discharge referrals generally suggest that there are more individuals who could benefit from the services than are receiving them.”
