Legislators have made strides in addressing issues within mental health but more to be done.

The Mississippi Department of Mental Health was ordered by U.S. District Court Judge Carlton Reeves to get in compliance with the Americans with Disabilities Act within the next 120 days. He also ruled that Dr. Michael Hogan would be appointed as monitor to oversee the state’s progress.

Judge Carlton Reeves

In 2016, the U.S. Department of Justice filed a suit against the Mississippi State Department of Mental Health, primarily the adult mental health care system. They cited several violations of the Americans with Disabilities Act.

In 2019, Reeves ruled that the state had, in fact, committed those violations by confining patients at institutions rather than in community settings. While it looked on paper that those community-based programs were in place, gaps in the system were preventing their utilization for adults with severe mental illness.

At the time, Judge Reeves cited PACT as being unavailable or under-enrolled, the lack of use for the Mobile Crisis Services, Crisis Stabilization Units were not available, Peer Support Services were not being billed, and the CHOICE housing program was much too small.

Now in August 2021, attorneys representing the federal government submitted recommendations regarding how Mississippi’s mental health department needed to come into compliance as well as the role a monitor will play. The state objected to having a monitor, but did agree to Dr. Michael Hogan taking the position.

Hogan was previously appointed by the court to assess the state’s mental health program in February 2020. He made several recommendations to the program by June of that year.

VIEW HOGAN’S 2020 RECOMMENDATIONS THOSE HERE

Prior to the verdict by Judge Reeves, a meeting was called between the United States attorneys and state attorneys. He was quoted by WLBT that this was “the opportunity to tell the court why the proposal of the United States should not be adopted.”

The meeting concluded that a monitor would be appropriate for this situation at the cost of the state. Federal attorneys recommended that the person holding the position would be responsible for reviewing the data and submitting consistent and regular reports regarding the information they are collecting. The state requested that those reports be concluded in 2022 and reassessed each year as to whether it should continue.

On Tuesday, Judge Reeves implemented mandates that must be included in the final plan submitted by the state within 180 days of the plan being formulated, as reported by WLBT.

The mandate includes evaluating patients to determine whether they qualify for at-home or community-based care, the planning for discharge of all patients admitted to state hospitals within 24 hours of their admission, and the discharge of individuals appointed to a state hospital previously within a year of their admission.

It will require the allocation of $200,000 each year beginning in FY 2022 for the medication assistance fund to help patients in community-based care get medicine needed. The state Department of Mental Health will be required to provide employment services to assist individuals with persistent mental illness in getting a job, providing support services, funding mobile crisis teams and crisis residential services in most regions, providing additional rental assistance vouchers to patients in FY2022 and FY2023, and providing chancery courts in each country with an annual overview of the mental health services in their area.

The department will also be required to implement a clinical review process for adequate services.

The issues within the Mississippi Department of Mental Health are not ones that have gone unnoticed. Lawmakers have worked over the last several years to refine the services provided to communities.

Senator Hob Bryan (D), who has been on the forefront of these conversations, said the lawsuit is addressing different aspects of what lawmakers are doing, ultimately with a lot of overlap. Bryan said the primary goal is to provide appropriate care for people who need help in Mississippi.

Sen. Hob Bryan

“I think over the past number of years the state has been moving in the right direction, just not as quickly as we should. There is a good bit of agreement as to where we ought to be,” said Senator Bryan.

He added that he hopes some of the movements the Legislature have approved will ultimately aid in the decision from the lawsuit because many of the core services they are hoping to improve are also being targeted by the federal government.

In 2020, the Legislature passed SB 2610 which established the Coordinator of Mental Health Accessibility. Bryan said in the past they were taking action to encourage these local mental health facilities to increase the availability of their core services, but to very little avail. He said the establishment of the coordinator position has now given specific authority to the department to require services, provide them, or shut down a facility if they are not meeting the appropriate needs.

While Bryan is not directly involved with the lawsuit, he said he hopes that the goal of providing appropriate care for those who need it in Mississippi will continue to be a priority.

The Mississippi Department of Mental Health could not be reached for comment at this time.

You can view the remedial order from Judge Reeves below:

Remedial Order from Judge Reeves by yallpolitics on Scribd