With Mississippi facing off against the Department of Justice in the longstanding battle over the state’s treatment of mentally ill Mississippians, its defense depends on the office of Attorney General Jim Hood — despite the fact that Hood has been, arguably, one of the biggest critics of the state’s mental health system.
In 2016 the U.S. Department of Justice sued Mississippi, claiming the state warehoused people seeking help in its state-run hospitals and institutions and defied the federal standard of community-oriented care.
Hood quickly latched on, criticizing lawmakers for cutting mental health funding.
“The fact is … it’s all about the money,” Hood said, criticizing the state Legislature to a room of mental health advocates in 2017. “And you have to spend a little bit of money to save money. And you can’t get these folks to understand that because they’re only focused on the next election.”
Two years later, few people are as focused on the next election as Hood, considered the front-runner for Democrats’ nomination for governor. And the lawsuit could provide ammunition against his likely opponent in November, Lt. Gov. Tate Reeves, a Republican who has controlled the purse strings of the state Legislature since 2012, months after the federal government sent Mississippi its first letter telling Mississippi the state was out of compliance with federal standards.
But Hood has toned down his rhetoric going into the trial, which started June 4 and is projected to last until July. When asked for a comment on the merits of the Department of Justice’s case and whether the state has sufficiently improved since 2016, Hood declined to comment.
Instead his office sent Mississippi Today a statement from 2016 in which the attorney general calls the lawsuit “a clarion call to all of us in state leadership to consider how we care for the least among us and how we can make it better” and asks the Legislature to increase its spending on mental health, noting litigation would likely be costly.
According to the attorney general’s office, the state has so far spent more than $1.4 million on outside counsel and expert witnesses.
Those outside attorneys have argued in a recent brief that the state is transitioning to community-based care responsibly and that “a mental health service system that has no ‘gaps’ and no ‘unmet needs'” is a system “no State can deliver.”
When asked about improvements over the last three years, the Department of Mental Health also declined to comment, citing the pending litigation. But the agency provided a document that spokesman Adam Moore said “highlights some of the ways community services have been expanded in Mississippi” since 2016. This includes $13.3 million that was shifted from the department’s institutional budget to community programs in 2019.
Mental health advocates on the ground acknowledge these strides but say the face of Mississippi’s mental health system remains largely unchanged.
“We are so far behind. We have a lot of ground to make up for,” said Polly Tribble, executive director of Disability Rights Mississippi. “We have a long way to go to make it acceptable for the people who receive these services.”
The foundation of Mississippi’s lawsuit is a 1999 Supreme Court decision in Olmstead v. L.C. that found the state of Georgia had violated the Americans with Disabilities Act by sequestering people with mental health disorders in institutions, even when therapists had determined these patients would fare better living in their communities. As a result, the Olmstead ruling says states must provide community-based services when appropriate.
The state of Mississippi has twice noted the ineffectiveness of its reliance on institutions. In 2008, a legislative watchdog report concluded that Mississippi was far behind the rest of the country in shifting towards community-based services even though institutional care “represents a much more expensive service delivery model than does community-based care.” In 2014, after budget cuts contributed to the closure of Mississippi State Hospital’s Community Services Division, a second legislative report criticized the department’s decision and recommended the agency develop a comprehensive system for tracking patients and implementing services.
The Department of Justice complaint against Mississippi, filed in 2016, paints its allegations in broad strokes, describing a system in which “individuals with persistent needs cycle through the state hospitals over and over again, to say nothing of admissions to local emergency rooms, private psychiatric hospitals, and jails” because services in the community, it says, are “insufficient.”
Hood has long blamed funding as the root of the problem. In 2017, months after the Department of Justice filed its suit against Mississippi, lawmakers slashed nearly $28 million from the Department of Mental Health’s $600 million budget, a move that eliminated more than 500 jobs within the state hospital system.
And to that end, Hood in 2017 and 2018 often portrayed the lawsuit as a political issue, linking the Department of Mental Health’s budget cuts to the package of corporate tax cuts Reeves championed in 2016.