In 2011, after an extended investigation of Mississippi’s mental health system, the United States Department of Justice found that Mississippi was “unnecessarily institutionalizing persons with mental illness” in violation of the Americans with Disabilities Act (ADA). The United States and Mississippi then engaged in negotiations for five years. Those negotiations failed, and the United States sued the State of Mississippi in 2016.
Judge Carlton Reeves presided over the trial and ruled in September 2019 that Mississippi was in violation of the ADA, stating, “On paper, Mississippi has a mental health system with an array of appropriate community‐based services. In practice, however, the mental health system is hospital‐centered and has major gaps in its community care. The result is a system that excludes adults with SMI from full integration into the communities in which they live and work, in violation of the Americans with Disabilities Act (ADA).”
For over ten years, the AG’s office has fought this lawsuit at every turn — stalling, denying, crafting confusing legal maneuvers, suppressing information and thwarting input from people receiving services, their families and service providers. Through its silence, the DMH has communicated its tacit agreement with every step the AG’s office has taken.
Not once, in over ten years, even when working closely with the Special Master for the past eighteen months, did either the AG’s office or the DMH provide sufficient verifiable proof to convince the Justice Department, Judge Reeves, or Dr. Hogan that the State is actually helping people with mental illness to live in the community in a manner compliant with the ADA. It begs the question of whether any such proof exists.
And now, the State is threatening to appeal because it is being required to implement the plan that it wrote and submitted, simply because Judge Reeves ordered that the implementation be independently monitored by the person the State selected and include a review of whether people receiving services benefit from the services. The arrogance of this stance is exponentially compounded by the State’s insistence that it was never in violation of the ADA and that Judge Reeves was wrong to rule that the State was out of compliance with the ADA.
Perhaps this arrogance would be bearable if it were true that the State’s mental health system is in compliance with the ADA. But it is not true. I recently invited Doug Miracle, lead attorney for the AG’s office to spend time with us at Families as Allies so that he could hear for himself the difficulties families face in getting help for members.
They face many challenges. I mentioned in a previous blog that over the past month, I tried to help three separate friends whose adult children were in mental health crises. I know what services are supposed to exist. None of these families got those services. One contacted her local crisis team and was told to call the sheriff instead, one was repeatedly told she should do something (in spite of the fact she was doing everything she could think to do), and one was completely shut out from their family member and those treating him.
But it’s not just about my experience. In spite of the DMH being the largest state employer with 5000 employees and a budget of around $600 million, there is little, if any, data about the effectiveness of its services. Mississippi consistently ranks low on national mental health measures. News articles (What will solve Harrison County’s ‘biggest crisis?’ Local, state officials look for a fix, Legal processes for mental health cases being re-evaluated in Jackson County) attest to the struggles that local community mental health centers face because the Department of Mental Health has not set up the infrastructure, overarching planning and technical assistance that community providers need to consistently provide responsive care. This does not mean that community providers are not trying their best. Almost all of them are, and many are doing a good job. But they do not have the support from the state that they need.
Wendy Bailey, appointed as the executive director of the DMH in January 2021, is in a challenging position. I like and respect Ms. Bailey and value her openness and willingness to work together. I told her late last week that I was going to publicly share these concerns because the situation is dire. I appreciate that she understood my position. I publicly implore Ms. Bailey and her board to do the right thing for people with mental illness and to prevail upon the AG’s office to NOT waste even more resources by appealing this case but to instead work with the Special Master who the State chose to implement the plan that the State wrote to create a service system that is as helpful in reality as it is on paper.
I beseech Doug Miracle, the lead attorney in the AG’s office and Jim Shelson, the primary Phelps Dunbar trial attorney, to cease any plans for appeal and simply work with the DMH, Dr. Hogan and Judge Reeves to implement the State’s plan – the plan that Mr. Miracle and Mr. Shelson likely wrote.
I ask all of you to tell the parties involved to stop wasting time and money by appealing this case and to simply do the right thing. It is past time.
Joy Hogge is Executive Director of Families as Allies.