A federal judge issued an order Wednesday in a case brought by the U.S. Department of Justice against the state about its treatment of the seriously mentally ill.
U.S. Judge Carlton Reeves issued his order in the lawsuit and he agreed with most of the recommendations of the court-appointed special master Dr. Michael Hogan to transition the state's mental health system from an institution-based model to one based more on community-based alternatives.
One of those is a court-appointed monitor, which Reeves ordered the state and the DOJ's Civil Rights Division to submit two possible candidates apiece within 30 days of the order. The monitor's role would be to ensure the state mental health system is compliant with the Americans With Disabilities Act.
Once the monitor candidates are selected and a remedial plan is entered, Judge Reeves will issue a final judgment in the case.
The original lawsuit by the DOJ, which was filed in 2016, alleges that Mississippi depends too much on segregated state hospital settings versus community-based alternatives.
Judge Reeves in his order says that Hogan's proposal was “careful and modest” and the improvements could come without a net cost to the state. According to the order, a similar case involving Alabama's mental health system resulted in its budget increasing from $16 million to $86 million (1970s dollars).
Dr. Hogan told the court that Mississippi has, on paper, a mental health system with an array of appropriate community-based services, but in practice the system is hospital-centered with gaps in its community care. It's because of those gaps, Judge Reeves said, that the state requires an independent monitor.
In the order, Judge Reeves also said Dr. Hogan was stymied by the state's objection to him communicating with non-party stakeholders in the state's mental health system. The state objected to this because it would've amounted to a second discovery period (where the parties in a case share all information). This meant that Dr. Hogan was deprived of family-level insight into the mental health program.
Dr. Hogan's recommendation of a clinical review process of 100 to 200 patients per year was lauded by Judge Reeves as it would ensure state services would working as intended to the address the needs of patients.
The federal government says the state's mental health system violates the 1999 U.S. Supreme Court decision, Olmstead v. L.C., in which the court says individuals with mental disabilities have the right to live in the community under the Americans With Disabilities Act rather than be institutionalized.
The Department of Justice began an investigation in 2011 and issued a findings letter to then-Gov. Haley Barbour. The state and the DOJ went into a round of negotiations to come up with a solution acceptable to both sides, but the DOJ later filed a lawsuit against the state on August 11, 2016 filed in U.S. District Court.
The federal government won the first round on September 3, 2019. Reeves ruled in favor of the federal government and designated a special master, Dr. Hogan, to help the court draft a remedial plan.