Final arguments were made in federal court Monday in a case that could change the way the state treats the seriously mentally ill.
Attorneys for the state of Mississippi and the U.S. Department of Justice argued in the U.S. District Court for the Southern District of Mississippi before U.S. Judge Carlton Reeves, whose final order in the case is forthcoming.
At stake is how the state transitions from a psychiatric hospital-based care system to a community-based one. Attorneys for the state argued that the Mississippi Department of Mental Health has made tremendous progress in moving to community-based alternatives in lieu of hospitalization for many with serious mental illnesses.
Depending on the final order in the case, the state can either appeal Judge Reeves' decision to the Fifth U.S. Circuit Court of Appeals or allow it to stand.
Judge Reeves used a baseball analogy in his closing remarks to illustrate where the five-year legal battle over the state's mental health system is.
“We're not at the end of this,” Judge Reeves said. “We want to make sure we're not jumping up and down and clapping our hands too early. We want to make the right decision.”
Testifying today was court-appointed special master Dr. Michael Hogan, whose remedial plan represents a middle ground between the one from the state and the federal plan, which would require three years of a court-appointed independent monitor plus a year of “substantial compliance.”
The state says the DOJ's plan would represent an open-ended plan and would be moving the goalposts of metrics that could put the state into compliance with the Americans With Disabilities Act.
Attorneys from the DOJ's Civil Rights Division reiterated their position before Judge Reeves that the state also needs more housing than suggested in the plan submitted by Dr. Hogan on June 3.
They also argued that the two of the community services suggested by Hogan in his plan are unproven and evidence of them wasn't presented during the after a four-week bench trial conducted by Reeves in 2019.
These two services — Intensive Community Outreach and Recovery Teams and employment services through the state Department of Rehabilitation Services — would replace Program of Assertive Community Treatment teams and Individual Placement Support for the employment of the serious mentally ill. The federal government says the state should use evidence-supported services such as the PACT teams and IPS and meet goals such as crisis response time for the county-based mental health teams. Often, law enforcement are left to deal with these crises with the mentally ill, something the federal government says they're ill-equipped to handle.
The DOJ attorneys also said that Hogan's solution to allow the state to develop tools to assess whether providers are compliant with the standards wouldn't provide any oversight into their success rates.
The special master's recommendation of expanding the state's subsidized housing for the seriously mentally ill over the next two years was insufficient, according to the DOJ.
The DOJ also wants a permanent prescription drug program for the seriously mentally ill, something that the state is willing to fund for a few years before re-evaluating it.
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.
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 AmericansWith Disabilities Act rather than be institutionalized.
The DOJ commenced 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 find a compromise, 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. Judge Reeves ruled in favor of the federal government and designated a special master, Dr. Hogan, to help the court draft a remedial plan.