The court-appointed independent monitor, Dr. Michael Hogan, released his second report last week about Mississippi’s mental health system, indicating that Mississippi's Department of Mental Health is complying with federal directives.
The report states, "Based on data provided by DMH and provided in the paragraphs that follow the Monitor determines that all the Core Services have been funded at, and in some cases above the levels required by the Order, meeting the first threshold for compliance." However, the report states, "Given the pilot nature of this review, the dynamic environment for crisis program development, and the fact that data systems to measure crisis care are not yet fully in place, definitive compliance findings with respect to crisis programs across Mississippi cannot yet be made."
The report also notes, "Mississippi continues to improve its crisis services to take advantage of these national developments. On paper, Mississippi’s current approach to crisis care is superior to that of some states given the statewide presence of mobile crisis teams and CSUs."
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Despite this general positive report, the report notes many challenges remain. "Levels of institutionalization in Hospitals have been reduced . . . Some of the reductions in levels of hospitalization are not attributable to improved community care but to bed closures related to COVID and staffing. These reductions do not indicate improved compliance with the Americans with Disabilities Act’s requirements, and from a quality of care perspective, these are reductions that may not be desirable."
The report further states, "Despite national legislation, there is still not “parity” or equitable care for mental illness compared with care for other illnesses in private health insurance programs and even in Medicare. State mental health systems must compensate for these failings, when it comes to care of people with SMI for whom private insurance or private care has not been available. Sustaining good care in a State managed system and coordinating care between this system and the overall health system introduces greater challenges than exist for care of other major medical conditions."
The report further states, "These patterns reveal a need for stronger protocols that focus better on needs of people with SMI who are not consistently engaged in care. The data also reveal potential weaknesses in methods to assure that CMHC’s identify needed adjustments in care—for people who are engaged—on an ongoing “just in time” basis."
The federal government has successfully argued that 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 commenced an investigation in 2011 and sent a findings letter to then-Gov. Haley Barbour. The state and the DOJ attempted to negotiate a solution acceptable to both sides, but the DOJ later filed a lawsuit against the state on August 11, 2016 in U.S. District Court.
The federal government won on September 3, 2019 in a bench trial conducted by Reeves, who ruled in favor of the federal government. He designated a special master, Hogan, to help the court draft a remedial plan.
