Sunday, March 13, 2011

Justice Department investigates Mississippi's continued funding of psychiatric hospitals as discrimination against disabled people

From The AP:

JACKSON, Miss. — The U.S. Justice Department is investigating whether Mississippi's mental health system is discriminating against disabled persons by funding large psychiatric institutions at the expense of community-based care.

The state Department of Mental Health said Mississippi has significantly improved care for disabled patients since the ruling, despite a lack of funds. Critics, however, said state policymakers have resisted shifting funds from hospitals to community care.

The state never carried out a 2001 plan to implement a Supreme Court ruling that barred states from over-reliance on institutions.

The Justice Department now is looking into whether state-operated residential facilities are providing the "most integrated settings possible" to people with mental illness or intellectual disabilities, according to a letter sent by the Justice Department to Gov. Haley Barbour on Feb. 25.

"If we find systemic violations, we will work with you to develop proper policies and practices prior to initiating any legal action," Assistant Attorney General Thomas Perez wrote in the letter to Barbour.

Jan Schaefer, a spokeswoman for Mississippi Attorney General Jim Hood, said the concerns stem from a 1999 Supreme Court ruling called the Olmstead decision. The court held it is discriminatory to institutionalize a disabled person who can live in the community with support.

DMH spokeswoman Wendy Bailey said the state follows the law in providing care, despite the Legislature's failure to provide funds to implement the 2001 Mississippi Access to Care plan. The plan was developed by state officials with citizen input after the Olmstead ruling.

The Justice Department has launched similar investigations into other states' mental health systems.

"The Olmstead decision requires people to receive treatment in the least restrictive environment appropriate for their needs," Bailey said in a written response. "DMH follows this standard."

The agency has taken several steps in recent years to transition mentally ill or disabled patients who can live in the community out of psychiatric hospitals, Bailey said.

The Mississippi State Hospital in Whitfield has eliminated roughly 200 inpatient beds over the past three years, after finding many clients could be served in less restrictive settings, Bailey said. The mental health agency last year put the state's community mental health centers in charge of six crisis centers, she said.

Jerry Mayo, who directs the Community Mental Health Center in Hattiesburg, said the recent changes decreased the likelihood people with mental illness will have to spend time in jail before getting care — but the state has a long way to go.

"It has a historical bias for institutional care, and again, while the rhetoric is there to move to community care, it's very hard to move the dollars necessary to make that a reality," said Mayo.

Mary Troupe, a disabilities advocate in Jackson, said institutional care costs taxpayers more that community care.

"And it's just taking forever, and we're not moving forward, and it's costing the state so much money," said Troupe, who leads the Coalition for Citizens with Disabilities.