Yet again, Mississippi finds itself facing alawsuit. On August 15, the Department of Justice began its suit against Mississippi for violating the Americans with Disabilities Act as a result of the state’s failure to provide community based treatment for individuals with mental illness.
Mississippi desperately needs to address the manner in which we treat persons with mental illness across the board, because the current system is both costly and ineffective. This lawsuit may finally force Mississippi’s legislators and government officials to reform our mental health treatment system.
In 1990, Congress enacted the Americans with Disabilities Act (ADA) to ensure people with disabilities protection from discrimination and provide them with equal opportunity and quality of life. According to the ADA, these protections applied to all persons with developmental disabilities and/or mental illnesses. Title II of the ADA further required the care those with mental illnesses receive as being as fully integrated as possible. Those struggling with mental illness have historically been held in institutions where they are segregated from the rest of the population and, therefore, have been denied opportunities to form relationships, find employment and build basic community ties.
In 1999, the Supreme Court ruling in Olmstead v. L.C. reaffirmed the Title II requirement that the mentally ill receive treatment in integrated settings and emphasized the need for community treatment programs as an alternative to institutions. However, 17 years later Mississippi has still failed to shift to community treatment programs. Now, the state is finally and rightfully being sued for it.
A 2011 investigation by the Department of Justice (DOJ) uncovered that Mississippi over-relies on the institution method for the treatment of mental health problems and developmental disabilities. Mississippi is the most institution reliant system in the nation. According to the DOJ, our state holds more than 25 percent of the developmentally disabled in institutions. Additionally, the study also points out that Mississippi is consistently ranked the worst on “treating persons with disabilities in integrated settings.”
The report went on to include multiple recommendations for areas in which Mississippi needed to improve in order to comply with the Supreme Court’s Olmstead ruling. This makes sense, since the use of community based treatment centers is not only affirmed by the Supreme Court as the method that best complies with Title II of the ADA, but is also a cost efficient practice that the ADA states is proven to be more effective in treating cases than hospitals and institutions.
The DOJ’s investigation found that, at the time, Mississippi spent 55 percent of its mental health budget on institutional care even though the national average spent by states was a mere 27 percent of the budget. In a state facing a looming deficit, we cannot afford to pour money into unapproved state institutions when focusing resources on community programs is both more effective and less expensive.
According to the Department of Justice, it costs approximately $150,000 a year to treat an individual in a state mental institution as opposed to $44,500 per year to treat them through community programs. Additionally, it costs approximately $110,000 per year to treat an individual with developmental disabilities in a state facility as opposed to $27,000 per year to treat someone in the community.
Switching to community treatment programs would allow the state to treat about four people in the community for every one it treats in an institutional setting.
Not only is the practice of relying on institutions for treatment costly, it also fails to provide citizens with a well-rounded treatment. Families are faced with the burden of choosing between keeping their loved ones close but without access to treatment or sending their loved ones to an institution where they will live in isolation from their family and the rest of society.
Community resources enable individuals with disabilities and mental illness to receive services while living close to family and help establish community support that prevents dependency on institutional care. The National Alliance on Mental Illness (NAMI) found that those who receive treatment in the community programs advocated by the DOJ are readmitted to hospitals l20 percent less often than those who receive treatment in institutions. NAMI found that participants in programs like Assertive Community Treatment (ACT) are also more likely to remain employed and experience less debilitating symptoms.
In regards to the lawsuit, Governor Phil Bryant said, “The current system of mental health in Mississippi has existed for many years, yet the DOJ has just now decided to take issue with it.” Governor Bryant also ignorantly deemed the allegations found in the lawsuit as “without merit.” However, for those who have had direct experience with treatment at mental health centers or, more importantly, lacked proper treatment from them, this lawsuit is long overdue.
U.S. Attorney General Loretta Lynch defended the lawsuit by stating, “For far too long, Mississippi has failed people with mental illness, violating their civil rights by confining them in isolating institutions.”
Just this year the Mississippi legislature passed a budget that cut $8.3 million from mental health throughout the state. When discussing the problems surrounding mental health in Mississippi, it is crucial to remember the state’s inadequacies can mean severe consequences for individuals in need of mental health services.
A recent article in Mississippi Today noted that many individuals find themselves waiting in jails across the state for weeks before ever receiving care at an institution. The recent lawsuit also indicated that in 2014, 56 people were released from institutional care into homelessness— and these are only a few examples. Righting the injustices Mississippians with developmental disabilities and mental illnesses face cannot be overlooked and should be done urgently.
The recent action taken by the DOJ should alert us as Mississippians to the unnecessary, state-mandated suffering of those with mental health issues. No, our anger and concern should not be about federal overreach—as Governor Bryant immediately clung to in his arguments. Instead, our frustration should be about the rights of Mississippians whose federal legal protections have been ignored for far too long.
If we cannot come to terms with our wrongdoings and policy inadequacies, the most vulnerable of citizens will pay for our pride. Let us stop wasting money fighting justified federal lawsuits and instead invest in the mental health of our citizens in a manner that is actually effective.
