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Judge nears decision on future of state mental health system

MGN Online

U.S. District Judge Carlton Reeves is expected to rule on a remedial plan for the Mississippi State Department of Mental Health in the near future.

Posted: Jul 13, 2021 9:11 AM
Updated: Jul 15, 2021 9:15 AM

JACKSON, Miss. (AP) — When Michael Hogan was appointed by a federal judge to help craft a road map for the future of Mississippi’s embattled mental health care system, he planned to tour community mental health centers in-person to see the state's services in action. He hoped to speak to patients and employees — perspectives he said would be vital in charting the Department of Mental Health’s path forward.

That was in early 2020, before the COVID-19 pandemic. Hogan, a mental health care veteran with 40 years of experience working across the country, said Monday in federal court his ability to work on the ground has been severely limited in the past year and half.

“I don't know anything about the situation on the ground, which troubles me some," he said.

Speaking at a hearing at the United States District Court in Jackson, Hogan said he feels the state has made progress at providing community-based programs for people with mental illness.

However, he repeatedly expressed concerns about a lack of data and analysis documenting the standards and overall effectiveness of the community mental health system, especially with how it’s doing at preventing hospitalizations. He said more should be done to reach out to community members for input.

“The most troubling issue is the lack of data,” he said. “There's no doubt that a lot of progress has been made since the time of the trial, but we don't know what it has been.”

U.S. District Judge Carlton Reeves is expected to rule on a remedial plan for the Mississippi State Department of Mental Health in the near future. On Monday, he heard from Hogan and lawyers representing the state of Mississippi and the United States Department of Justice, which successfully sued the state two years ago when Reeves ruled Mississippi was in violation of the Americans with Disabilities Act (ADA).

Hogan and lawyers representing the federal government have argued that an independent “monitor” should be appointed to oversee the state's progress in complying with the ADA.

Hogan said the position would be “the eyes and ears of the court” and act like a referee, an unbiased individual who will make sure rules are enforced. The state adamantly opposes a monitor, saying the department has made changes and that the position is unneeded.

He also recommended that the state conduct a survey of a sampling of 100 to 200 patients in the state's mental health care system to get feedback on services.

Litigation over the way Mississippi cares for people with mental illness has been underway for years now. The federal government issued a letter in 2011 saying Mississippi had done too little to provide mental health services outside mental hospitals. The Justice Department sued the state in 2016.

Federal attorneys said during the 2019 trial that mentally ill people were being held in jails because crisis teams didn’t respond. They said people had been forced to live far from their families because mental health services weren’t available in their hometowns. They also said people made repeat trips to Mississippi mental hospitals because there was no effective planning for them to make a transition to community services, and the most intensive kinds of services weren’t being made available.

Federal attorneys said Monday that they believe Mississippi is still in violation of the ADA and that they've seen no evidence otherwise.

James Shelson, a lawyer representing the state, said Mississippi has enacted mobile crisis teams and crisis stabilization units, or facilities that provide intensive short-term mental health care for those experiencing acute psychiatric crises. The state also offers Programs for Assertive Community Treatment (PACT), or services to help patients transition between levels of care or to avoid the need for hospitalization, as well as supportive housing and peer support services.

“We heard your honor two years ago, we didn't sit around and do nothing,” he told Judge Reeves.

Deena Fox, a trial attorney in the Civil Rights Division of the United States Department of Justice, said those services need to be expanded and that there need to be metrics in place to ensure they are working. For example, the state should require that professionals respond to a person in crisis within one hour after receiving a call in an urban area, and within two hours in a rural area.

She said it's not of help if there is a crisis team in place in an area, but they respond to calls too late or defer to law enforcement.

Fox said more than 1,000 people need access to supportive housing in Mississippi, and that the state should be working to accommodate as many of those individuals as possible. Having a place to live, a job and income is key to preventing hospitalizations, she said. However, the state's current plan calls for expanding supportive housing by fewer than 100 units, according to Fox.

“The state's proposal is to keep the status quo, which is not sufficient,” Fox said.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 501097

Reported Deaths: 9990
CountyCasesDeaths
Harrison34338538
DeSoto32117403
Hinds31939628
Jackson24494382
Rankin21995390
Lee15543235
Madison14581280
Jones13851242
Forrest13453251
Lauderdale11991317
Lowndes11050188
Lamar10521135
Pearl River9533237
Lafayette8550140
Hancock7732127
Washington7438158
Oktibbeha7146131
Monroe6777177
Warren6694176
Pontotoc6664102
Neshoba6637206
Panola6531131
Marshall6467134
Bolivar6317148
Union602894
Pike5820152
Alcorn5669101
Lincoln5436135
George496879
Scott472898
Tippah469281
Prentiss467281
Leflore4658144
Itawamba4636105
Tate4588111
Adams4587119
Copiah448592
Simpson4446116
Yazoo444187
Wayne439772
Covington428894
Sunflower4239105
Marion4226108
Coahoma4160105
Leake408288
Newton381779
Grenada3707108
Stone360364
Tishomingo359792
Attala331589
Jasper329965
Winston314291
Clay308076
Chickasaw300367
Clarke292494
Calhoun279446
Holmes267987
Smith264050
Yalobusha234047
Tallahatchie228051
Greene219348
Walthall218763
Lawrence212940
Perry205556
Amite205156
Webster202946
Noxubee186740
Montgomery179656
Jefferson Davis171743
Carroll169138
Tunica159839
Benton148838
Kemper141941
Choctaw133426
Claiborne132737
Humphreys129538
Franklin120228
Quitman106428
Wilkinson105139
Jefferson94534
Sharkey64120
Issaquena1937
Unassigned00

Alabama Coronavirus Cases

Cases: 820011

Reported Deaths: 15407
CountyCasesDeaths
Jefferson1148361924
Mobile726091339
Madison52337697
Shelby37622350
Baldwin37258552
Tuscaloosa35117612
Montgomery34116740
Lee23536246
Calhoun22232488
Morgan20952378
Etowah19834500
Marshall18372304
Houston17390412
St. Clair16064339
Cullman15454293
Limestone15349199
Elmore15264286
Lauderdale14314295
Talladega13842283
DeKalb12662261
Walker11206370
Blount10197176
Autauga10047148
Jackson9874184
Coffee9211191
Dale8900185
Colbert8871201
Tallapoosa7089198
Escambia6775134
Covington6713183
Chilton6645162
Russell637059
Franklin5962105
Chambers5610142
Marion5007127
Dallas4975200
Pike4796106
Clarke475784
Geneva4574127
Winston4519103
Lawrence4324117
Bibb425286
Barbour357876
Marengo338390
Monroe331564
Randolph329764
Butler326496
Pickens316384
Henry312766
Hale311688
Cherokee302860
Fayette294180
Washington251651
Cleburne247760
Crenshaw245275
Clay243368
Macon234863
Lamar224447
Conecuh186253
Coosa180240
Lowndes175364
Wilcox168939
Bullock151744
Perry138840
Sumter133238
Greene126744
Choctaw88527
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Clear cool and dry to begin your weekend, but both afternoons should be a little bit above what we expect for this time of year temperature wise. Rain chances begin to return late Sunday night, with at least two chances for storms over the next week, summer could be strong.
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