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Fifth Circuit Court Supports State in Longstanding Mental Health Lawsuit

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Mississippi’s mental health system has battled the United States Department of Justice in court for over a decade. In 2011, the United States issued a comprehensive letter of findings about Mississippi’s mental health system for children, adults and all people with intellectual disabilities, alleging the state violated the rights of people with mental health disabilities and segregated those people into institutions.

The two sides negotiated until the negotiations failed in 2015. The United States sued Mississippi in 2016 for its adult mental health system. The case went to trial in the Southern District of Mississippi in 2019, and Judge Carlton Reeves ruled in U.S. v. Mississippi that Mississippi’s mental health system discriminates against people with mental illness in violation of the Americans with Disabilities Act.

The two sides could not agree upon a remedy. After many months of discussions between the parties, Judge Reeves then adopted the remedy that the Monitor, Dr. Michael Hogan, proposed. He based the remedy mainly on the Department of Mental Health’s standards, services and recommendations. Both sides began working to implement the remedy, and Mississippi also appealed the case to the Fifth Circuit.

On September 20, 2023, a panel of three justices from the Fifth Circuit Court of Appeals reversed the District Court’s ruling, stating:

Title II of the Americans with Disability Act (“ADA”) prohibits “discrimination” against “qualified individual[s] with a disability.” 42 U.S.C. § 12132. The Act authorizes “any person alleging discrimination” to sue. 42 U.S.C. § 12133 (emphasis added). The United States filed suit against the state of Mississippi, alleging that its entire mental health care system violated the “integration mandate” prescribed by 28 C.F.R. § 35.130(d) and reified in the Supreme Court’s decision, Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 119 S. Ct. 2176 (1999). The district court conducted a trial, upheld the federal government’s novel theory of liability, and ordered not only sweeping modifications to the state’s system but also the indefinite appointment of a monitor who, along with the federal government and the court itself, would all oversee the system. This novel plan of reconstruction fails on many levels. We REVERSE.

The United States can now choose to let the decision stand or appeal the decision to the full panel of judges on the Fifth Circuit. The U.S. could also appeal directly to the U.S. Supreme Court.

On September 22, Judge Reeves ordered Court Monitor Dr. Michael Hogan and his team to finish their work on this case in the next 14 days.

Attorney General Fitch shared this statement about the Fifth Circuit’s ruling:

We are pleased that the Fifth Circuit Court of Appeals has reversed the lower court’s ruling that gave the federal government the ability to dictate the way Mississippi provides mental healthcare to its citizens. As the court noted in its opinion, the “district court’s sweeping injunction is ‘intrusive and unworkable,’ and requires far more than what might have been required to comply with” federal law.

For too long, federal agencies have used the threat of legal action based on “novel theories] of liability,” like those that started this case, to coerce Mississippi and other states into adopting their preferred policies and budget priorities. This opinion is a good reminder to Washington that the people have the right to speak through their state elected leaders to set their own priorities.

Stewart Rutledge, Chair of the Board of Mental Health, stated:
 
“Mississippi chose to fight, and we fought for our citizens who desperately need mental health services. Conversely, the US Department of Justice spent the last twenty years bleeding mental health systems nationwide in bare pursuit of a win. Mississippi took a huge risk standing up to this bullying, but with this victory, Mississippi – and the rest of the states – can put their full resources back toward serving our fellow citizens in need.”

This is the Mississippi Department of Mental Health’s Statement. 

Additional Coverage:
 
Statement from Disability Rights Mississippi

Appeals court rules against federal government in Mississippi mental health case, The Center Square, Steve Wilson

‘Mississippi chose to fight’: Court overturns Justice Department efforts to overhaul state’s mental health system Mississippi Today, Isabelle Taft

Federal appeals court reverses ruling that found Mississippi discriminated in mental health care Associated Press, Emily Wagster Pettus

Court: Mississippi Not Guilty of Mental Illness Discrimination, Mississippi Free Press, Ashton Pittman

Appeals Court rules in favor of Mississippi in mental health lawsuit brought by U.S. government
Magnolia Tribune, Sarah Ulmer

We will include a discussion of the appeal court’s ruling and avenues families have to give feedback into the mental health system during our virtual Leadership Coaching and Policy Discussion on September 27 from noon to 1:00 p.m. CDT.

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