Appeals court tosses order requiring Mississippi to change mental health system

[September 21, 2023]  By Brendan Pierson

(Reuters) - A U.S. appeals court on Wednesday threw out a lower court order that required the state of Mississippi to make changes to its mental health system to avoid the risk of unnecessarily institutionalizing people with mental illness.

In a unanimous opinion, a three-judge panel of the 5th U.S. Circuit Court of Appeals found that the 2021 order, which came in response to a lawsuit by the U.S. Justice Department, went too far in requiring "sweeping modifications" of state policy.

That ruling from U.S. District Judge Carlton Reeves in Jackson required the state to fund housing vouchers and hire specialists to help people with mental illness live and receive treatment in the community, rather than in state hospitals. Reeves, who was appointed by Democratic former President Barack Obama, also required the state to report to a court-appointed monitor.

"This novel plan of reconstruction fails on many levels," Circuit Judge Edith Jones wrote for the panel. Jones and the other two judges on the panel, Leslie Southwick and James Ho, were all appointed by Republican presidents.

"We are pleased that the 5th 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," Mississippi Attorney General Lynn Fitch, a Republican, said in a statement.

The Justice Department declined to comment.

The department began investigating Mississippi in 2011, during the Obama administration, and sued the state in 2016. It alleged that the state violated the Americans with Disabilities Act (ADA) by institutionalizing people unnecessarily.

In siding with the department, Reeves pointed to a survey by government experts of people who had been institutionalized, which concluded that many could have avoided institutionalization with adequate community-based care.

The judge said the state's system put all people with mental illness at heightened risk of being institutionalized, which amounted to illegal discrimination under the ADA.

The 5th Circuit said Wednesday, however, that merely heightened risk, rather than actual institutionalization, could not be the basis for an ADA discrimination claim.

It also said that Reeves' "sweeping" order was "intrusive and unworkable."

(Reporting by Brendan Pierson in New York; Editing by Alexia Garamfalvi and Stephen Coates)

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