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Mississippi’s troubled mental health system shows signs of repair, report says

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Mississippi’s troubled mental health system shows signs of repair, report says

Fewer Mississippians in mental health crises are stuck waiting in jail cells for a hospital bed each day than they were a year ago, but the state has yet to eliminate the troubling practice completely, according to a new report.

The latest data available shows that from December to mid-January, an average of 23 people in crisis waited for a hospital bed each day. Eight of those waited in jail, despite not being charged with any crime.

Those numbers were much higher not long ago: In the first quarter of this fiscal year, which started in July, an average of 72 people waited for a bed with 24 in a jail cell each day. Similar numbers had been reported for the prior fiscal year.

“The scope of progress is substantial,” wrote Dr. Michael Hogan, the author of a court-mandated biannual report on the state of Mississippi’s mental health system. “But the work is not complete, and some conditions remain that should satisfy no one.”

Hogan’s report comes as the result of a 2016 lawsuit filed against the state by the U.S. Department of Justice. A judge sided with the federal government in 2019, finding the state had violated the Americans with Disabilities Act by separating people with mental illness in hospitals from their homes and families. Hogan, a former New York State Commissioner on Mental Health, is now tasked with writing the twice-yearly reports on the state’s compliance with the lawsuit’s consent agreement as a court monitor.

Ultimately, the report found DMH was compliant or in partial compliance with all key issues pointed out in the agreement.

Wendy Bailey, executive director of the Department of Mental Health, speaks to an audience during the Mental Health Meet Up at the Two Mississippi Museums in Jackson, Miss., Wednesday, May 26, 2022.

“The Mississippi system could fairly be described as the most unbalanced state system in terms of preferences for institutional care in the country,” Hogan wrote, referring to alarming issues in patient care first documented by the DOJ in 2011. “As this report is being written, a decade of attention means this imbalance in care has been substantially addressed.”

Late in 2022, DMH reopened a 30-bed unit at East Mississippi State Hospital that had been closed because of staffing shortages. A closed 20-bed unit at Mississippi State Hospital was reopened in January. The added beds contributed to keeping people with mental illness out of jail cells.

Patient counts that the department supplied to Mississippi Today show the number of people waiting in jail for a state hospital bed has been steadily declining for months.

“This is not a small undertaking and is due to the unwavering dedication of an incredible team of staff at DMH Central Office, the four state hospitals, and community mental health centers who strive daily to improve the state’s system of care,” the department’s Executive Director Wendy Bailey told Mississippi Today in a statement, “and to state leaders and legislators who are supporting and funding the efforts.”

The latest report, the third ever, was published this week and charted much of the Mississippi’s Department of Mental Health’s progress in care access across the state. However, lingering staffing retention troubles, data collection and use, patient outreach and communication issues, and jail stays remain sore points in need of improvement, according to Hogan’s report.

When community mental health centers were created 40 years ago – each with their own designated region – they operated with little oversight from the DMH, which focused on running state hospitals. As a result, statewide mental health care was often disjointed or inconsistent.

Hogan’s report studied discharge documentation to better understand how often patients across the state were getting intervention to lessen the likelihood they hit a severe crisis point again requiring inpatient treatment.

While entering inpatient treatment can help stabilize severe mental illness, it doesn’t cure it, Hogan points out. Follow ups are needed to prevent relapses and readmission. Hogan and his team found that community mental health centers contacted a hospitalized client, while the individual was in the hospital, at a rate of 45%.

He said “lukewarm success” in establishing relationships while people are still hospitalized makes impacts whether they attend a follow-up appointment after discharge. The overview found that initial visits were completed in 59 of 89 incidents they could track – about 66%. The rate of follow-up and engagement efforts were adequate in 56 of 87 cases they could track – or 64%.

“Some Regions do a good job on some elements and all do a good job some of the time,” Hogan wrote. “But consistency is lacking.”

Workers like peer support specialists who help contact patients after discharge are often paid at or below what a fast food worker can make, Hogan pointed out. The staffing shortages among these roles were higher than that of other vacancies, such as registered nurses and therapists.

Bailey acknowledged the same hardships but hopes average annual salaries for those support staff positions reach $30,000 by fiscal year 2025. The department has asked the legislature for more funding to help raise wages and improve retention rates.

“We are not only dealing with competition from the private sector, we are dealing with burnout from staff dealing with patients who require 24/7 care who have significant mental and behavioral challenges,” Bailey said in her statement.

Hogan’s first report, issued in March, described Mississippians sometimes waiting weeks in jail for a bed at a state hospital. He also found that some people admitted to state hospitals did not have a serious mental illness – meaning the hospital wasn’t the right place for them and they were occupying a bed that could have been used by someone else.

In his second report, he surveyed North Mississippi State Hospital and community mental health centers in the northern part of the state and did not find patients admitted without a serious mental illness diagnosis.

Bailey said that DMH expects to also see more positive results from people now working as court liaisons who help staff identify community treatment options. The department has also grown programs that provide transitional housing, supported employment and community outreach over the last several years.

Recently the agency began fidelity monitoring, or progress monitoring, of its mobile crisis teams, another positive step Hogan recognized.

“Are there improvements still to be made?” Bailey posed, reflecting on state’s mental health system. “Yes.”

“Has progress been accomplished? Absolutely.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1961

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mississippitoday.org – Jerry Mitchell – 2024-11-22 07:00:00

Nov. 22, 1961

Credit: Courtesy: Georgia Tourism & Travel

Five Black students, made up of NAACP Youth Council members and two SNCC volunteers from Albany State College, were arrested after entering the white waiting room of the Trailways station in Albany, Georgia. 

The council members bonded out of jail, but the SNCC volunteers, Bertha Gober and Blanton Hall declined bail and “chose to remain in jail over the holidays to dramatize their demand for justice,” according to SNCC Digital Gateway. The president of Albany State College expelled them. 

Gober became one of SNCC’s Freedom Singers and wrote the song, “We’ll Never Turn Back,” after the 1961 killing of Herbert Lee in Mississippi. The tune became SNCC’s anthem. 

After her release from jail, Gober joined other students, and police arrested her and other demonstrators. Back in the same jail, she sang to the police chief and mayor to open the cells, “I hear God’s children praying in jail, ‘Freedom, freedom, freedom.’” 

Albany State suspended another student, Bernice Reagon, after she joined SNCC. She poured herself into the civil rights movement and later formed the Grammy-nominated a cappella group Sweet Honey in the Rock to educate and empower the audience and community. 

“When I opened my mouth and began to sing, there was a force and power within myself I had never heard before,” a power she said she did not know she had. 

Other members of the Freedom Singers included Cordell Reagon, Bernice Johnson, Dorothy Vallis, Rutha Harris, Bernard Lafayette and Charles Neblett. On the third anniversary of the sit-in movement in 1963, they performed at Carnegie Hall. 

“This is a singing movement,” SNCC leader James Forman told a reporter. “The songs help. Without them, it would be ugly.” 

Today, the Albany Civil Rights Institute houses exhibits on these protesters, Martin Luther King Jr. and others who joined the Albany Movement.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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IHL deletes the word ‘diversity’ from its policies

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mississippitoday.org – Molly Minta – 2024-11-21 14:32:00

The governing board of Mississippi’s public universities voted Thursday to delete the word “diversity” from several policies, including a requirement that the board evaluate university presidents on campus diversity outcomes.

Though the Legislature has not passed a bill targeting diversity, equity and inclusion initiatives in higher education, the Institutions of Higher Learning Board of Trustees approved the changes “in order to ensure continued compliance with state and federal law,” according to the board book

The move comes on the heels of the re-election of former President Donald Trump and after several universities in Mississippi have renamed their diversity offices. Earlier this year, the IHL board approved changes to the University of Southern Mississippi’s mission and vision statements that removed the words “diverse” and “inclusiveness.”

In an email, John Sewell, IHL’s communications director, did not respond to several questions about the policy changes but wrote that the board’s goal was to “reinforce our commitment to ensuring students have access to the best education possible, supported by world-class faculty and staff.”

“The end goal is to support all students, and to make sure they graduate fully prepared to enter the workforce, hopefully in Mississippi,” Sewell added.

On Thursday, trustees approved the changes without discussion after a first reading by Harold Pizzetta, the associate commissioner for legal affairs and risk management. But Sewell wrote in an email that the board discussed the policy amendments in open session two months ago during its retreat in Meridian, more than an hour away from the board’s normal meeting location in Jackson.

IHL often uses these retreats, which unlike its regular board meetings aren’t livestreamed and are rarely attended by members of the public outside of the occasional reporter, to discuss potentially controversial policy changes.

Last year, the board had a spirited discussion about a policy change that would have increased its oversight of off-campus programs during its retreat at the White House Hotel in Biloxi. In 2022, during a retreat that also took place in Meridian, trustees discussed changing the board’s tenure policies. At both retreats, a Mississippi Today reporter was the only member of the public to witness the discussions.

The changes to IHL’s diversity policy echo a shift, particularly at colleges and universities in conservative states, from concepts like diversity in favor of “access” and “opportunity.” In higher education, the term “diversity, equity and inclusion” has traditionally referred to a range of efforts to comply with civil rights laws and foster a sense of on-campus belonging among minority populations.

But in recent years, conservative politicians have contended that DEI programs are wasteful spending and racist. A bill to ban state funding for DEI in Mississippi died earlier this year, but at least 10 other states have passed laws seeking to end or restrict such initiatives at state agencies, including publicly funded universities, according to ABC News.

In Mississippi, the word “diversity” first appeared in IHL’s policies in 1998. The diversity statement was adopted in 2005 and amended in 2013. 

The board’s vote on Thursday turned the diversity statement, which was deleted in its entirety, into a “statement on higher education access and success” according to the board book. 

“One of the strengths of Mississippi is the diversity of its people,” the diversity statement read. “This diversity enriches higher education and contributes to the capacity that our students develop for living in a multicultural and interdependent world.”

Significantly, the diversity statement required the IHL board to evaluate the university presidents and the higher learning commissioner on diversity outcomes. 

The statement also included system-wide goals — some of which it is unclear if the board has achieved — to increase the enrollment and graduation rates of minority students, employ more underrepresented faculty, staff and administrators, and increase the use of minority-owned contractors and vendors. 

Sewell did not respond to questions about if IHL has met those goals or if the board will continue to evaluate presidents on diversity outcomes.

In the new policy, those requirements were replaced with two paragraphs about the importance of respectful dialogue on campus and access to higher education for all Mississippians. 

“We encourage all members of the academic community to engage in respectful, meaningful discourse with the aim of promoting critical thinking in the pursuit of knowledge, a deeper understanding of the human condition, and the development of character,” the new policy reads. “All students should be supported in their educational journey through programming and services designed to have a positive effect on their individual academic performance, retention, and graduation.” 

Also excised was a policy that listed common characteristics of universities in Mississippi, including “a commitment to ethnic and gender diversity,” among others. Another policy on institutional scholarships was also edited to remove a clause that required such programs to “promote diversity.” 

“IHL is committed to higher education access and success among all populations to assist the state of Mississippi in meeting its enrollment and degree completion goals, as well as building a highly-skilled workforce,” the institutional scholarship policy now reads. 

The board also approved a change that requires the universities to review their institutional mission statements on an annual basis.

A policy on “planning principles” will continue to include the word “diverse,” and a policy that states the presidential search advisory committees will “be representative in terms of diversity” was left unchanged.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Closed St. Dominic’s mental health beds to reopen in December under new management

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mississippitoday.org – Gwen Dilworth – 2024-11-21 13:54:00

The shuttered St. Dominic’s mental health unit will reopen under the management of a for-profit, Texas-based company next month. 

Oceans Behavioral Hospital Jackson, a 77-bed facility, will provide inpatient behavioral health services to adults and seniors and add intensive outpatient treatment services next year. 

“Jackson continuously ranks as one of the cities for our company that shows one of the greatest needs in terms of behavioral health,” Oceans Healthcare CEO Stuart Archer told Mississippi Today at a ribbon cutting ceremony at its location on St. Dominic’s campus Thursday. “…There’s been an outcry for high quality care.” 

St. Dominic’s 83-bed mental health unit closed suddenly in June 2023, citing “substantial financial challenges.”

Merit Health Central, which operates a 71-bed psychiatric health hospital unit in Jackson, sued Oceans in March, arguing that the new hospital violated the law by using a workaround to avoid a State Health Department requirement that the hospital spend at least 17% of its gross patient revenue on indigent and charity care.

Without a required threshold for this care, Merit Health Central will shoulder the burden of treating more non-paying patients, the hospital in South Jackson argued. 

The suit, which also names St. Dominic’s Hospital and the Mississippi Department of Health as defendants, awaits a ruling from Hinds County Chancery Court Judge Tametrice Hodges-Linzey next year. 

The complaint does not bar Oceans from moving forward with its plans to reopen, said Archer.

A hallway inside Oceans Behavioral Hospital in Jackson, Miss., is seen on Thursday, Nov. 21, 2024, during the facility’s grand opening. Credit: Eric Shelton/Mississippi Today

Oceans operates two other mental health facilities in Mississippi and over 30 other locations in Louisiana, Oklahoma and Texas. 

“Oceans is very important to the Coast, to Tupelo, and it’s important right here in this building. It’s part of the state of Mississippi’s response to making sure people receive adequate mental health care in Mississippi,” said Lt. Governor Delbert Hosemann at the Nov. 21 ribbon cutting.

Some community leaders have been critical of the facility. 

“Oceans plans to duplicate existing services available to insured patients while ignoring the underserved and indigent population in need,” wrote Hinds County Sheriff Tyree Jones in an Oct. 1 letter provided to Mississippi Today by Merit Health. 

Massachusetts-based Webster Equity Partners, a private-equity firm with a number of investments in health care, bought Oceans in 2022. St. Dominic’s is owned by Louisiana-based Catholic nonprofit Franciscan Missionaries of Our Lady Health System.

Oceans first filed a “certificate of need” application to reopen the St. Dominic’s mental health unit in October 2023. 

Mississippi’s certificate of need law requires medical facilities to receive approval from the state before opening a new health care center to demonstrate there is a need for its services. 

The Department of Health approved the application under the condition that the hospital spend at least 17% of its patient revenue on free or low-cost medical care for low-income individuals – far more than the two percent it proposed. 

Stuart Archer, CEO of Oceans Healthcare, speaks during the grand opening of Oceans Behavioral Hospital in Jackson, Miss., on Thursday, Nov. 21, 2024. Credit: Eric Shelton/Mississippi Today

Oceans projected in its application that the hospital’s profit would equal $2.6 million in its third year, and it would spend $341,103 on charity care.

Merit Health contested the conditional approval, arguing that because its mental health unit provides 22% charity care, Oceans providing less would have a “significant adverse effect” on Merit by diverting more patients without insurance or unable to pay for care to its beds. 

Oceans and St. Dominic’s also opposed the state’s charity care condition, arguing that 17% was an unreasonable figure. 

But before a public hearing could be held on the matter, Oceans and St. Dominic’s filed for a “change of ownership,” bypassing the certificate of need process entirely. The state approved the application 11 days later

Merit Health Central then sued Oceans, St. Dominic and the State Department of Health, seeking to nullify the change of ownership. 

“The (change of ownership) filing and DOH approval … are nothing more than an ‘end run’ around CON law,” wrote Merit Health in the complaint. 

Oceans, St. Dominic’s and the Mississippi Department of Health have filed motions to dismiss the case. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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