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How many are jailed awaiting mental health treatment in Mississippi? We still don’t know

No one in Mississippi knows exactly how often people are jailed without criminal charges while they await psychiatric evaluations and treatment through the civil commitment process. That remains true today despite a 2023 law that aimed to close the data gap. 

Mississippi Today and ProPublica reported last year that people were jailed without criminal charges at least 2,000 times from 2019 through 2022 in just 19 of the state’s 82 counties. At least 14 people have died after being jailed during the commitment process since 2006, and no other state routinely jails people without criminal charges for days or weeks at a time while they await help.

Sheriffs have raised the alarm about the practice for decades. Leaders of the Department of Mental Health have said for years that they want to see it stopped.

And though the Department of Mental Health published new data in recent years, basic facts remain unclear.

The now-overturned remedial order in a federal lawsuit over the state’s mental health services required the agency to publish data on how often people are admitted to a state hospital directly from jail. It has done so for the last two fiscal years, reporting a total of more than 1,500 people admitted from jail.

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But that doesn’t include anyone who goes to jail before being transported to another type of treatment facility, or sent home because doctors found they didn’t need inpatient treatment at all. The agency data only counts the days people spend in jail after their court hearings, which could take place seven to 10 days after the process begins, or longer if a county does not follow DMH guidelines. 

DMH leaders have known about the data gap for years. In 2019, then-director Diana Mikula testified in federal court that the agency had no way of tracking people jailed during the commitment process before a judge ordered them admitted to a state hospital.

Last year, lawmakers sought to collect more information about jail detentions during the civil commitment process. They passed mental health legislation that included a requirement that counties report certain information to the Department of Mental Health. 

But the first report since the law passed doesn’t shed much light on the basic question of how often counties are detaining people in jail at any stage of the commitment process. Mississippi Today obtained the report through a public records request.

Twenty-four counties did not submit data in time to be included, with some chancery clerks citing technical issues and others saying they simply didn’t get around to it. And the agency didn’t directly ask counties to report exactly how often they jailed people during the process. 

Instead, it asked counties to use a registry of available beds at crisis stabilization units – 13 facilities around the state designed to provide short-term treatment and to keep people out of jail during the commitment process – to report how often they jailed people after a crisis unit turned them away. But some counties don’t contact their local crisis units until late in the commitment process, after people have already been jailed. 

For example, in DeSoto County, unless someone has health insurance, they are usually jailed until their hearing. Only then does the county contact a CSU to find a bed. The closest is about 40 minutes from Hernando. DeSoto County chancery clerk Misty Heffner told Mississippi Today she tallied zero CSU denials. The current data collection system only gathers information about jail placements that follow a CSU denial. 

Mississippi Today and ProPublica previously found that DeSoto County jailed nearly 500 people with no criminal charges from 2019 through 2022 as they awaited evaluations and treatment for either mental illness or drug or alcohol addiction. (DeSoto was not included in the report; Heffner said there were software issues with the portal and she is now submitting the information.)

Some counties didn’t provide complete information, in some cases reporting denials by the CSUs but not providing the reasons given for the denials, or reporting CSU denials without reporting where the person went instead. 

Rep. Sam Creekmore, R-New Albany, the author of HB 1222 last year, told Mississippi Today that he saw inconsistencies in the first round of reporting and thinks there was a “learning curve.” 

“But I think going forward we’ll be able to see a clearer picture,” he said. 

Adam Moore, a spokesman for the Department of Mental Health, said in an email that the agency hopes that inconsistencies and questions will be resolved for the second round of reporting, which has a deadline of Jan. 30.

“It is our goal that people in need of mental health treatment avoid having to wait for care and thus avoid jail placements when they have not committed a crime,” he said.

HB 1222 contained two different sections discussing data reporting requirements. Section 8 says counties must report to DMH where people wait both before and after a civil commitment hearing. “The data shall include information concerning individuals held in jails and the cost of holding such individuals,” the law says, adding that the agency is “authorized to determine the specific data to be submitted.” It set a compliance deadline of Dec. 1, 2023. 

Section 9 lists specific information counties must report every quarter, including the number of commitment affidavits filed, hearings held, and court orders for treatment. That section also requires chancery clerks to report how many crisis stabilization unit denials they receive and what they do after receiving a denial, including placing someone in jail. 

DMH communicated with counties in accordance with Section 9, but did not collect the more general information described in Section 8. It did not ask counties to distinguish between pre-hearing and post-hearing holding locations, nor to report jail detentions in general or the cost of those detentions.

Moore said that Section 8 appeared to be a one-time reporting requirement. The deadline of Dec. 1, 2023 has now passed.

“DMH is continuing to work through the most effective way to collect this data, given the difficulties that have been experienced with inputting information into the bed registry, which currently does not differentiate between jail placements prior to and after a commitment hearing,” he wrote. 

Moore said that despite challenges with the bed registry, the agency believes it is the “most effective” way to collect the data and hopes to make changes so that counties can use it to distinguish between pre-hearing and post-hearing placements.

“We do not believe that requesting individual emails or faxes from Mississippi’s 82 counties is an effective way to gather data,” he wrote. “Our preference is to utilize the bed registry for counties to submit this information, which not only provides an effective process but requires them to look at the bed registry to become familiar with open and available beds in their service area.”

He added that the agency has expanded community services since 2019 and that state hospital admissions have declined by 11%, both of which were objectives of the remedial order.

Mississippi Today reached out to all of the chancery clerks in the 24 counties that did not submit data in time to be included in the report. Seven said they had had issues with the technology but that they were working with DMH to resolve them and would submit the data moving forward. 

Moore said the agency sent reminder emails in September, October and November and also reached out to each county that had had technical issues, accepting a spreadsheet document if clerks were unable to report the information through the bed registry. 

Five said that they were new clerks still getting up to speed on the roles. One clerk said he hadn’t known about the law. Others said they just didn’t have time to get to it. 

An employee for Monroe County chancery clerk Ronnie Boozer said in an email that “once he realized that he had missed the deadline for sending the data, he didn’t try any further.”

Eight clerks did not respond. 

“Ignorance of the law is no excuse,” Creekmore said, adding that he was “disappointed, but not surprised” that some counties didn’t meet the statutory deadline to report. 

“Based on our findings in researching mental health in the state of Mississippi there are inconsistencies all across the state,” he said. “Everybody in each region seems to do it a little bit different … It’ll be the Department of Mental Health’s responsibility to get these people on the same page, and their community mental health centers, which are held accountable by their commissioners.” 

Creekmore said that if lawmakers need to clarify language in the statute around reporting requirements, “we’ll do it.” 

Wilkinson County Chancery Clerk Nakia Stewart Anderson said her county’s data wasn’t included because she had issues with the reporting system. The Department of Mental Health gave her the opportunity to report the data on paper, but she didn’t have time amid a surgery and “a lot of other deadlines.” 

She said she would prefer to be able to report the information through Mississippi Electronic Courts, where she already records civil commitment case information. 

“That would make life a whole lot easier, especially for our small counties,” she said.

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