For years, Mississippians have been jailed without criminal charges while they await mental health treatment.
This session, lawmakers will propose bills aiming to significantly curtail that practice, legislators said in interviews last week. And in the House, the measures will be sponsored by the chair and vice chair of the Public Health and Human Services Committee, to which at least some of the proposals may be referred.
“We can’t send people with mental illness to jail because the county doesn’t want to pay” for an alternative, said Rep. Kevin Felsher, R-Biloxi, vice chair of that committee.
No legislation has been filed so far. But Felsher and Rep. Sam Creekmore, R-New Albany, the new public health chairman, said they plan to introduce a slate of bills that together would address multiple aspects of the civil commitment process and impose new limits on the jailing of people without criminal charges.
The Department of Mental Health supports those efforts, Director Wendy Bailey said in an email.
Last year, Mississippi Today and ProPublica reported that hundreds of Mississippians are jailed every year without criminal charges while they await mental health treatment through the civil commitment process. At least 14 Mississippians have died following incarceration during commitment proceedings since 2006, and no other state routinely jails people for days or weeks without charges during the commitment process.
Currently, the state’s commitment code says people detained before their commitment hearings “shall not be held in jail unless the court finds that there is no reasonable alternative.”
Felsher said one of his bills will impose stricter limits on the use of jail.
“You have to look for every other alternative before jail would become an option,” he said.
In some counties, Creekmore said, jail is “the default place to put them.”
Bailey told Mississippi Today that her agency had reviewed commitment statutes in states including Minnesota, Tennessee, Alabama, South Dakota, and Virginia. Alabama, Tennessee and Virginia prohibit jailing people without criminal charges during the process. Statues in Minnesota and South Dakota strictly limit it.
“Limits that could be considered include requirements such as a chancellor must issue a specific order for someone to be held in jail, that the person cannot be held in jail unless actively violent, the local mental health authority would offer to provide services while someone is held in jail and limiting the amount of time the person is held in jail,” Bailey wrote.
Bailey has emphasized that she opposes jailing people without criminal charges while they await treatment.
Last year, Creekmore sponsored HB 1222, which became law and requires more mental health training for law enforcement and expanded a court liaison program that aims to help families find treatment options other than civil commitment, if appropriate.
Jailed for lack of health insurance?
Felsher also plans to reintroduce legislation that failed last year, establishing that a person being committed can’t be held in jail just because they are indigent and lack health insurance to pay for treatment. That bill would have required counties to pay for a person’s treatment after their hearing if a publicly funded state hospital or crisis stabilization unit bed is unavailable, capping costs at the Medicaid reimbursement rate.
Harrison County, part of which Felsher represents, and some other counties in the state, such as Neshoba, already pay for private treatment if a public bed is unavailable.
The measures could trigger a fight with counties, many of which are reluctant to spend money to treat people instead of jailing them while they wait for a state-funded bed.
For example, Lee County Chancery Clerk Bill Benson said in an interview that it costs about $40 per day to jail someone in his county. When a county sends a resident to a private hospital, it pays more than $500 a day, according to contracts Mississippi Today reviewed.
At a hearing in November 2022, Felsher asked Benson whether he would support his county paying hospitals to treat county residents as an alternative to jail.
“My supervisors would hang me … if I said yes,” Benson said.
On Thursday, Benson said cost is still an issue. He thinks county leaders would want some assurance that they won’t have to pay for long hospitalizations of a week or more.
“And who is going to be responsible for finding that place to house them?” he said.
According to data from the Department of Mental Health, Lee County jailed 25 people before their admission to a state hospital in fiscal year 2023, detaining them for more than five days on average (a figure that doesn’t include the days they likely spent in jail before their hearings).
Felsher said he thinks county supervisors support keeping people out of jail without criminal charges but could be concerned about costs. He said he hopes to improve access to public treatment so that counties aren’t on the hook.
A pilot project and more
Creekmore said he plans to sponsor a measure requiring an evaluation before commitment paperwork can be filed—a change that would mean someone can’t be detained unless at least one mental health provider has recommended it. Currently, a person can be detained on the basis of a sworn affidavit by anyone alleging that the individual is dangerous to themselves or others because of a mental illness.
Creekmore said he also plans to propose a pilot project that would eliminate jail detentions in participating counties by designating the local crisis stabilization units as the only place deputies can take someone they pick up after an affidavit has been filed. If the person was violent, a deputy would remain with them at the facility for some time period instead of taking them to jail, as sometimes happens now.
“If that can be successful, then maybe that can simplify it for all regions,” Creekmore said.
The proposed pilot would include Region 8 and Region 10, the community mental health centers serving a total of 14 counties around Jackson and east central Mississippi
“The involuntary commitment process is a heart wrenching experience and we, as a society, have a moral and ethical responsibility to put forth our best effort to help these hurting families identify and access the most humane and appropriate environment in our communities,” said Dave Van, the executive director of Region 8, in a text message to Mississippi Today.
A summary of mental health proposals lawmakers are discussing:
Proposals addressing civil commitment:
- Stricter limits on jail detentions
- Requiring counties to pay for private treatment if a public bed is unavailable after a judge has ordered someone to receive psychiatric treatment, and capping county costs at the Medicaid rate
- Prohibiting jailing someone during the commitment process because they can’t pay for treatment
- Requiring a pre-evaluation before someone can be detained
- A pilot project to designate the crisis stabilization units in two regions as a “single point of entry” where deputies take people after picking them up and stay with them if necessary, aiming to eliminate jail detentions
Other mental health proposals
- Expanding Medicaid coverage for people with serious mental illness to pay for supportive housing, aiming to bring new facilities to Mississippi
- Establishing a mental health peer support program to address suicides among teenagers
- Requiring the 988 suicide and crisis lifeline to be printed on all state IDs, including student IDs
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