Mississippi mental health patients have been jailed without being charged, new state law aims to change that

A Troubling Reality in the Magnolia State

In the heart of Mississippi, a disturbing trend has been unfolding. Hundreds of people, many suffering from mental health issues, have been jailed without ever being charged with a crime. This practice, often referred to as the "Lunacy Zone," has raised grave concerns about the state's approach to mental health care and the treatment of those in need.

The Numbers are Alarming

According to recent investigations by Mississippi Today and ProPublica, at least 2,000 people have been jailed while awaiting civil commitment for mental health treatment between 2019 and 2022. Of these, 1,200 individuals were held for more than three days, a period during which they can begin experiencing withdrawal symptoms from psychiatric medications. The lack of timely access to appropriate care has resulted in dire consequences, including the deaths of at least 13 people in jail since 2006, with nine of those deaths being suicides.

The Civil Commitment Process

The civil commitment process is designed to ensure that individuals who pose a risk to themselves or others receive the necessary mental health treatment. However, in Mississippi, this process often leads to prolonged stays in jail, where conditions are not conducive to healing. Instead of being treated in hospital settings, many are housed in local jails. Here, they are often subjected to the same stringent rules and harsh conditions as those accused of crimes. This can lead to further deterioration of their mental health and increased vulnerability to physical assault and theft of personal items.

The "Lunacy Zone" in Reality

The cells where these individuals are held have been nicknamed the "Lunacy Zone" by jail guards. In these environments, patients are frequently shackled and forced to wear jail scrubs. The lack of access to prescribed psychiatric medications and therapy exacerbates their conditions. One former superintendent of Parchman state penitentiary, Ed Hargett, noted that the treatment of those in the commitment process is often indistinguishable from that of violent offenders: "They become a prisoner just like the average person coming in that’s charged with a crime. Some of the staff that works in the jail, they don’t really know why they’re there… Then when they start acting out, naturally they deal with them just like they would with a violent offender".

Calls for Change

The situation has prompted widespread calls for reform. Mississippi lawmakers have taken steps to address this issue. In March, the House approved legislation (HB 1640) that aims to limit when people can be jailed solely on the basis of mental illness. The bill requires a specific judge’s order to hold someone in jail and caps the detention period at 24 hours unless a mental health professional requests an additional 24-hour hold.

Key Provisions of HB 1640

• Screening Requirement: Before initiating the commitment process, a staffer from a local community mental health center must assess the individual’s condition.
• Judge’s Order: A judge must determine that someone is “violent” to justify holding them in jail.
• Shorter Detention Period: Detention is capped at 24 hours, with provisions for extending it only under specific circumstances.
• Mental Health Treatment: The community mental health center must provide treatment while the individual is in jail.
• Hearing Timeline: The legislation ensures that a person gets a hearing within three to five days of their evaluation, compared to seven to ten days under current law.

Challenges Ahead

Despite these efforts, challenges persist. The implementation of HB 1640 is contingent on counties having certified holding facilities that meet health and safety standards, including suicide prevention protocols. Currently, only two facilities in the state are certified: the Chickasaw County Detention Center and the Magnolia Regional Health Center in Alcorn County.

Advocacy Groups' Concerns

While the legislation is seen as a step forward by some, advocacy groups continue to push for further changes. Disability Rights Mississippi plans to sue the state and several counties, arguing that the practice is unconstitutional. Mental health experts like Dr. Paul Appelbaum, a professor of psychiatry at Columbia University, also question the justification for putting someone who needs hospital-level care in jail, even for 24 hours: “There is no justification for putting someone who needs hospital-level care in jail, not even for 24 hours.”

State Response and Future Plans

The Department of Mental Health acknowledges the limitations of its authority over county facilities and courts. They are working to improve the process by educating county officials and encouraging certification of holding facilities. Additionally, there are plans to add more flexible admission hours at state hospitals to expedite patient admissions.

Conclusion

Mississippi's "Lunacy Zone" represents a stark national outlier. While every state has a civil commitment process, Mississippi stands alone in its practice of jailing people without charges while they await mental health treatment. The new legislation, HB 1640, aims to address this issue by ensuring more humane treatment and limiting the duration individuals can be held in jail. However, the path to reform remains complex, and continued advocacy is necessary to ensure that those in need receive the care they deserve in appropriate settings.

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References

1. "The ‘Lunacy Zone’: How Mississippi Jails 700 Mentally Ill People a Year Without Charges" by Mississippi Today and ProPublica, January 1, 2024, Link.

2. "House Approves Limits to Jailing People with Mental Illness Charged Without Crime" by Mississippi Today, March 12, 2024, Link.

3. "Mississippi Lawmakers Move to Limit Jail Detentions During Civil Commitment" by ProPublica, May 13, 2024, Link.

4. "Mississippians Jailed for Mental Illness: 5 Takeaways from Our Investigation" by Mississippi Today, January 4, 2024, Link.