United States v. Mississippi

The Department of Justice (DOJ) (plaintiff) filed suit against the State of Mississippi (state) (defendant) for violating the integration mandate of Title II of the Americans with Disabilities Act (ADA). The DOJ argued that the state overly relied on state psychiatric hospitals to treat mentally disabled citizens, which denied the citizens the most integrated setting for treatment services. The record established that the state’s current mental-health structure consisted of both a community-based services framework and a system of state hospitals. However, the community-based services were poorly implemented, with some services present in only 14 out of 82 counties, others that failed to respond to crisis calls as intended, and all services being under-enrolled and failing to serve the community. Most individuals with mental disabilities were sent to state hospitals, often more than once. The state continued to invest in state hospital beds and resources, despite assurances that it was moving toward community-based care. The DOJ formed a clinical review team (CRT) survey of over 100 of the hospitalized patients and found that the patients would benefit from community-based care, that most patients were unopposed to community services, and that community services would cost the same amount as the state-hospital program.