/Mississippi mental health agency withholds records

Mississippi mental health agency withholds records

These facilities had to deal with staff shortages that were similar to those in Mississippi hospitals. No matter how many of their colleagues were lost, the staff that remained had to be available to provide 24-hour care for residents with severe mental illness or intellectual disabilities. The group sought records from the Mississippi Department of Mental Health, just like other state counterparts. This was to gain a better understanding of the operations inside these facilities. The Department, however, claimed that the group was too broad and blocked the request. Now, the two groups are battling it out in court. Disability Rights Mississippi, the state’s “protection & advocacy (P&A system) is charged by Congress with representing people with disabilities and investigating complaints of abuse or neglect in programs that provide them. They sent similar letters to 10 mental health and behavioral facilities across the state asking for information on recent incidents and to continue to receive them in the future. According to Polly Tribble, the goal was to find patterns and understand the experiences of residents. DMH refused to release the reports. The state lawyers claimed that the group’s “boilerplate” letters did not demonstrate sufficient probable cause to warrant a systematic investigation of the facilities. Adam Moore, communications director at the Department, stated that he cannot discuss ongoing litigation. A case in progress is also not being addressed by the attorney general’s office. DMH lawyers claim that the organization simply wanted to go on a fishing trip with its request for records. The DMH lawyers claim that the letters didn’t mention the staffing issue or the suspicion of neglect or abuse and didn’t justify access to incident reports. DRMS and other state counterparts see the situation as straightforward. Federal law grants these organizations broad investigative, monitoring and oversight authority. Part of this work is reviewing incident reports. Tribble wonders why DMH is trying to withhold reports. She said, “It makes one wonder if they are trying to hide anything.” Geraldo Rivera, Fox News host, is the first to introduce the P&A system. Rivera, an investigative reporter at ABC News in New York fifty years ago. Rivera took a camera with him to Willowbrook State School on Staten Island, which is a school for people with disabilities. He revealed the neglect and abuse that he witnessed there. This led to widespread outrage among the public and Congress passing laws creating P&A system and empowering them to advocate for people with disabilities. Each state has a P&A system that allows staff to visit mental health facilities and speak with patients and staff. They want to be a resource for families and a place where they can go to raise concerns about abuse or neglect. Dave Boyer is the National Disability Rights Network’s managing attorney for community integration. This D.C.-based umbrella organization for the P&A system said that they have broad access to information about facilities. In the past 40 years, he estimated that they have faced between 150 to 200 court cases challenging their access to records and information. The court sided with P&A in all but a handful of cases. He stated that it was very rare for a P&A case to be lost. Mississippi’s mental hospitals are regularly visited by staff from DRMS. Sometimes, investigators find problems on their own. Sometimes, investigators receive calls from family and staff. This is how it can work according to a document that was filed in the lawsuit. On November 10, DRMS notified South Mississippi Regional Center in Long Beach it was opening an investigation into the treatment a resident received. This investigation was separate from the larger one that is at the heart of the lawsuit. The letter states that a contract employee claimed she had seen dried feces on the heads, ears, and cheeks of residents who were brought in for routine grooming. The resident was also seen by the same contract employee three months later. “Her scalp was infected and raw.” “The nurse was informed by the contract employee that the shampoo used was alcohol-based and likely to cause great pain when applied to her damaged scalp.” The resident is not verbal. A visitor to the facility asked for information about the area residents get grooming services. The letter stated that it was dirty and in poor condition. DRMS requested records and interviews from staff to conduct its investigation. DRMS does not focus on every resident or incident. Tribble stated that DRMS began receiving reports last year about staff shortages leading to neglect at DMH facility. DMH director Wendy Bailey also raised concerns about staffing shortages. She stated that staffing problems at both state-run facilities as well as community mental health centers are affecting care in her December presentation to a legislative subcommittee that allocated funds from the American Rescue Plan Act. Certain facilities, such as the crisis stabilization units could decrease the number of beds available to ensure adequate staffing. This is not possible for facilities that serve people with intellectual or developmental disabilities. She stated that you cannot reduce the bed capacity for our IDD (intellectual & developmental disabilities) regional programs. They call it their home. “We have to have staff available to care for the individuals 24 hours per day, seven days per week with high needs.” Moore sent Mississippi Today an email stating that the agency had lost over 1,000 employees since January 2020, which is about one-sixth of all employees at the time. Moore wrote that there were 4,970 DMH workers at 11 locations in the state as of January 2022 compared to 6,062 employees in January 2020. DRMS requested incident records from the Mississippi State Hospital Whitfield in August 2021. This facility, located near Jackson, has 311 beds and a 276-bed nursing center. Tribble stated that reviewing all incident reports from a facility could help DRMS find patterns and problems. Perhaps one employee’s name would be mentioned again and again. Perhaps there would be more incidents in a given shift. An attorney general’s lawyer wrote to DRMS refusing to grant the request. He argued that it was beyond DRMS authority and would be “unduly overwhelming.” In October, DRMS received letters requesting incident reports from nine additional facilities. These requests were also rejected by the state’s attorney. Special assistant attorney general MaCall Chastain wrote that DRMS’ request must be limited to a complaint or sufficient probable reason justifying a request to DMH for incident reports. This includes but not only a date of the incident and the individual named in its request. “No DMH programs will comply at this point unless DRMS’ request can be narrowed to a complain or sufficient probable cause justification,” he said. DRMS sued DMH in November, claiming that federal law required the agency to share records. Boyer stated that P&A systems in certain states receive incident reports “just as a rule.” Nancy Anderson, associate director at the Alabama Disability Advocacy Program (DRMS’ counterpart in Alabama), said that her organization launched a “systemic inquiry” following tips that indicated a pattern of abuse or neglect. She said that systemic investigations are used to examine the practices and patterns of the facility in order to determine what is happening.
Devon Orland, the Georgia Advocacy Organization’s legal director, stated that her organization routinely obtains incident reports via records requests in their efforts to monitor facilities. GAO staff can request an unredacted copy if they notice anything troubling in the reports. Orland will make a request for records if she hears of a series issues at a facility. She said that “our access authority is very wide.” She said, “And there is a reason why that is: because history has shown that people who are pushed out of society are really susceptible to abuse and neglect… If (we don’t) have access, then we can’t protect them.” The state also argued that DRMS failed to prove that it had “probable cause to” investigate the abuse and neglect in state-run facilities. DMH stated that the letters it sent to the 10 facilities didn’t contain any details to support the release of records in a February 8 filing. DMH shared information from other cases where DRMS provided more detail about why it was seeking records related to a specific case of suspected abuse or neglect. They cited the Nov. 10, letter in which DRMS described South Mississippi Regional Center’s conditions as an example of a valid probable cause claim. However, Tribble and other P&A staff across the country claim that courts have ruled that P&A systems are generally able to determine if they have probable cause to investigate. Boyer stated, “We’re kinda the judge in all this.” U.S. District Judge Carlton Reeves invited U.S. Department of Justice in January to weigh-in by March 14. A spokesperson for the Justice Department told Mississippi Today via email that they were aware of Reeves invitation, but could not comment further. DMH has been fighting Reeves’ Justice Department for almost six years in another case. Reeves appointed a monitor in 2021 to assess DMH’s progress at providing community-level services, rather than institutionalizing patients at state-run hospitals. Reeves’ order is being appealed by the Attorney General to the 5th Circuit. The state claims it has expanded community services, and Reeves has placed “perpetual federal supervision” over the system. The two court cases against DMH in Mississippi suggest that DMH doesn’t want anyone to scrutinize its work. Tribble stated, “We all talk about transparency.” “Well, they are now in a position where they can be transparent and they have chosen not to fight it.”