Kentucky puts people with mental illness in psych hospitals ‘unnecessarily,’ DOJ says
People with mental illness in Louisville are being “unnecessarily” placed in psychiatric hospitals when they could be cared for in the community, an investigation by the Justice Department found.
The department said there’s “reasonable cause” to believe the state is in violation of the Americans with Disabilities Act.
The investigation, which began in May 2022, found that access to community-based services — which could prevent people from being admitted to psychiatric hospitals in Louisville — is “insufficient.” And after people are released from a hospital stay, they still are not being connected to the services they need.
The findings were released Tuesday in a 28-page report.
“Because of the lack of community-based services, law enforcement officers are routine responders to mental health crises in Louisville,” the Justice Department report states. “Many of these encounters could have been avoided with community-based services, and those community services could have provided an alternative to incarceration in Louisville Metro Detention Center.”
More than 1,000 people end up having multiple admissions to Louisville’s psychiatric hospitals each year, and hundreds spend more than a month out of the year there.
“These hospitals are highly restrictive, segregated settings in which people must forego many of the basic freedoms of everyday life,” the DOJ. “Admission to these institutions can be traumatizing, and it can upend the lives of people who experience them. With the right community-based services, many of these hospitalizations could be prevented.”
Assistant Attorney General Kristen Clarke, of the DOJ’s Civil Rights Division, said in a news release Tuesday that “people with serious mental illnesses in Louisville are caught in an unacceptable cycle of repeated psychiatric hospitalizations because they cannot access community-based care.”
Clarke thanked the state for cooperating with the investigation and said “Kentucky has already begun taking important steps to expand access to a range of key services, including crisis response services; medication management supports; and housing and employment supports. Our goal is to work collaboratively with Kentucky so that it implements the right community-based mental health services and complies with the ADA.”
“Kentucky can reasonably modify its service system to avoid this discrimination,” the report states.
The report indicates that the DOJ is prepared to file a lawsuit against the state to force compliance with the ADA if improvements are not made.
Crystal Staley, communications director for Gov. Andy Beshear’s office, issued a statement saying the report took the administration by surprise, since they had not heard from the Justice Department since September.
“There are sweeping and new conclusions that must be reviewed as well as omissions of actions that have been taken. We will be fully reviewing and evaluating each conclusion,” she said.
“The administration continues to prioritize Kentuckians’ mental health,” Staley wrote. “Gov. Beshear has signed legislation requiring mental health to be treated equally with physical health and has worked to expand Medicaid coverage and telehealth services and has successfully launched the 988-crisis hotline. The state has also received a waiver from the federal government to help individuals with serious mental health needs in areas like affordable housing. We have also increased the number of treatment beds in the state and improved the ability to access mental health treatment providers.”
Staley said the governor also wanted to set up crisis response teams, but the legislature did not fund them during the last General Assembly.
“These findings demonstrate that the Commonwealth of Kentucky fails to provide adequate community-based mental health services for individuals with serious mental illness in the Louisville Metro area,” U.S. Attorney Michael A. Bennett, who represents the Western District of Kentucky, said in the news release. “Beyond the violations, however, these findings are also about recognizing the dignity and potential of every individual who has mental illness.”
The Justice Department said this investigation is different from one in which the results were released in March 2023, where it found ”that the Louisville Metro Government and Louisville Metro Police Department violated the ADA by subjecting people with behavioral health disabilities to an unnecessary police response.
“The department and Louisville are currently negotiating a consent decree to resolve these and other issues.”
