The United States Department of Justice said the Commonwealth of Kentucky may be breaking a federal law with how few mental health services are available in the state.
In a release on Tuesday, August 27, the DOJ said it has “reasonable cause to believe” that Kentucky is violating the Americans with Disabilities Act (ADA) in the Louisville metro area for segregating adults with mental illness into psychiatric hospitals instead of providing care in integrating community settings, like Wellspring, one of the few community-based mental health service provider in Louisville.
“People with serious mental illnesses in Louisville are caught in an unacceptable cycle of repeated psychiatric hospitalizations because they cannot access community-based care,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “We thank Kentucky for its full cooperation with our investigation, including readily providing access to staff, documents, and data. We also recognize that 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.”
The department's investigation uncovered how Kentucky failed to provide access to the Louisville community-based mental health services for people with serious mental health illness who needed them, with services like mobile crisis response, crisis stabilization and crisis respite, case management, Assertive Community Treatment, Permanent Supportive Housing, supported employment and peer support being under established in the Louisville metro area, leading to more mental health related issues being segregated to psychiatric hospitals.
According to the DOJ, every year, thousands of people are admitted to psychiatric hospitals in Louisville, with more than a thousand people experiencing multiple admissions to these “restrictive and often traumatizing settings,” the DOJ said in its statement.
Kathy Dobbins, the CEO of Wellspring, said in an interview with LEO Weekly that the loss of freedom in restrictive settings like psychiatric hospitals can not only be financially expensive, but mentally as well.
"For somebody who is psychotic or in the throes of a deep depression, it can be very traumatic," she said. "Sometimes it is necessary, but ideally, in these community-based interventions... if you can intervene earlier, then you hope to prevent that."
And as a "major proponent" of community-based mental health services, Dobbins said the need for those services are necessary not only to see success in any one person, but to help cultivate more contributing members of the Louisville community.
"I've been doing this work for 40 years. I am a lifelong believer in not just the value of community-based services, but the successes that result from community-based services," she said. "People have better lives, greater quality of life, and many are able to achieve a level of recovery that allows them to actually be contributing members of our community. That's not possible when somebody who's going in and out of the hospital or going in and out of jail. That that hurts our community, and it's costly."
Seven Counties Services, which also provides community-based mental health services, put out a statement regarding the DOJ report. The service provider said it had partnered earlier this year with the University of Louisville Schools of public Health, which was meant to conduct a health needs assessment focused on the "crisis continuum of care in our community."
"As a community and organization, Seven Counties Services remains fully dedicated to providing quality care and health services to improve the lives of individuals and families. Providing community-based services and access to care for all individuals in our community including those with SMI and/or those in crisis is at the heart of our mission."
The assessment provided sessions to 75 "separate entities" and over 130 people, with Seven Counties Services and UofL learning more about what Louisville residents go through when dealing with a mental health crisis.
"Currently, we are closely analyzing the report and look forward to our continued collaboration with state and local partners to provide increased access to community-based resources for individuals with Serious Mental Illness (SMI)," Seven Counties Services stated in a press release.
In a different investigation in March 2023, the DOJ found that people with behavioral health disabilities were also subjected to unnecessary police responses to their crises, which is considered an ADA violation as well. According to the DOJ, the department is working with Louisville to negotiate a consent decree to resolve these types of issues in the future.
“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,” said U.S. Attorney Michael A. Bennett for the Western District of Kentucky. “Beyond the violations, however, these findings are also about recognizing the dignity and potential of every individual who has mental illness.”
In a former list, LEO Weekly released its findings of community-based mental healthcare services in and around Louisville.
