In Mississippi, many people awaiting court-ordered treatment for mental illness or substance abuse are jailed, even though they haven’t been charged with a crime.

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Mississippi lawmakers have overhauled the state’s civil commitment laws after Mississippi Today and ProPublica reported that hundreds of people in the state are jailed without criminal charges every year as they wait for court-ordered mental health treatment.

Right now, anyone going through the civil commitment process can be jailed if county officials decide they have no other place to hold them. House Bill 1640, which Gov. Tate Reeves signed Wednesday, would limit the practice. It says people can be jailed as they go through the civil commitment process only if they are “actively violent” and for a maximum of 48 hours. It requires the mental health professional who recommends commitment to document why less-restrictive treatment is not an option. And before paperwork can be filed to initiate the commitment process, a staffer with a local community mental health center must assess the person’s condition.

Supporters described the law, which goes into effect July 1, as a step forward in limiting jail detentions. Those praising it included county officials who handle commitments, associations representing sheriffs and county supervisors, and the state Department of Mental Health.

“This new process puts the person first,” said Adam Moore, a spokesperson for the Department of Mental Health, which provides training, along with some funding and services related to the commitment process. “It connects someone in need of mental health services with a mental health professional as the first step in the process, before the chancery court or law enforcement becomes involved.”

But some officials involved in the commitment process said that unless the state expands the number of treatment beds, the effect of the legislation will be limited. “Just because you’ve got a diversion program doesn’t mean you have anywhere to divert them to,” said Jamie Aultman, who handles commitments as chancery clerk in Lamar County, just west of Hattiesburg.

Although every state allows people to be involuntarily committed, most don’t jail people during the process unless they face criminal charges, and some prohibit the practice. Even among the few states that do jail people without charges, Mississippi is unique in how regularly it does so and for how long. Under Mississippi law, people going through the commitment process can be jailed if there is “no reasonable alternative.” State psychiatric hospitals usually have a waiting list, and short-term crisis units are often full or turn people away. Officials in many counties see jail as the only place to hold people as they await publicly funded treatment.

Idaho lawmakers recently dealt with a similar issue. There, some people deemed “dangerously mentally ill” have been imprisoned for months at a time; this spring, lawmakers funded the construction of a facility to house them.

Nearly every county in Mississippi reported jailing someone going through the commitment process at least once in the year ending in June 2023, according to the state Department of Mental Health. In just 19 of the state’s 82 counties, people awaiting treatment were jailed without criminal charges at least 2,000 times from 2019 to 2022, according to a review of jail dockets by Mississippi Today and ProPublica. (Those figures, which included counties that provided jail dockets identifying civil commitment bookings, include detentions for both mental illness and substance abuse; the legislation addresses only the commitment process for mental illness.)

Sheriffs have decried the practice, saying jails aren’t equipped to handle people with severe mental illness. Since 2006, at least 17 people have died after being held in jail during the civil commitment process; nine were suicides.

The bill’s sponsors said Mississippi Today and ProPublica’s reporting prompted them to act. “The deficiencies have been outlined and they're being corrected,” said state Rep. Kevin Felsher, R-Biloxi, a co-author of the bill.

An affidavit of someone who was committed and held in a Mississippi jail for mental health issues Credit: Obtained by Mississippi Today and ProPublica. Highlighted by ProPublica.

As a chancery clerk in northeastern Mississippi’s Lee County, Bill Benson has long dealt with people seeking to file commitment affidavits asserting that someone, often a family member, should be forced into treatment. He said first requiring a screening by a mental health professional is a good move. “I’m an accountant. I’m not going to try and make a determination” about whether someone needs to be committed, he said. He generally allows people to file commitment papers so he can “let the judge make that call.”

The bill says that if the community mental health center recommends commitment after the initial screening, someone can’t be jailed while awaiting treatment unless all other options have been exhausted and a judge specifically orders the person to be jailed. The legislation also says people can be held in jail for only 24 hours unless the community mental health center requests an additional 24-hour hold and a judge agrees. Roughly two-thirds of the people jailed over four years were held longer than 48 hours, according to Mississippi Today and ProPublica’s analysis.

However, the bill does not address the underlying reason that many people are jailed as they await a treatment bed. “I’m not certain there are enough beds and personnel available to take everybody,” Benson said. “I think everyone will attempt to comply, but there are going to be some instances where somebody’s going to have to be housed in the jail.”

Nor does the legislation say anything about how the provisions will be enforced. House Public Health Chair Sam Creekmore, R-New Albany, the primary sponsor of the bill, said the Department of Mental Health will “police this.” He also said he hopes the law’s new reporting requirements for community mental health centers will encourage county supervisors to monitor compliance.

Moore, at the Department of Mental Health, said the agency won’t enforce the law, although it will educate county officials, who are responsible for housing people going through civil commitment until they are transferred to a state hospital. “We sincerely hope all stakeholders will abide by the new processes and restrictions,” Moore said. “But DMH does not have oversight over county courts or law enforcement.”

Several mental health experts and advocates for people with mental illness say the law doesn’t go far enough to ban a practice that many contend is unconstitutional. For that reason, representatives of Disability Rights Mississippi have said they’re planning to sue the state and several counties.

“The basic flaw remains,” said Dr. Paul Appelbaum, a professor of psychiatry at Columbia University and former president of the American Psychiatric Association. “There is no justification for putting someone who needs hospital-level care in jail, not even for 24 hours.”

Agnel Philip of ProPublica and Isabelle Taft, formerly of Mississippi Today, contributed reporting.