Two bills aim to keep mental health commitments out of jail

• Legislation filed by Senator Boyd and Rep. Creekmore both made it out of their respective chamber’s committees before the deadline last week.

When a person is affected by a mental illness that might put themselves or others in danger, for many in Mississippi a jail cell is where they are held until a suitable facility with space can be found.

The number of beds at state hospitals capable of treating those with a mental illness are finite in the Magnolia State, which is why those who have been civilly committed by family members often wait in prisons.

As previously reported, when a person was held in jail awaiting a bed at a state hospital in 2022, they could have been there for about 8 days. Today, the average wait is about 2.7 days, Mississippi Department of Mental Health Executive Director Wendy Bailey reported to House and Senate Committees of Public Health and Welfare earlier this year.

While Bailey says the number of people who are held in jail awaiting treatment is declining, it still happens in many parts of the state. Yet, two bills in the Mississippi Legislature have made it out of committee that could address the issue by creating a new system.

Under the proposed legislation, a mental health screening will be required prior to a family member being allowed to file an affidavit against the patient. The goal is to ensure only those who are violent are held in a jail cell, or if there is just no place else to put them in nonviolent cases, and even then, it would still be for up to two days.

House Bill 1640, authored by State Rep. Sam Creekmore IV (R) and Senate Bill 2744, authored by State Senator Nicole Boyd (R), both aim to put those safeguards in place. 

“We need to get the mentally ill out of our jails. And so, we have a process here that we worked with. Basically, what happens is, before somebody is able to take out an affidavit on someone, they are going to work with their community mental health center. They will do a pre-affidavit screening when possible. If they can’t do it, they are going to make notations as to why they can’t do that, why it’s not feasible. But they’re also going to talk to relatives or anyone that really is trying to get this affidavit filed. They have to do that within 24 hours,” Senator Boyd said during a Senate Judiciary A Committee meeting last week. “If the community mental health center is not available the judge has some authority to appoint someone to go get this done. If after they do the screening process and find out there is cause that this person does need to be committed, that will start the process.”

The ultimate goal is to ensure those who need mental health assistance get that help quickly without being housed in less-than-ideal conditions. 

“What this process does it makes sure that basically you have to look at our crisis intervention centers, you have to look at our state hospitals, you have to look at all alternate forms before you put someone in a jail. If there is just absolutely no place else to put them for that moment, basically they have 24 hours to secure another place to put them,” Senator Boyd continued. “This is incredibly important. If you read the articles this week, the state is facing litigation because we are continuing to put those that are mentally ill in our jails, and I think this will go a long way in making sure that we work through this.”

Senator Boyd outlined some of the checks and balances to be in place for community health centers as part of the bill, including requiring them to provide monthly reports to the Board of Supervisors within their counties concerning the number of commitments as well as if any and how many people had to be held in a jail, along with other information. A quarterly audit would be reviewed by the Department of Mental Health if her bill becomes law. Boyd added that each community mental health center would be tasked with keeping six months of operational expenses on hand. There are also some remedial measures in the bill to address issues at those centers other than the only two options currently available.

“One of those options is to take away their funding that the Legislature gives them. The only second other option is to decertify that (center), basically close it down. So, there’s no remedial steps that can be taken with that community mental health center. This (bill) puts remediation plans in place with procedures that the Department of Mental Health can do and really work with our community mental health centers to strengthen them and make sure that process is stronger,” Boyd elaborated.

The bills were created in coordination with personnel at the Mississippi Department of Mental Health who looked at policies in other states, such as Tennessee. 

“We have looked at states that require a mental health professional to conduct a pre-screening before an affidavit for commitment is filed. This can prevent a writ from being issued prior to a screening and the recommendation from a mental health professional. If the pre-screening is conducted prior to the filing of an affidavit and the issuance of a writ, diversion strategies can be further utilized before law enforcement would ever become involved,” Bailey told Magnolia Tribune. “The proposed legislation also includes a safety valve which allows an affidavit to be filed and writ issued if the community mental health center, which is the local mental health authority, cannot conduct the screening. Civil commitment should be rare and only an option when there is a threat of danger to oneself or others.”

Currently, there are 11 community mental health centers in the state, with an additional center slated for a coastal county, Senator Boyd advised the committee. 

“Over the last several years, we have utilized state legislative appropriations to fund numerous services at community mental health centers around the state, shifted funding from state hospitals to the community, and most recently planned the utilization of federal ARPA funds to even further continue the expansion of community services,” Bailey told Magnolia Tribune. “Newer services like court liaisons, peer respite, and diversion centers are also under way or planned for expansion. Region 8 Mental Health Services just held a ribbon cutting on a new 16-bed crisis stabilization unit in Rankin County this (month). These services are focused on preventing the need for longer term inpatient care and avoiding unnecessary jail holds.”

Senator Boyd added that her bill includes a review of the pay scales for each director of a community mental health center to address stark disparities. She added that the pay scale for such positions should be capped at 20 percent of what the state’s mental health director makes, or a cap of $215,000, but current pay scales range from $100,000 to as high as $382,000.

Rep. Creekmore’s HB 1640, like the Senate bill, also proposes a mandate that a mental health pre-screening take place before a person can file an affidavit for civil commitment on another person. 

Much like the Senate bill, the screening should be conducted by community mental health center personnel or another medical professional. If a community mental health center is not available, a licensed physician, psychologist, nurse practitioner or physician assistant can perform the screening. 

Additionally, while an interview with the proposed patient is preferred, if that person cannot be interviewed, specific reasons as to why must be noted. If the proposed patient is uncooperative with the screening process or becomes violent, then the community mental health center personnel can suggest filing the affidavit and issue a writ, allowing the local Sheriff’s department to get involved. 

If the person is violent, they can only be held in the jail for 24 hours and charges cannot be placed against that individual solely due to the lack of a state hospital bed or because they have a mental illness. An extension of another 24 hours can be requested to the chancery court judge by the community health center, if it’s needed.