Mental health suits await decision on combination

JACKSON, Miss. -- If Mississippi gets its way, a long-running case challenging the state's mental health care for children could be rolled up with the more recent suit by the federal government over how the state provides mental health care for adults.

The federal government, though, is fighting that effort, saying the two cases should remain distinct.

The Troupe case was filed in 2010 by the Southern Poverty Law Center, alleging Mississippi was far too reliant on sending children away from their families to psychiatric institutions for mental health treatment. The adult case was filed in August, making similar accusations that adults were being confined in institutions instead of being offered care in community settings.

Under federal law and court decisions, states are supposed to provide care in the least restrictive setting possible, helping people live at home and not in state mental hospitals or private institutions.

Mississippi, though, has been slow to follow those directives, still relying on institutions to provide much of its care, even though those settings are more expensive than community care.

The state argues that the two cases have similar issues, both feature the state as a defendant, and both feature Justice Department involvement. The federal government hasn't intervened in Troupe but has filed briefs and taken part in unsuccessful settlement talks.

"While Troupe involves children and this matter involves adults, there is no legitimate dispute that any alleged needed changes in the State's care of individuals with mental illness would necessarily involve changes for the care of both children and adults," attorney Gregg Mayer wrote on behalf of the state.

The federal government opposes combining the cases, saying care issues for children and adults are distinct, and there would be few advantages to a court examining the issues together.

"Few experts or witnesses could effectively testify in both cases because of the significant differences in the relevant institutions and services for each population," lawyer Elizabeth Kelley wrote for the Justice Department.

The state is also trying to freeze discovery in the case until consolidation is decided, while the Justice Department wants to go ahead with requesting documents and deposing witnesses.

The Troupe case had been stuck in suspended animation, but under pressure from the 5th U.S. Circuit Court of Appeals over delays in many cases, U.S. District Judge Henry T. Wingate made some important rulings in November. He dismissed part of the lawsuit claiming the state was violating early screening requirements of the Medicaid program, adopting a magistrate's conclusion that the plaintiffs had failed to ask for screening.

The plaintiffs' claim that Mississippi is violating the Americans with Disabilities Act continues, and after Wingate dismissed the Medicaid claims, he opened up discovery in the case after a yearslong freeze.

Wingate has never decided whether he will certify Troupe as a class action, repeatedly putting off ruling. If he rejected class-action status, that outcome could be fatal to the suit, because any remedies won by the plaintiffs would apply only to the original plaintiffs.

The adult suit is being heard by U.S. District Judge Carlton Reeves, and the federal government may be trying to avoid Wingate's courtroom. With the incoming Trump administration, long delays could mean new leaders at the Justice Department change their mind and agree to a settlement that gives the state more of what it wants.

In one way, though, it might be appropriate for the cases to be merged. The Troupe case has existed in limbo so long that all the original child plaintiffs are now adults. The youngest person named in the complaint, then 13, is now at least 19 years old.

Jeff Amy has covered politics and government for The Associated Press in Mississippi since 2011.

Editorial on 12/07/2016

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