Kentucky Mental Health Systems Face Call for Change

The Department of Justice demands reforms in Kentucky’s mental health services while issuing a stern warning of potential legal action.

At a Glance

Kentucky likely violates federal law by not providing community-based services to adults with serious mental illness in Louisville, according to The Department of Justice.
The state relies heavily on segregated psychiatric hospitals, depriving many of community care.
The DOJ may sue the state if compliance with the ADA is not achieved.
The absence of community services leads to repeated hospitalizations, trauma, and increased encounters with law enforcement.

DOJ Investigation Findings

The DOJ report alleges Kentucky is likely violating federal law by not providing adequate community-based services to adults with serious mental illness in Louisville. The state relies extensively on segregated psychiatric hospitals, which the DOJ criticizes for being highly restrictive and traumatizing. This pattern of care allegedly fails to comply with the Americans with Disabilities Act (ADA).

The report highlights that repeated psychiatric hospitalizations are a direct result of the system’s heavy reliance on institutionalized settings instead of community-based care services. This vicious cycle not only restricts the freedoms of these individuals but also exacerbates their conditions.

Kentucky officials, including Governor Andy Beshear’s office, expressed surprise over the DOJ’s conclusions and are currently reviewing them. Assistant Attorney General Kristen Clarke emphasized the cycle of repeated hospitalizations due to lack of community care, urging the state to adopt substantial reforms.

Justice Department Finds Kentucky Unnecessarily Institutionalizes Louisville Residents with Serious Mental Illness in Psychiatric Hospitals

🔗: https://t.co/dgWe11zDTn pic.twitter.com/9dtVbOZbS1

— DOJ Civil Rights Division (@CivilRights) August 27, 2024

Impact on Law Enforcement

The DOJ report also points out that the absence of community-based mental health services results in increased interactions between those with serious mental illnesses and law enforcement. Police are often the first responders to behavioral health crises, a role for which they may not be adequately trained, leading to avoidable arrests and further trauma.

Despite some efforts to expand services, including crisis response initiatives and support for housing and employment, the state has not seen significant improvements. The DOJ emphasizes that without adequate community services, the cycle of hospitalization, trauma, and encounters with law enforcement will continue.

DOJ’s Call for Reform

The DOJ has indicated a willingness to collaborate with Kentucky to address these pressing issues. However, the government agency has made it clear that it will pursue legal action if the state does not achieve compliance with the ADA. The investigation suggests that many hospital admissions could be prevented with proper community-based services, including crisis stabilization, supported employment, permanent housing, and targeted case management.

“Instead, Kentucky relies unnecessarily on psychiatric hospitals in violation of the ADA,” a statement from the Justice Department said. “Each year, thousands of people are admitted to psychiatric hospitals in Louisville, and more than a thousand people experience multiple admissions to these restrictive and often traumatizing settings.”

Mayor Craig Greenberg’s office acknowledged the nationwide issue of lacking community-based mental health services and called for federal support to make significant progress. The DOJ report includes recommendations for reform and may lead to a lawsuit if no resolution is reached. Kentucky has expanded Medicaid, telehealth services, and launched a 988 crisis hotline, but funding for crisis response teams was not approved in the 2024 legislative session.