Following an 18-month investigation, the U.S. Justice Department found that the state of Missouri violated the Americans with Disabilities Act for "unnecessarily institutionalizing adults with mental health disabilities in nursing facilities," according to a report published June 18.
"Missouri has failed to divert and transition adults with mental health disabilities from nursing facilities," the DOJ report states.
Since COVID-19, more patients have been diagnosed with mental health conditions, which has skyrocketed demand for expanded mental healthcare. Nursing homes, long-term care facilities and hospitals have experienced more patients coming in with these care needs, leading to issues like in Missouri's case.
"People with mental health disabilities should not have to be confined to a nursing facility because they cannot access the community-based services they need…" Kristen Clarke, assistant attorney general of the Justice Department's Civil Rights Division, said in the release. "The state's reliance on guardianships that serve as a pipeline to nursing facilities, rather than engaging people in community-based mental health services, has led to violations of the ADA."
Overall, the investigation found that "almost none of the adults with mental health disabilities living in nursing facilities in Missouri need to be in these institutions, even for short-term stays," the report states.
"Instead of diverting people with mental health disabilities from unnecessary nursing facility admission or transitioning people from nursing facilities who do not need to be there, people are sent out of sight and out of mind," the report reads. "Instead of focusing resources and attention on serving this group of people in the community, the state relies on nursing facilities as a key piece of the system for serving people with mental health disabilities."
Among several things, the Justice Department report outlines that Missouri failed to provide the following care for mental health patients in need of it:
- Assertive community treatment
- Case management
- Supported employment
- Mobile crisis response
- Crisis stabilization services
- Permanent supportive housing
- Peer support
- Supported decision-making
In its update, the Justice Department also said the state can remedy things and "reasonably modify its system to remedy this violation by expanding community-based services and implementing processes to ensure that individuals can receive those services rather than entering nursing facilities."
Becker's reached out to the Missouri Department of Health and Senior Services to request comment. The department confirmed receipt of the request, but has not yet sent a response. If new information becomes available, the story will be updated.