Reform Is Heating Up In Mississippi

Mental health reform has lagged unconscionably in Mississippi for years. Now things are really heating up in Mississippi, and it is not even spring yet.

A little background is in order first. Mississippi has an uncomfortable political situation that my state of North Carolina had for the last four years and made reform and budgetary cooperation almost impossible. The governor and attorney general of North Carolina before this past November’s election were from opposing political parties and were political rivals. I shall not go into a political review or rant over this, as we all have had too much of that sort of thing over the last year and a half at the national level and everywhere else. In any case, the governor of NC was voted out and the attorney general took his place as governor. While Mississippi may not have quite the same political situation [and I hope they do not, I would not wish what we in NC went through the last 2 years on anyone, it was awful], the two top political officials of the state are sniping, are not friends it sounds like and certainly not working together on many matters including mental health reform.

Things have apparently gotten worse in Mississippi in late February when MS Governor Phil Bryant made a demeaning pseudo-Huey Long colloquialism, to “Gimme some of that mental health reform.” Had I been present in the governor’s audience, I likely have muttered under my breath, that this is not ‘ol time religion,’ nor is it the movie ‘Oh brother, where art thou.’

The attorney general Jim Hood had even stronger reactions than I, in his newspaper opinion piece in the Jackson Free Press newspaper of the capital of Mississippi, “Governor Obfuscates with Call for ‘Gimme some of that mental health reform.’ The attorney did himself no favors either as he excoriated the governor literally charging that the governor was taking monies of the Missisissipi taxpayers for noble causes such as mental health reform [this was implied in the article] and giving them to “his” “huge corporate benefactors.” Whew, as I stated in my title, things really are heating up, down there…

But it turns out that the attorney general Mr. Hood may know more of which he speaks and has likely a compelling motive for supporting genuine mental health reform in MS. He states in the above-referenced article that he is defending the state of Mississippi against a number of lawsuits regarding mental health reform. Many observers of the national mental health reform movement have been observing the travails of MS as lawsuit after has been brought against the state for huge and serious lapses, gaps and just plain inadequate state and local level mental health services. As another article, “Mississippi Still Faces Merged Mental-health Lawsuits,” and detailed in “In the Statehouse and the Courtroom, Mental Health is Embattled,” also published in the Jackson Free Press, MS now faces a consolidated federal lawsuit by the Department of Justice and many other parties including the Southern Poverty Law Center. The second article gives a great deal of background on the new lawsuit, Troupe vs. Barbour [as in the former governor, Haley Barbour of a few years ago]. It also details the difficulties that are preventing the politicians from coalescing into a working coalition to get something done. [Gee, where have I seen that before in some august legislative body?]

Things are so bad that the Jackson Free Press editors have weighed in on the process in their call for positive action and an end to the political paralysis, “Stop the Mental Health Politicking.” In reading through the editors’ exhortation to stop the infighting and to get to work on the issues, I was struck by the similarities in the MS logjam with many others in states who have or are still struggling to come to terms with mental health reform. The editors angrily state outrights that MS’s mental health programs have been “shrouded in secrecy,” and that the deficiencies have been known and ignored by the state’s legislature “for decades.” Not ringing endorsement of the past or present efforts.

And the editors, as the voice of reality, [when did politicians ever pay attention to that? Answer: only when they have to, as one anonymous wag stated eons ago], reform will take large efforts, closing some institutions [angering workers, local economies etc.], and a lot of money. And when one gets to the stage of “talking serious money,” as the saying goes, the specter of taxes, new revenue streams, cutting other vested interests, all come into play. And especially in the South sometimes, the code is to try to be polite and not offend anyone. [I speak as a transplanted pseudo Southerner from the South(west) who has spent more than 3/4 of my adult life in the American South].

So it will be interesting to watch in the coming legislative session or sessions, whether the government of Mississippi can collectively come together for the benefit of patients, providers and all the other groups and peoples with interests in mental health care delivery, and construct something that works. If they do not, I am sure the “feds,” will help them get motivated to do so. But solutions are borne out of compulsion often do not have the self-generated altruism and pride to do something positive, and fall apart as soon as the “occupying force,” leaves, whether it is Iraq in our time, or Reconstruction in the American South after the Civil War, or the Gaza Strip in the Middle East. So stay tuned to the coming jockeying, political horse trading, and whatever else it takes to enact and implement mental health reform in Mississippi. It will be interesting.



Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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