DOJ report accuses Kentucky of 'unnecessarily' hospitalizing Louisville residents with mental illnesses (2024)

LOUISVILLE, Ky. (WDRB) -- A new report by the U.S. Department of Justice accuses the state of Kentucky of failing people with mental illnesses.

It's all laid out in a nearly 30-page investigation released Tuesday, accusing the state of breaking the law.

The DOJ's findings claim the state is violating the Americans with Disabilities Act by how it treats people with serious mental illnesses, specifically in Louisville.

“People with serious mental illnesses in Louisville are caught in an unacceptable cycle of repeated psychiatric hospitalizations because they cannot access community-based care,” Assistant Attorney General Kristen Clarke said in a release Tuesday.

The report said thousands of people are admitted to psychiatric hospitals, like Central State Hospital, every year in Louisville.More than 1,100 patients had multiple admissions in a year, and some spent more than a month in the hospitals.

The DOJ said the state “relies unnecessarily on segregated psychiatric hospitals to serve adults with serious mental illness who could be served in their homes and communities.”

"These hospitals are highly restrictive, segregated settings in which people must forego many of the basic freedoms of everyday life," the report reads. "Admission to these institutions can be traumatizing, and it can upend the lives of people who experience them."

But, the DOJ said, many of those admissions could be prevented with the right community-based services. They said Louisville needs crisis stabilization services, supported employment, permanent housing, transportation, and targeted case management for people with mental illnesses.

Kentucky's Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID) contracts with Louisville-based Seven Counties Services and the University of Louisville Hospital to run the only psychiatric emergency department in the area, called Emergency Psychiatric Services (EPS) at UofL Hospital. It also contracts with the state-run Central State Hospital in Louisville.

Seven Counties isthe Community Mental Health Center for Jefferson County and six neighboring counties and one of the primary behavioral health services providers in Louisville.

EPS provides "emergency psychiatric treatment and stabilization to approximately 2,250 adults with serious mental illness each year, on average," the DOJ said. "Many of those adults have multiple stays per year."

Officials said the state's DBHDID relies on EPS "to provide short-term crisis stabilization and refer people to community-based services or hospitalization."

The DOJ said the city could cut down on how often police officers respond to mental health crises, as a lack of community-based services has left law enforcement as routine responders, which the report said contributes to "avoidable law enforcement encounters and incarceration."

The DOJ said many residents with mental illness are "caught in a cycle of law enforcement contacts, EPS visits, and inpatient hospitalizations" where EPS is often "at the center of" that cycle because many people go there before being admitted to Central State Hospital, or another area hospital that provides in-patient services.

The report said individuals often arrive at EPS in police custody, with officers being "by far the most common mode of transportation to EPS," which is the state's "primary method for diverting hospital admissions in Louisville."

But because EPS is a hospital-based emergency room, it can be "a highly chaotic and sometimes very traumatic experience." It's described as a "small, 'relatively sterile' space that serves the limited purpose of evaluating whether a hospital admission is needed and is not well-suited to ensuring long-term engagement in outpatient services."

The DOJ cites officials who said they would prefer people avoid EPS altogether by accessing community-based crisis services, which the city is accused of lacking.

"Instead, for many individuals in Louisville today, police officers, EPS, and hospitals are the primary options for help," the DOJ said. "And without a connection to long-term services, many simply reappear at EPS the next time a crisis occurs."

Additionally, the DOJ cites deficiencies in Louisville Metro Government's emergency response system, pointing to their investigation into the Louisville Metro Police Department prompted by the police killing of Breonna Taylor in March 2020, the results of which were released in March 2023.

It was that investigation, which uncovered a pattern of conduct in which LMPD engaged in a pattern of depriving people of their constitutional rights, that prompted officials to investigate unnecessary hospitalizations for people with mental illnesses in the city. The DOJ opened this investigation in May 2022 under Title II of the ADA.

The LMPD report, the DOJ said, revealed the department violated the ADA by "subjecting people with behavioral health disabilities to an unnecessary police response."

LMPD and city officials are still negotiating terms of a consent decree — federally-mandated police reform — ordered by the DOJ when releasing the findings of that investigation last March.

The Justice Department acknowledged the state has taken steps to expand access to services, including crisis response initiatives and housing and employment support.

The report also acknowledged an effort by the city of Louisville to connect some 911 emergency calls to teams that can handle mental health crises instead of sending police officers. A pilot program was expanded this year to operate 24 hours a day.

Louisville Mayor Craig Greenberg's office was not immediately returned on Tuesday, but did release the following statement on Wednesday:

"The lack of community-based mental health services is a nationwide problem that leaves far too many individuals without critical, often lifesaving, care. As the DOJ acknowledged in its findings report, Louisville Metro Government has expanded our Deflection program to provide 24-hour emergency services for residents in crisis.

We know Louisville’s health care providers and first responders are working hard to serve our most vulnerable residents. The Mayor looks forward working with leaders in Frankfort to ensure that all Kentuckians facing a mental health crisis can get the care they need. But ultimately, cities like Louisville need our federal partners to help provide comprehensive resources and investments if we are to make the meaningful progress we all want."

Aspokesperson for Kentucky Gov. Andy Beshear's office said state officials were “surprised by today's report.”

“There are sweeping and new conclusions that must be reviewed as well as omissions of actions that have been taken," James Hatchett, a spokesperson for the governor’s office, said in a statement to the Associated Press on Tuesday. “We will be fully reviewing and evaluating each conclusion.”

The Justice Department said it would work with the state to remedy the report’s findings. But if a resolution cannot be reached, the government said it could sue Kentucky to ensure compliance with the Americans with Disabilities Act.

To read the full report, click hereor on the PDF embedded in this story.

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Copyright 2024 WDRB Media. All Rights Reserved. The Associated Press also contributed to this report.