The state’s costly effort to set up a better treatment network for mentally ill Georgians has run into trouble, forcing it to ask a federal judge Tuesday to delay a scheduled review by a court-appointed monitor.
U.S. District Judge Charles A. Pannell granted a one-year extension to July 2013 but warned he will come down hard on the state if he doesn’t see results.
“I’m going to give them just as much rope as I think they need and then we’re going to have a hanging party if they don’t comply,” Pannell told a lawyer for mental health advocacy groups that opposed the extension.
The state, in a 2010 agreement with the U.S. Department of Justice, committed to making sweeping improvements in mental health treatment. The deal followed a federal investigation into state mental hospitals, triggered by stories in The Atlanta Journal-Constitution that found dozens of psychiatric hospital patients had died from abuse or neglect.
The heart of the state’s plan is an improved network of community mental health teams that work almost daily with the mentally ill patients to help them stay on medications, adapt to the community and stay out of hospitals, jails or homelessness.
But Mark Cohen, an attorney representing the state’s behavioral health department, told Pannell that 13 of 20 community teams — each of which cost about $700,000 annually to staff and operate — were being disbanded and that the remaining seven teams were not up to standard.
He said a one-year delay in the review would give the state a better chance at restructuring the teams to be effective and gain a passing grade. He noted the department just this month brought on a new commissioner, Frank Barry. Cohen said Barry will be more responsive to working with mental-health advocates, and more effective at establishing the promised programs.
“That was a problem early on and that is not going to be a problem now,” Cohen said of the department’s poor communication with advocates. “That chapter is over.”
The state is nearing the halfway point in the 5-year agreement with the court and with the Justice Department. Following the deal, the state released hundreds of patients from the hospitals and agreed to spend at least $70 million a year to house and treat an estimated 9,000 mentally ill people in need of assistance, said Tom Wilson, spokesman for the state Department of Behavioral Health and Developmental disabilities.
The state was to have its Assertive Community Treatment (ACT) teams running by July 1. Each team - made up of case workers, nurses and other specialities — was to ensure 2,000 seriously mentally ill patients in their area took medications and remained integrated into the community.
The program assigns each 10-person team of caseworkers to monitor up to 100 patients.
Joshua Norris, a lawyer representing mental health advocates, asked the judge to give the court-appointed monitor, Elizabeth Jones, control over the state’s efforts. Norris also urged Pannell to deny the state’s request for an extension.
He argued the state has already spent more than two years trying to establish ACT teams and an effective management system for them. He noted that at least one group of patients will be on their third ACT team when a new one is constituted.
“That is not a recipe for stability,” he said.
But Pannell said making Jones the de facto head of establishing state ACT teams would only allow the department to dodge responsibility if the promised effort again failed. Pannell, a former Georgia Superior Court judge and juvenile judge, said the state had an abysmal track record at protecting vulnerable people such as the mentally ill, the disabled and foster children.
“I want the state to live up to its promise in the agreement,” Pannell said. “I don’t want to let the state off the hook.”
Both the Justice Department and Jones advocated giving the department another chance to get its ACT teams running and establishing effective oversight of them before the official review.
“The only way for this settlement agreement to succeed is for everybody to work together,” Jones said.
About the Author
