Gaps in mental health care worry officials

Two Northeast Mississippi legislators who serve as public health committee chairs say they want bridges in the mental health care system, which might have prevented a fatal shooting in Oxford recently.
Sen. Hob Bryan, D-Amory and Rep. Steve Holland, D-Plantersville, are trying to find why gaps exist between in-hospital care and community care for mentally ill Mississippians. They’re co-chairs of a special legislative study committee on mental health due to report to the Legislature by Dec. 1.
Bryan said it’s clear the state’s treatment system is too heavily weighted on the institution side, instead of local care where the people are.
“But how do we move in that direction?” he said.
Holland said a big issue “is that mentally ill people should be treated like physically ill people. You wouldn’t want to be locked up, if you were sick, would you?”
He’s referring to the frequent practice of jailing people who await legal commitment or for a bed to open up in one of the state’s facilities, which treat patients in need of more extended therapy than at walk-in community health centers.
Local follow-up for these patients also is lacking after their discharge, many mental health professionals agree.
In Oxford two weeks ago, 24-year-old Bilethon Autry reportedly was out of North Mississippi State Hospital in Tupelo only a few days before he was arrested and charged with shooting to death his stepbrother, Charlie Ray Hodges, 50.
His father, Billy Ray Autry, said Bilethon often neglected to take medication prescribed for his disorder and compounded his mental health problems by using illegal drugs and alcohol.
Ed LeGrand, director of the Mississippi Department of Mental Health, is quick to admit the treatment gaps can cause tragic, unintended consequences.
“I think the system as a whole needs revamping,” he said, noting that his agency asked for the legislative study.
He said patients need a system of care that’s more community oriented and that can build local bridges and services to ensure they get the care they need every day.
Bryan said it’s important for the Legislature to solve funding issues related to the service problems.
In addition to care gaps, Holland said they want to look at improving state laws for commitment, issued by chancery courts to order a person into mental health treatment.
And he expressed concern that a judge can order a person’s commitment and immediately place that person in jail to await transportation to a care facility.
Lee County Sheriff Jim Johnson frequently complains about that situation, saying a jail is no place for a mentally ill person.
“The problem is that my facility is not going to give that individual the necessary treatment that a mental health facility is designed to do,” Johnson said soon after Bilethon Autry’s arrest in Lafayette County.
Holland also said it’s not easy bringing together the state’s Department of Mental Health and its 15 locally autonomous mental health districts.
“It’s a turf battle worse than the community colleges,” he noted.
Both community colleges and community mental health districts derive their base support from their member counties through boards of supervisors, who appoint district board members.
“This is a big money issue,” Holland said. The state’s current mental health funding hits about $600 million.
He’s looking for better follow-up care after patients are released from longer term treatment. “So many times they get out and then they’re right back, in need of help,” he said.
LeGrand said his agency and some of the local districts are making a concerted effort to get together on the problem. But, he admitted, not everybody wants the system to change.
Bryan is more optimistic, but knows change is complicated. “I think there’s a good bit of good will on how to change.”

Contact Patsy R. Brumfield at (662) 678-1596 or patsy.brumfield@djournal.com.

Patsy R. Brumfield/NEMS Daily Journal