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In recent years, Mayor Marion Barry has repeatedly asked the federal government to assume responsibility for the District’s troubled mental health commission. It looks as though Barry might finally be getting his wishalthough not exactly the way he planned it: The District’s mental health commission is on the verge of becoming the third city agency placed in receivership by a federal or D.C. judge.
Attorneys representing 7,000 mentally ill District residents filed a motion in U.S. District Court Dec. 16 asking Judge Aubrey Robinson to place a receiver in charge of programs now administered by the mental health commissioner, the Department of Human Services, and the mayor. The federal receiver would have dictatorial powers to override personnel and procurement laws to improve mental health services, which would still be funded with District money.
The motion came from the plaintiffs in Dixon v. Barry, a lawsuit initiated way back in 1974 that produced a court order requiring the city to move patients from St. Elizabeths Hospital into less restrictive community-treatment sites. The city has repeatedly violated the order by discharging hospital patients without establishing adequate services for them in the community. The latest action marks the second time in two years the group has petitioned the court for a receiverin 1995, the city worked out an agreement to stave off a federal takeover. Since then, however, the mental health system has degenerated further into chaos.
Mental Health Commissioner Guido Zanni resigned in August, but he is still in the job awaiting a replacement. The commission lacks basic necessities, including a maintenance contract for its copiers and fax machines80 percent of which are reportedly broken. And while St. Elizabeths now holds 800 patientsdown from 1,200 in the early 1990ssome 6,000 other mentally ill people now reside in the community. Yet 64 percent of the city’s mental health budget goes to the hospital, and only 36 percent to community services.
Court documents point to other lapses. While the city was required to issue millions of dollars in contracts for such things as outreach services to the homeless mentally ill, at one point the commission laid off its entire contracting office. Two of the commission’s programs are currently working out of condemned buildings. When the commission has managed to get patients out of St. E’s, it has transferred many of them inappropriately to Maryland state nursing homes, often without notifying the patients’ families.
Dixon coordinator Robert Moon says no single foul-up prompted the receivership motion. Instead, the Dixon plaintiffs are addressing a pattern of neglect that has denied mentally ill people’s basic right to treatment in the least restrictive setting. “The [mental health] system doesn’t work as a whole. It’s still extremely fragmented, even after 22 years of litigation,” Moon says.
The city is still opposed to the receivership motion, and hearings before Robinson are scheduled for the second week in March.CP