In Mississippi, the path to treatment for a serious mental illness may run through your local jail– even if you have not been charged with any crime.

In 2023, Mississippi Today and ProPublica investigated the practice of jailing people solely on the basis of possible mental illness while they wait for help through the civil commitment process.

We found that people awaiting treatment were jailed without criminal charges at least 2,000 times from 2019 to 2022 in just 19 counties, meaning the statewide figure is almost certainly higher. Most of the jail stays lasted longer than three days, and about 130 were longer than 30 days.

Some people have died after being jailed purportedly for their own safety.

Every state has a civil commitment process in which a court can order someone to be hospitalized for psychiatric treatment, generally if they are deemed dangerous to themselves or others. But it is very uncommon for people going through that process to be held in jail without criminal charges for days or weeks – except in Mississippi.

So far, we have spoken with people who were jailed solely on the basis of mental illness, family members of people who went through the process, sheriffs and jail administrators, county officials, lawmakers, the head of the Department of Mental Health and experts in mental health and disability law. We have filed more than 100 records requests and reviewed lawsuits and Mississippi Bureau of Investigation reports on jail deaths.

We plan to keep reporting. If you’d like to share your experiences or perspective, please email Isabelle Taft at itaft@mississippitoday.org or call her at (601) 691-4756.

Here are five key findings from our reporting so far:

1. People jailed solely on the basis of mental illness are generally treated the same as people accused of crimes

We spoke to more than a dozen Mississippians who were jailed without criminal charges. They wore jail scrubs and were often shackled as they moved through the jail. They were frequently unable to access prescribed psychiatric medications, much less therapy or other treatment. They had no idea how long they would be jailed, because they could get out only when a treatment bed became available. They were often housed alongside people facing criminal charges. One jail doctor told us the people going through the commitment process were vulnerable to physical assault and theft of their snacks and personal items.

“They become a prisoner just like the average person coming in that’s charged with a crime,” said Ed Hargett, a former superintendent of Parchman state penitentiary and corrections consultant who has worked with about 20 Mississippi county jails. “Some of the staff that works in the jail, they don’t really know why they’re there … Then when they start acting out, naturally they deal with them just like they would with a violent offender.”

2. Jails can be deadly for people in crisis

At least 14 people have died after being jailed during the commitment process since 2006, according to our review of lawsuits and records from the Mississippi Bureau of Investigation. Nine died by suicide, and three died following medical care that experts called substandard. Most recently, 37-year-old Lacey Handjis, a Natchez hospice-care consultant and mother of two, died in a padded cell in the Adams County Jail in late August. Her death was not by suicide and is still under investigation.

Mental health providers we spoke with said jail can exacerbate symptoms when someone is in crisis, increasing their risk of suicide. Jail staff with limited medical training may interpret signs of medical distress as manifestations of mental illness and fail to call for additional care.

After three men awaiting treatment died by suicide in the Quitman County jail in 2006, 2007 and 2019, chancery clerk Butch Scipper no longer jails people going through the commitment process. His advice to other county officials: “Do not put them in your jail. Jails are not safe places. We think they are, but they’re definitely not” for people who are mentally ill.

3. Mississippi is a stark national outlier

Mississippi Today and ProPublica surveyed disability rights advocates and state behavioral health agencies in all 50 states and the District of Columbia. Nowhere else did respondents say people are routinely jailed for days or weeks without criminal charges while going through the involuntary commitment process. In three states where respondents said people are sometimes jailed to await psychiatric evaluations, it happens to fewer people and for shorter periods. At least a dozen states ban the practice altogether, while Mississippi law allows it when there is “no reasonable alternative.” In Alabama, a judge ruled it unconstitutional in 1984.

National experts and disability rights advocates in other states used words like “horrifying,” “breaks my heart” and “speechless” when they learned how many Mississippians are jailed without criminal charges while they wait for mental health care every year.

4. Despite a 2009 state law, there has been almost no oversight of jails that hold people awaiting treatment

In 2009, the legislature passed a law requiring any county facility that holds people awaiting psychiatric treatment through the commitment process to be certified by the Department of Mental Health. The department developed certification standards requiring suicide prevention training, access to medications and treatment, safe housing and more. But the law contains no funding to help counties comply and no penalties if they don’t. Only a handful of counties got certified, and after 2013 the department’s efforts to enforce the law apparently petered out.

As of late last year, only one jail – out of 71 that had recently held people awaiting court-ordered treatment – was still certified. There is no statewide oversight or inspection of county jails.

After we asked questions about the law, the Department of Mental Health sought an opinion from the Attorney General’s Office, which opined that it is a “mandatory requirement” that the agency certify the county facilities, including jails, where people wait for treatment. In October, the department sent letters to counties informing them of the ruling and encouraging them to get certified. It is waiting for counties to initiate the certification process, even though it knows exactly which jails have held people after their hearings. Department leadership, including Director Wendy Bailey, have emphasized that they have limited authority over counties and can’t force them to do anything.

5. The practice is not limited to small, entirely rural counties

According to data from the DMH, 71 of the state’s 82 counties held a total of 812 people prior to their admission to a state hospital during the year ending in June. According to state data and our analysis of jail dockets obtained through public records requests, the two counties that jail the most people during the commitment process are DeSoto and Lauderdale – together home to three of the state’s 10 largest cities. DeSoto has one of the highest per capita incomes in the state and Lauderdale’s is above average.

Meanwhile, some smaller, rural counties don’t jail people during the process or do so very rarely. Guy Nowell, who served as chancery clerk of Neshoba County until the end of 2023, said the county arranged each person’s commitment evaluations and hearing to take place on the same day to eliminate waits between appointments. If no publicly funded bed is available after the hearing, the county pays for people to receive treatment at a private psychiatric hospital.

A brief summary of the civil commitment process:

The civil commitment process (also called involuntary commitment) begins when someone – usually a family member, but under state law it can be anyone – files paperwork with the county chancery clerk’s office alleging that another person is so sick that they are a danger to themselves or others. Schizophrenia and bipolar disorder are common diagnoses, but not everyone who gets committed has a serious mental illness.

Then the person can be taken into custody by county sheriff’s deputies. They may wait at a medical facility for evaluations, a hearing and treatment– or if no publicly funded bed is available, they can sit in a jail cell with no criminal charges, receiving minimal care in the midst of a mental health crisis, until a treatment bed opens up.

The Department of Mental Health says the process from initial evaluation to court hearing should take seven to 10 days, but it can take longer. If the judge orders someone hospitalized, they typically join the waiting list for a state hospital or crisis bed.

Last fiscal year, the average wait time in jail for a state hospital bed after a hearing fell to just under five days from more than eight days the year before as the Department of Mental Health reopened state hospital beds. It’s not clear how much time Mississippians spend jailed without criminal charges before their commitment hearings. Legislation passed last year requires counties to report to the DMH about where people are held both before and after their hearings, so more information should be available soon.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.