US Justice Department says Kentucky may be violating federal law for lack of mental health services

LOUISVILLE, Ky. -- Kentucky is likely violating federal law for failing to provide community-based services to adults in Louisville with serious mental illness, the U.S. Department of Justice said in a report issued Tuesday.

The 28-page DOJ report 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.”

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.

“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. Clarke, who works in the Justice Department's Civil Rights Division, also led an i nvestigation into civil rights violations by the city's police department.

The report said admissions to psychiatric hospitals can be traumatizing, and thousands are sent to those facilities in Louisville each year. More than 1,000 patients had multiple admissions in a year, and some spent more than a month in the hospitals, the report said.

“These hospitals are highly restrictive, segregated settings in which people must forego many of the basic freedoms of everyday life.” the report said.

The lack of community and home-based services for the mentally ill in Louisville also increases their encounters with law enforcement, who are the “primary responders to behavioral health crises,” the report said. That often leads to people being taken into custody “due to a lack of more appropriate alternatives and resources.”

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

“Our goal is to work collaboratively with Kentucky so that it implements the right community-based mental health services and complies with the (Americans with Disabilities Act),” a Justice Department media release said.

A spokesperson for 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 AP Tuesday. “We will be fully reviewing and evaluating each conclusion.”

Kentucky has worked to expand Medicaid coverage and telehealth services along with launching a 988 crisis hotline, Hatchett said. The governor also attempted to implement crisis response teams, but that effort was not funded in the 2024 legislative session, Hatchett said.

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.

“The lack of community-based mental health services is a nationwide problem that leaves far too many individuals without critical, lifesaving care,” Kevin Trager, a spokesperson for Louisville Mayor Craig Greenberg, said in statement. The mayor hopes to work with state government to improve care in Kentucky “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," Trager said.