LOUISVILLE, Kentucky — Kentucky likely violated federal law by failing to provide community-based services to adults in Louisville with serious mental illness, the U.S. Department of Justice said in a report released Tuesday.
The 28-page DOJ report states that the state “needlessly relies on segregated psychiatric hospitals to care for adults with serious mental illnesses who could be helped at home and in their communities.”
The Justice Department said it would work with the state to improve the report’s findings. But if a resolution cannot be reached, the government said it may sue Kentucky to ensure compliance with the Americans with Disabilities Act.
“People with serious mental illness in Louisville are trapped in an unacceptable cycle of repeated psychiatric hospitalizations because they lack access to care in the community,” Assistant Attorney General Kristen Clarke said in a news release Tuesday. Clarke, who works in the Justice Department’s Civil Rights Division, also led an i investigation into civil rights violations by city police.
The report said admissions to psychiatric hospitals can be traumatic, and thousands are sent to those facilities in Louisville each year. More than 1,000 patients were admitted multiple times a year, with some spending more than a month in the hospitals, the report said.
“These hospitals are highly restrictive, segregated environments in which people are deprived of many of the basic freedoms of daily life,” the report said.
The lack of community and home care 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 results in people being taken into custody “due to a lack of more appropriate alternatives and resources.”
The Justice Department acknowledged that the state has taken steps to expand access to services, including crisis response initiatives and housing and employment assistance.
“Our goal is to work with Kentucky to ensure it implements appropriate community-based mental health care and complies with the (Americans with Disabilities Act),” a Justice Department news release said.
A spokesman for Gov. Andy Beshear’s office said state officials were “surprised by today’s report.”
“There are significant and novel conclusions that must be reviewed, as well as omissions from actions that were taken,” James Hatchett, a spokesman for the governor’s office, said in a statement to the AP on Tuesday. “We will fully review and evaluate each conclusion.”
Kentucky has worked to expand Medicaid coverage and telehealth services, along with launching a 988 crisis line, 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 route 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 care is a nationwide problem that leaves far too many people without essential, life-saving care,” Kevin Trager, a spokesman for Louisville Mayor Craig Greenberg, said in a statement. The mayor hopes to work with the state government to improve care in Kentucky, “but ultimately cities like Louisville need our federal partners to provide expanded resources and investments if we are to make the meaningful progress we all want,” Trager said.