June 2024 DOJ findings concluded Missouri unnecessarily institutionalizes thousands of adults with mental health disabilities in nursing facilities instead of supporting community-based services. Approximately half the institutionalized population with mental health conditions are under 65.
June 2024 DOJ findings concluded Missouri unnecessarily institutionalizes thousands of adults with mental health disabilities in nursing facilities instead of supporting community-based services. Approximately half the institutionalized population with mental health conditions are under 65.
This record is here because it helps show how institutions, services, and community conditions can combine to produce preventable harm.
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missouri-doj-settlement-on-nursing-facility-pipeline-for-adults-with-serious-mental-illnessState fails to provide intensive community-based services such as Assertive Community Treatment (ACT), which are designed to support individuals with serious mental illness in their own homes and communities.
State relies on guardianship and conservatorship appointments as a mechanism to facilitate nursing facility placement, even when individuals do not meet clinical criteria for institutional care or express desire to remain in community.
Thousands of primarily younger adults with serious mental illness are placed in nursing facilities despite minimal physical care needs, converting what should be post-acute care settings into de facto psychiatric institutions.
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A recurring pattern in which people with disabilities or serious mental illness are kept in, discharged to, or steered toward segregated settings because community-based services, housing, and placement options are withheld or underbuilt.
This pattern shows how systems can violate community-integration obligations without dramatic headlines: by making institutional placement the default while treating home- and community-based alternatives as unavailable, delayed, or optional.