Brewer Announces Landmark Mental Health Settlement

By  Al Macias
January 08, 2014

After more than 30 years of legal battles over the state’s treatment of seriously mentally ill people, a historic settlement was announced on Wednesday by Gov. Jan Brewer. The state and attorneys for the mentally ill reached an agreement that promises more services and opportunities.

The case dates back to the early 1980s when Maricopa County and the state released seriously mentally ill people from the state hospital with the promise of better alternatives to long term confinement, but those alternatives never materialized, and the seriously mentally ill or SMI’s were left to fend for themselves on the streets.

Michael Shafer is the director of the Arizona State University Center for Applied Behavioral Health Policy. He said when the suit was filed, Arizona had a bad reputation for its treatment of the mentally ill.

"In 1988 when this suit was filed, the National Alliance for the Mentally Ill,  (it was) a national ranking as 53rd in the country in per capita spending on mental health expenditures for community mental health services, 53rd in a country with only 50 states," Shafer said.

In 1989 after years of legal wrangling, the Arizona Supreme Court found that Maricopa County and the state were deficient in providing services to citizens with serious mental illnesses. The two sides negotiated multiple agreements to deliver those services. The process dragged on over three decades. County Supervisor Mary Rose Wilcox said the state and county were responsible for some of the delays.

"Quite frankly the Arizona and Maricopa County in the past had not taken care of it. It was very onerous and very very long but sometimes things need to be watched over," Wilcox said.

An independent monitor was appointed to make sure the state and county were living up to the agreements. The cost for implementing the programs and services over the years runs into the hundreds of millions of dollars, and no one knows the exact amount.

Anne Ronan is with the Center for Law in the Public Interest. She said over the years the state and plaintiffs have built an infrastructure of programs that led to the final agreement.

"You know, at some point the infrastructure was there and now with the expansion of Medicaid and the commitment of state dollars to housing, the last piece, the key, which is that the services be funded fell into place," Ronan said.

Some of the key stipulations in the tentative final agreement call for the state Department of Health Services to develop crisis response teams and intervention services, family and peer support assistance and housing services. Brewer announced the settlement Wednesday.

"You know I’m really proud of what were able to accomplish, what we’ve been able to accomplish, and I think Arizona is the model for behavioral health across the country," Brewer said.

If the governor’s prediction is right that would be a long way from where the state ranked 33 years ago. The final agreement must still meet court approval.