In this study, researchers estimated the state of mental health care in Mississippi has been in freefall for years.Because of the ripple effects of the financial crisis, Mississippi saw its state support for mental health care slashed by $42 million from 2009 to 2011, roughly 15% of the Department of Mental Health’s budget.

In 2016, after years of failing to heed warnings from federal prosecutors, Mississippi was sued by the U.S. Department of Justice for failing to deliver adequate care to its residents. The cutbacks in funding, however, have only continued, with another $14 million of cuts coming in 2017, amounting to another 6% of the Department of Mental Health’s budget.

The consequences have been grim: Just last month, Mental Health America, a nonprofit organization dedicated to improving mental health services, issued a state-by-state scorecard for mental health care. Mississippi ranked last in access to care.

Amid such a wholesale evisceration of mental health care, no one in Mississippi is surprised that requests for money to address the state’s backlog of prisoners awaiting basic mental health evaluations have been routinely denied or ignored. The forensic unit at the state hospital where those evaluations take place had 35 total beds in the 1980s, 15 for pretrial evaluations.

The number has not changed since, despite repeated requests from the officials at the Department of Mental Health for money to expand the number of beds to 60 and improve the building’s safety. In one survey of the Mississippi State Hospital at Whitfield in 2014, the Department of Justice found that 55% of the 206 adults in shorter-term care had been admitted two or more times before.

Just over 11% had ten prior admissions. One man, a 27-year-old, according to the DOJ, had over 22 prior admissions. Mississippi negotiated for five years before the DOJ finally sued in 2016. Mississippi has decided to fight the suit. The consequences of a refusal to fund adequate mental health care can be quantified at Whitfield, the once formidable state hospital just outside Jackson.

Gone is the community services division; the 29-bed acute medical, psychiatric service unit, which provided services to people with severe mental disorders who needed close monitoring; the 42-bed male chemical dependency unit, which treated men with substance abuse disorders.

In addition to the state institutions, Mississippi has a network of regional mental health and crisis centers that offer people emergency services and outpatient therapy. The scorecard done by Mental Health America this fall found that just over 11% of youngsters in Mississippi suffering from severe depression receive any form of care.

In Minnesota, the highest-ranked state in the category, 40% of youngsters do. Mississippi has its share of private operators, offering both inpatient and outpatient mental health care. The government itself contracts with private psychiatrists and psychologists to work at its institutions.