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Mental health services suit drawing to a close

WASHINGTON — A long-running lawsuit over the way the District of Columbia provides health services to seriously mentally ill residents is coming to a close.

A federal judge on Monday gave preliminary approval to a settlement in a class-action lawsuit from the 1970s that led to changes in the way the city cares for its mentally ill residents. Thirty years ago, public care for the mentally ill in Washington consisted almost exclusively of hospital treatment. Now, most residents remain in their communities while receiving treatment and hospital stays are shorter. The change coincided with a national movement for community-based mental health care.

Under the agreement, which ends long-running court oversight of the city’s mental health program, the city will increase job services and housing for the mentally ill. In addition, the city will reduce its use of restrictive inpatient facilities for mentally ill youth and increase community-based treatment, letting children live at home and get care at their homes, schools or local clinics. The city has until September 2013 to carry out the agreement.

“We’d be the first to tell you there are still many challenges … but the District has made incredible progress,” said Stephen Baron, the director of the Department of Mental Health since 2006.

In a statement, D.C. Mayor Vincent Gray called the agreement a “significant milestone.”

Patients at the city-run mental health hospital, Saint Elizabeths, originally filed the lawsuit in 1974 seeking treatment alternatives in their communities instead of hospitalization. The case became known as the “Dixon case” after one of the plaintiffs, William Dixon.

At the time the lawsuit was filed, some 3,600 people were being treated at Saint Elizabeths and patients often spent a long time hospitalized in dilapidated buildings. Today, the hospitalized population is less than 300 patients, the city said. A new facility opened to house those patients in 2010.

Under the settlement agreement, the city will increase the number of mentally ill residents who get housing subsidies from 1,400 to 1,700. In addition, the city will expand services to support mentally ill individuals who want to hold jobs. Currently, about 700 people get job support services. That number would expand by about 200 people under the settlement.

The city plans to send out notice of the agreement to some 27,000 people currently enrolled in the public health system. They will have a chance to speak at a hearing Feb. 2 where a judge could grant final approval of the settlement.

The city will make quarterly reports on its progress for the next two years.