After nearly four decades of litigation spanning three judges and seven mayors, the District's once inadequate and outdated mental health system has been deemed fit to function on its own.
Mayor Vincent Gray and others involved in the 1974 Dixon class-action lawsuit announced Thursday that District Court Judge Thomas F. Hogan approved a settlement agreement releasing the Department of Health from almost 40 years of court oversight. Hogan dismissed the case with prejudice, calling it a historic moment for the city.
"What this signals, I believe, is that we really have over the years made enormous progress in building a solid community mental health system here in the District of Columbia," Gray said.
The agreement, first proposed in 2003, outlined 19 areas of needed improvements to the city's mental health services. The Department of Mental Health has met 15 of those so far under supervision of a court monitor. The remaining four criteria -- an increase in child services, continuity of care, supportive housing and employment -- are expected to be fulfilled over the next two years.
"When you get to the point where you can look at it and say we have a sustainable system that wants to get better, then you know you're at a point when the court doesn't need to be putting it's imprimatur on this," Court Monitor Dennis Jones said.
Gray said the city funded 100 housing units this year for mentally ill residents with a goal of 300 units by 2014. The approved agreement also calls for a 25 percent increase in job counseling to serve 875 new residents and a renewed focus on early childhood education services.
The mental health system as a whole has undergone a major shift from centralized to community-based care. More than 20,000 residents are treated at 27 local clinics across the District.
When the lawsuit arose, almost 4,000 patients were housed in a single hospital. Plaintiff and patient William Dixon argued that many of St. Elizabeths patients could live on their own but lacked the community services they needed.
As a result of the lawsuit, more than 98 percent of mental health patients are now treated at local clinics throughout the city and fewer than 300 patients are housed at the hospital.