In 1974, patients confined at the Federal Mental Institution (FMI) in the District of Columbia filed this class action lawsuit in the U.S. District Court for the District of Columbia. The plaintiffs filed under the Hospitalization of the Mentally Ill Act (HMIA), 21 D.C. Code §501, against the District of Columbia. The plaintiffs, represented by the Center for Law and Social Policy and the Mental Health Law Project, asked the court for a declaration of the following: 1) that they had a right to treatment at facilities outside the FMI where such placement was determined to be consistent with the rehabilitative purposes of the HMIA; 2) that the District of Columbia and the federal government had a joint duty to provide for such treatment where appropriate; and 3) that this duty had been breached because there were numerous individuals in the hospital who had been determined to be in need of placement in such outside facilities, but who had been denied such placement.

On December 23, 1975, the U.S. District Court for the District of Columbia (Judge Aubrey E. Robinson, Jr.) granted partial summary judgment to the plaintiffs, holding: 1) that the plaintiffs had the right to the treatment in question where the institution had determined that such treatment was appropriate; 2) that the primary responsibility for exploring and providing alternative facilities at the commitment level rested upon the District of Columbia; 3) and that the District of Columbia and the federal government would bear the joint responsibility for provision of alternative facilities for individuals who were still in need of psychiatric care despite their readiness for placement in alternative facilities. Dixon v. Weinberger, 405 F.Supp. 974 (D.D.C. 1975).

In 1980, the District Court entered a Consent Order and Final Plan to implement the findings of its 1975 decision. The Plan had a target completion date of 1985, but the defendants were unable to meet their obligations under it. After extended negotiations, the parties agreed upon a Service Development Plan, which was incorporated into another Consent Order of the Court on January 27, 1992.

In early 1993, the plaintiffs asked the court to hold the defendants in contempt for failure to meet the terms of the 1992 Consent Order. On May 14, 1993, the District Court (Judge Robinson) held that the defendants' failure stemmed from inability, rather than unwillingness, to meet the terms of the 1992 Order. To ensure progress, the Court appointed Dr. Danna Mauch as Special Master to monitor and report on implementation of the 1992 Consent Order. Dixon v. Kelly, No. 74-285, 1993 U.S. Dist. LEXIS 6511 (D.D.C., May 14, 1993).

In 1996, the plaintiffs asked the District Court to appoint a Receiver over the District of Columbia Commission on Mental Health Services (CMHS) due to repeated failures of defendants to comply with the Court's orders. On June 13, 1997, the District Court granted the request and approved the appointment of a Receiver. Dixon v. Barry, 967 F.Supp. 535 (D.D.C. 1997). On September 11, 1997, appointed Scott H. Nelson as the Receiver to administer the CMHS in accordance with its June 13, 1997 Order. The Court also terminated the duties of Special Master Mauch. The Receiver administered the operation of the CMHS until 2000.

On March 6, 2000, the District Court (Judge Thomas F. Hogan) entered a Consent Order which reflected the agreement of the parties as to the process by which to terminate the receivership and return the day-to-day operation of the mental health system to the District of Columbia. The District Court appointed Dennis R. Jones to act as Transitional Receiver.

The Transactional Receiver submitted a plan to the Court for the implementation of compliance with the various orders and decrees of the District Court. That plan called for the creation of a separate Department of Mental Health which would set mental health policy for D.C., certify and license mental health institutions and operate a hospital and core service agency. The District Court (Chief Judge Norma H. Johnson) approved the plan of the Transactional Receiver on April 2, 2001.

On May 23, 2002, the District Court entered an order terminating the receivership. The Court ordered that the former Transactional Receiver Dennis R. Jones be appointed as Monitor to ensure the defendants' compliance with the April 2, 2001 Plan.

On December 12, 2003 the parties agreed to a consent order that established 19 exit criteria that the Defendants were to seek to substantially comply with. The parties further agreed that once the District of Columbia substantially complied with each of the 19 criteria, the litigation was to be dismissed.

On September 4, 2009 the Defendant District of Columbia filled a motion to vacate the December 12, 2003 Consent Order and dismiss the litigation. The District of Columbia argued that it had remedied the statutory violation that had given rise to the Consent Order. Furthermore, the District argued that it had remedied the original systematic violations and had faced a "change in circumstances" recognized by the Supreme Court in Horne v. Flores, 129 S. Ct. 2579, 2593 (2009) which makes the continued enforcement of the Consent Decree inequitable. Lastly, the District of Columbia argued that it had substantially complied with the exit criteria established by the Court in 2003. From the date of the 2003 Consent Order, the District had filled 14 monitoring reports with the court detailing its progress substantially complying with the 19 exit criteria. As of the date of the motion, the Court monitor had moved 6 exit criteria to inactive status, and had found the district had made notable progress in regard to 6 additional exit criteria. Taken together, this progress, the District argued, rendered it in substantial compliance with the exit criteria established by the Court in the December 12, 2003 Consent Decree.

According to the Court Monitor's July 26, 2011 report to the court, the District of Columbia had complied with 14 of the 19 exit criteria. However, the Court did not act on Defendant's motion.

Instead, on September 8, 2011, the parties reached another class-action settlement agreement settling all remaining claims. The court retained jurisdiction to enforce the settlement. On February 16, 2012, the court approved the consent decree. The agreement would terminate on March 30, 2014, unless an enforcement action was filed before then. No enforcement action were filed and the case was finally closed in 2014.