Supreme Court Upholds Mental Patients' Rights to Community Care

Tom Boland (
Thu, 24 Jun 1999 09:03:07 -0700 (PDT)
FWD  Reuters - June 22, 1999


     By James Vicini

WASHINGTON (Reuters) - In a landmark disability rights
decision, the U.S. Supreme Court ruled Tuesday that a state may
not discriminate against psychiatric patients by keeping them in
hospitals instead of community homes.

The court, by a 6-3 vote, said the nine-year-old federal law
which prohibits discrimination against the disabled may require
that states provide treatment in community-placement programs
rather than in "segregated" mental institutions.

The ruling was a decisive victory for advocates of the
mentally ill and for the U.S. Justice Department, which said
states under the law must provide treatment in the most
integrated setting that would be appropriate.

The decision may affect many of the more than 75,000
mentally ill Americans in state institutions. Advocates for the
mentally ill estimated that half those in state institutions
could live in community homes.

Reading from the court's 22-page majority opinion, Justice
Ruth Bader Ginsburg declared from the bench, "Unjustified
institutionalization of persons with mental disabilities ...
qualifies as discrimination."

She added, "Unnecessary segregation of persons with mental
disabilities perpetuates unwarranted assumptions that such
persons are unfit for, or unworthy of, participating in
community life."

Ginsburg said community placement would be required when
state professionals have determined it was appropriate, the
transfer was not opposed by the affected person and it can be
reasonably accommodated, taking into account the resources
available and the needs of others with mental disabilities.

Ginsburg made clear the state's responsibility, once it
provides community-based treatment, was not "boundless."

The case involved a lawsuit filed by two mentally ill
patients, Lois Curtis, 31, and Elaine Wilson, 47, who were
housed in a Georgia psychiatric hospital.

They charged that the state's failure to provide them with
care in the most "integrated" setting appropriate to their
needs violated the law that prohibits discrimination against the

Justice Anthony Kennedy wrote a separate opinion concurring
with the judgement. He said the ruling should be applied with
"caution and circumspection."

Otherwise, "states may be pressured into attempting
compliance on the cheap, placing marginal patients into
integrated settings devoid of the services and attention
necessary for their condition," he said.

Kennedy noted that about 5.6 million Americans each year
will suffer from severe mental illness, and that millions of
other Americans suffer from mental disabilities of a less
serious nature, such as mild depression.

Advocates for the mentally ill applauded the ruling.

"Thanks to this landmark decision, states will have fewer
excuses for segregating people with mental disabilities in
institutions," said Michael Faenza of the National Mental
Health Association.

"The ability to lead more normal lives and achieve greater
recovery from serious mental illnesses will now be possible for
those who are shut away in state institutions," he said.

Georgetown University law professor Chai Feldblum said the
decision correctly noted the importance of integration in
mainstream society for people with disabilities.

The court's three most conservative members -- Chief Justice
William Rehnquist and Justices Clarence Thomas and Antonin
Scalia -- dissented.

"Temporary exclusion from community placement does not
amount to 'discrimination' in the traditional sense of the
word," Thomas wrote.

He said the two women failed to show that the state
"discriminated against them by reason of their disabilities."
He said requiring them to "wait their turn" for community
placement simply shows the state has "limited resources."


**In accordance with Title 17 U.S.C. section 107, this material
is distributed without charge or profit to those who have
expressed a prior interest in receiving this type of information
for non-profit research and educational purposes only.**

5,000+ POSTS by or via homeless & ex-homeless people
Nothing About Us Without Us - Democratize Public Policy