The United States may be at the brink of an important turning
point in the way the nation cares for those with mental
This week, the US Supreme Court takes up a case that could force
state governments to stop using state mental hospitals as what
critics say are little more than human warehouses for the mentally
Advocates for the disabled say the case may be the most important
in a century in helping to integrate those with mental disabilities
into American society. And it could go a long way in finally closing
the door on the nation's well-documented history of ill-treatment of
those diagnosed with mental retardation or mental illness.
"It's about freedom. It's about society recognizing one's
capacity and one's entitlement to lead the same kind of life that
everyone else leads," says Ira Burnim, legal director of the Bazelon
Center for Mental Health Law in Washington.
The case, argued April 21, involves two women diagnosed as
mentally retarded who were being housed at a mental hospital in
Georgia, even though care professionals determined they would most
benefit from a community-based program.
Georgia does not dispute that its own professionals determined
that the women, Lois Curtis and Elaine Wilson, could live safe and
productive lives outside the hospital. But lawyers for the state
argue that Georgia must retain the discretion to decide when to move
individuals out of a hospital and into locally run programs.
Whichever way the court decides, legal analysts say, it will be a
significant decision. "If the court agrees with Georgia, it will
make the Americans with Disabilities Act a dead letter, at least in
the public-services area," says Steven Caley, one of the Atlanta
Legal Aid lawyers to file suit on behalf of Ms. Curtis and Ms.
Other analysts say that if Georgia loses, it could trigger a
massive shutdown of mental institutions across the country and force
states to set up community-based programs costing hundreds of
millions of dollars.
Limiting state benefits
In the Georgia case, the two women were on a waiting list for
community placement and were asked to wait their turn. "It is a
hallmark of everyday citizenship, not a mark of disability, to be
eligible for some benefits when they become available," writes
Beverly Patricia Downing, senior assistant attorney general of
Georgia in her legal brief to the court. "No civil rights statute of
which we are aware has ever barred such an approach to allocating
limited government benefits."
Lawyers for Curtis and Wilson counter that the Americans with
Disabilities Act of 1990 requires state governments to immediately
transfer mental hospital residents to community-based programs when
care professionals determine it would be beneficial.
Such community programs include assisted group-living arrangements
and small-scale treatment, counseling, and education. Most experts
believe community-based programs foster an atmosphere that is more
conducive to the happiness and progress of citizens diagnosed as
being mentally retarded. …