Justices Weigh Outpatient Mental Care: Fear Mass Dumping from Hospitals
Murray, Frank J., The Washington Times (Washington, DC)
Five Supreme Court justices voiced fears yesterday that the nation's mental hospital "floodgates" would open and dump 70,000 or so patients onto the streets if two mildly retarded Georgia women win a fight for outpatient care.
"A lot of the 76,000 people in institutions really need it. What bothers me is writing something which, as it works out in the real world, leaves many of those who really need institutionalization out abandoned in the streets," Justice Stephen G. Breyer said of the appeal touted as the most important disability case in a decade.
While a few justices openly supported the option of states to treat the mentally disabled only in institutions, some appeared to seek an explanation for potential patient-dumping if the court rules that Georgia violated the Americans With Disabilities Act (ADA).
There was no clear answer from lawyers arguing the case - even when Justices David H. Souter, Ruth Bader Ginsburg, John Paul Stevens and Sandra Day O'Connor pressed the point. A lawyer who filed a friend-of-the-court brief for 36 groups called it a false issue.
"The people who are in the real world don't think so. You've got the entire mental health community coming down in support of the patients," said Alan M. Wiseman, whose client list includes the American Association on Mental Retardation, the American Association of Retired Persons, Catholic Charities and the AIDS Legal Referral Panel.
Also supporting that view were nine other briefs from such interests as the American Psychiatric Association and the National Organization on Disability.
"What Georgia did here was simply to provide hospital services to a mentally disabled patient," said Beverly P. Downing, the state's senior assistant attorney general, who argued the ADA does not require states to pay for hospitals and a parallel community-care program.
"The mere fact that a person could also be treated in the community does not by itself make hospital treatment discriminatory," Miss Downing said. …