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Thirty Years of Landmark Advocacy

Below are selected successes in the Bazelon Center's work to uphold the rights of people with mental disabilities.

Right to Treatment/Protection from Harm

• Wyatt v. Stickney sets minimum standards for physical conditions, staffing and safeguards of human rights in Alabama's psychiatric and mental retardation institutions (1972) and ultimately mandates community care for residents (1999).
• Morales v. Turman establishes standards to protect children in Texas juvenile facilities (1974).
• New York State Association for Retarded Children v. Carey, to protect residents of Willowbrook State School from harm, requires their transfer to appropriate community-based programs (1975).
• Congress mandates preadmission screening of nursing home applicants and annual review of residents' service needs to prevent inappropriate "warehousing" and require active treatment (1987).

Right to Liberty

• O'Connor v. Donaldson establishes the right of a non-dangerous person to freedom from purely custodial confinement (1975).

Right to Live in the Community

• Stoner v. Miller upholds the constitutional right of people released from institutions to live in a New York community (1974).
• The Fair Housing Amendments Act of 1988 makes it illegal to deny access to housing based on disability. When repeal is threatened (1998-1999), the Coalition to Protect the Fair Housing Act successfully protected it.
• Horizon House v. Town of Upper Southampton holds that a requirement of minimum distance between group homes for people with disabilities in Pennsylvania violates the federal Fair Housing Act (1992).
• Oxford House v. Babylon establishes that a group of people with disabilities living together is a "family" for zoning purposes and therefore cannot be excluded from a neighborhood of single-family homes (1993).
• Potomac Group Homes v. Montgomery County holds that jurisdictions cannot use different safety standards or neighbor-notification rules for housing to be occupied by people with disabilities (1993).
• Olmstead v. L.C. upholds the right of people with disabilities to receive services in the least restrictive setting consistent with their need (1999).

Access to Mental Health Services

• For the first time, mental health is included in a national policy debate on health care (1994).
• The first federal parity law requires private insurers to equalize their annual and lifetime limits on mental and physical health coverage (1996).
• Mental health block grant, level-funded since 1981, is expanded by 23% in 2000 and another 15% in 2001. States now receive $420 million to help them provide community-based rehabilitation and other mental health services.
• Jail diversion program authorized for individuals with mental illnesses who come into contact with the criminal justice system; $4 million appropriated in first year (2001).

Right to Education

• Mills v. Board of Education establishes the right of all children with disabilities to appropriate education through the public schools (1972). In 1975, Mills is codified in the federal Education for All Handicapped Children Act, now the Individuals with Disabilities Education Act (IDEA).
• Children's right to receive a free, appropriate public education, including when they are suspended or expelled from regular school for behavior related to their disability, survives challenges in Congress (1980, 1997).
• Blackman v. Board of Education requires school district to serve children with serious emotional disturbances in their home communities with non-disabled peers rather than sending them to private residential facilities (1998).

Systems of Care for Children

• A far-reaching settlement in R.C. v. Hornsby mandates creation of a new system of home- and community-based care for emotionally or behaviorally disturbed children in or at risk of foster care (1991, implementation ongoing).
• Child Mental Health Services program is created with demonstration grants to 11 states (1992); today the program provides nearly $92 million in grants to all states.
• J.K. v. Eden establishes principles governing operation of a state's Medicaid managed mental health care system for children (2000, implementation ongoing).

Right to Receive Services in the Community

• Dixon v. Weinberger mandates creation of community-based alternatives for people unnecessarily in or at risk of confinement in the District of Columbia's St. Elizabeths Hospital (1975, implementation ongoing).
• Wuori v. Zitnay sets standards for community-based programs serving former residents of a Maine facility for people with mental retardation (1979).

Access to Federal Entitlements

• Minnesota Mental Health Association v. Schweiker orders the Social Security Administration to stop using arbitrary criteria to decide applicants' eligibility for federal disability benefits on the basis of mental impairment (1983).
• Congress reforms the Social Security disability program (1984) and the Social Security Administration issues new standards and procedures for evaluating mental disability in adults (1985).
• Bowen v. City of New York mandates use of new mental impairment standards and orders the payment of retroactive benefits to all New York State residents dropped from the rolls through use of the illegal procedures (1986).
• SSA revises children's disability criteria (1990); the Bazelon Center's Children's SSI Campaign results in eligibility for cash assistance and Medicaid for a million children with serious disabilities (1992-1994).

Protections Against Discrimination

• Souder v. Brennan applies federal labor laws to residents working at institutions, who, until then, were widely exploited as free institution-maintaining labor (1973).
• Allen v. Heckler prohibits discrimination in the terms and conditions of employment on the basis of mental disability (1984).
• The Americans with Disabilities Act outlaws discrimination against people with physical or mental disabilities, in employment, public services and all aspects of public life (1980).
• Clark v. Virginia Board of Bar Examiners declares that broad questions about a person's history of mental health treatment violate the Americans with Disabilities Act (1994).

Protections for People Subject to Intrusive Procedures

• Wyatt v. Hardin establishes procedures to be followed before an institutional resident may be sterilized (1974) and sets standards governing the use of electroshock in Alabama institutions (1975, revised in 1992).
• Ihler v. Chisholm recognizes constitutional limitations on the use of seclusion and restraint in Montana's mental hospital (1991).
• Federal rules for the first time govern seclusion and restraint in Medicaid-funded hospitals (1999) and set standards for their limited use in residential treatment facilities for children (2000).

Due Process Protections in Civil Commitment

• American Bar Association's Commission on Mental Disability publishes the Bazelon Center's legislative guide, Legal Issues in State Mental Health Care: Proposals for Change (1977).
• Addington v. Texas sets the standard of clear and convincing evidence of the need for commitment (1979).
• Wallace v. Stubbs develops due process protections for people subject to civil commitment in Mississippi, which the state legislature enacts in 1984.
• Streicher v. Washington requires meaningful periodic review of civil commitment orders (1997).

Access to Advocacy

• Congress creates the protection and advocacy systems for people with developmental disabilities and funds the Bazelon Center to provide technical assistance to them (1977).
• The Civil Rights of Institutionalized Persons Act authorizes the U.S. Department of Justice to initiate or intervene in lawsuits to protect the rights of people in state hospitals and developmental disabilities facilities (1980).
• Coe v. Hughes leads to funding of a civil legal assistance program for inmates of Maryland's mental institutions (1985).
• Congress establishes and funds protection and advocacy systems for institutionalized people with mental illnesses in every state (1986). In 1991 the program expands to include people living in the community.

Self-Determination and Privacy

• Template developed for Bazelon website enables individuals who may later be subject to a finding of incompetence to create an advance directive for mental health treatment (1999).
• New federal health rules give mental health consumers access to their own treatment records and protect their privacy (2000).