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The Bazelon Center has led efforts for the past 45 years to ensure that people with mental health needs have access to non-coercive community and evidence-based mental health services. As a major player in the mental disability rights movement in the mid-1970s, the Bazelon Center was able to secure a host of landmark court decisions that laid out requirements that are now firmly embedded as standard practice in mental health systems. The Bazelon Center was involved in Wyatt v. Stickney (Alabama), O’Connor v. Donaldson (Florida), Dixon v. Gray (Washington, DC) and other important cases that established vital legal precedents, including requirements for: (1) a factual basis beyond psychiatric diagnosis for civilly committing an individual to a hospital; (e.g., “danger to self or others”); (2) the right to legal representation and due process; (4) freedom from coercive or dangerous treatment (e.g., seclusion and restraint or brain surgery); (5) access to meaningful health treatment and physical healthcare; and (6) freedom from unnecessary confinement (i.e., “least-restrictive treatment”).
These hard-won rights spurred deinstitutionalization, whereby hundreds of thousands of individuals who had been consigned to custodial “back” wards of state hospitals were discharged to various community settings (including nursing homes and group homes) that were state-of-the-art at the time. Additionally, the Americans with Disabilities Act (ADA), has provided the Bazelon Center to advocate and build a mental health system that provides the necessary community services.
The Bazelon Center is working to ensure individuals with psychiatric disabilities at all income levels have access to the core set of community mental health services that will enable them to live and work independently in the community.
People with mental disabilities should make their own life decisions. They should not be made by government or medical professionals. At the Judge David L. Bazelon Center for Mental Health Law, we work to protect people’s autonomy, including their right to vote, participate in community life, and make choices about the care they receive.
Forced mental health care is never appropriate, except when there are immediate and serious safety risks. And even then, listening to consumers and respecting their choices is essential to designing service plans that succeed. For choice to be real, systems must offer a wide array of interventions and supports, and consumers must understand their benefits and risks.
Adequate services available on a voluntary basis that help people maintain homes, jobs, and family and community ties encourage people to seek the assistance they need. Coercive systems with a limited menu of medications, office-based therapy and institutional care often result in poor outcomes and discourage help-seeking. A new trend is self-directed care, which puts some of the resources in the hands of consumers to spend on services they choose. In the Driver’s Seat: A Guide to Self-Directed Mental Health Care (PDF) describes this.
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