OUR HISTORY – AN OVERVIEW

1970s

• Wyatt v. Stickney (PDF) establishes the constitutional right to treatment for people with mental disabilities committed to state institutions.
• The Willowbrook case (NYSARC v. Carey) mandates transfer of institutional residents with developmental disabilities to community programs.
• Souder v. Brennan applies federal labor laws to resident-workers in state institutions.
• The U.S. Supreme Court decides O’Connor v. Donaldson, creating the right of a non-dangerous person to freedom from purely custodial confinement.
• Dixon v. Weinberger mandates creation of community-based alternatives for people unnecessarily confined in D.C.’s St. Elizabeth’s Hospital.
• Addington v. Texas sets the standard of “clear and convincing” evidence of a need for civil commitment.
• Stoner v. Miller upholds the constitutional right of people released from a New York state hospital to live in a community.
• Mills v. Board of Education establishes a constitutional right to education for all children and the Education of All Handicapped Children Act creates the right of children with disabilities to a “free and appropriate public education.”
• Congress requires states to develop protection and advocacy systems for people with developmental disabilities.
• Rogers v. Okin establishes a competent patient’s right to refuse treatment except in emergency situations.

1980s

• Congress enacts the Mental Health Systems and Bill of Rights Act of 1980, though a year later repeals it, creating instead the mental health block grant.
• The Bazelon Center is named the mental health law backup center for Legal Services programs, but withdraws five years later when federal restrictions threaten our advocacy.
• Congress reforms the Social Security disability programs and the Social Security Administration (SSA) issues new standards for determining mental disability. The Bazelon Center wins court orders requiring SSA to review the claims of thousands of adults and children it had denied or dropped from the rolls.
• Congress mandates screening and annual review of the mental health needs of nursing home residents with mental-impairment diagnoses (PASARR) and delivery of alternative services to those found not to need nursing care.
• Allen v. Heckler prohibits discrimination in the terms and conditions of employment on the basis of mental disability.
• The Fair Housing Amendments Act of 1988 makes it illegal to deny access to housing based on physical or mental disability. The Bazelon Center develops a body of case law to help advocates enforce the amendments.

1990s

• The Americans with Disabilities Act (ADA) prohibits discrimination on the basis of mental or physical disability.
• The U.S. Supreme Court, in Olmstead v. L.C., affirms the ADA’s rule requiring that people with disabilities be served in the “most integrated setting” consistent with their needs.
• For the first time, mental health is included in a national policy debate on health care reform, setting the stage for a federal law requiring private insurers to equalize their annual and lifetime limits on mental and physical health coverage.
• The state Children’s Health Insurance Program (PDF) (S-CHIP) gives many children whose families earn too much to qualify for Medicaid access to health care.
• The R.C. settlement in Alabama creates a model system of family-based care for children with emotional or behavioral disorders who are in or at risk of foster care. Class actions in Arizona and California adapt its principles to reform mental health and child welfare systems.
• The Social Security Administration revises its disability criteria for children to consider their functional limitations.
• The 30-year-old Wyatt case that inspired the mental health law movement ends, with the court noting that its standards and mandate of community case are “now federal law.”
• Federal rules for the first time placed restrictions on the use of seclusion and restraint in Medicaid-funded hospitals

2000s

• Congress enacts full parity (PDF) for mental health services with private insurance coverage of medical/surgical care. CHIP reauthorization also mandates parity, and expands coverage to 4 million otherwise uninsured children.
• Settlements in lawsuits brought by students disciplined for seeking mental health care (Nott v. GWU and Jane Doe v. Hunter) lead colleges and universities to reform their punitive policies.
• Congress appropriates funds for collaboration among criminal justice and mental systems to prevent incarceration and recidivism among individuals with mental illnesses.
• The Americans with Disabilities Act Amendments Act (PDF) (ADAAA) restores ADA protections, weakened by courts, for all people with disabilities, including those who take psychiatric medications.
• The federal court in O’Toole v. Cuomo rules that Olmstead applies to for-profit facilities receiving state funds to serve people with mental disabilities in addition to public institutions. The court subsequently orders the state to create supportive housing for the 4,000 people living in New York City’s “adult homes.”
• The Patient Protection and Affordable Care Act includes many provisions expanding access to community-based services for people with mental illnesses.

…and more to come.