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This blog post is chapter 4 in a four-part series reflecting on the legacy and significance of the Americans with Disabilities Act (ADA). Written by Yair Oded and Jesús Veliz; edited by Jennifer Mathis.
September 11, 2025
For many years, community services such as supported housing, assertive community treatment, peer support, supported employment, and mobile crisis teams have shown that people with the most significant mental health disabilities can succeed in their own homes and communities.
The landmark 1999 Supreme Court decision in Olmstead v. L.C. (Lois Curtis) established that access to community-based services is not simply a matter of policy preference — it is a legal right protected under the ADA. In that case, the Court held that the unjustified institutionalization of people with disabilities is a form of discrimination under the ADA. The ruling affirmed that people with disabilities have a right to receive services in the most integrated setting appropriate to their needs. The ADA’s “integration mandate” has been applied not only to settings where people live, but also settings where they work or receive day services, and where they go to school.
Just weeks ago, we celebrated the conclusion of an important integration mandate case brought by the Bazelon Center and others: O’Toole v. Cuomo. The O’Toole case challenged New York State’s practice of housing people with serious mental health disabilities in large, state-licensed adult homes. Initially filed in 2003 as Disability Advocates, Inc. v. Paterson, the case exposed how these institutions, which were the only living option offered to thousands of New Yorkers with mental health disabilities, restricted people’s lives, fostered isolation and segregation, and failed to offer real pathways to independent living. Residents were often overmedicated, isolated, and stripped of autonomy.
In 2009, the court found that the state violated the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, and in 2010 directed to provide supported housing for adult home residents. That order was overturned on standing grounds. In a 2014 settlement between a class of people with mental health disabilities, the state of New York, and the Department of Justice, the state agreed to provide supported housing for qualified adult home residents who wanted it and to take a number of steps to ensure that people could access the services they needed. By 2025, nearly 1300 class members had transitioned into supported housing — homes of their own with services that enabled greater independence and self-determination. A final hearing in June 2025 marked the conclusion of that case.
At the settlement hearing, class member Debra Hunter described her experience in an adult home: “Living at Wavecrest took away my ability to think for myself; stripped my pride… I felt broken. […] Now that I live in my own apartment, it is awesome… I get up when I’m ready, eat, take my medication, schedule my medical appointments, and I listen to music, I take walks, I go visit with friends, family, and church.”
Many class members who moved into the community over a decade ago remain stably housed — reaffirming the success of supported housing.
The O’Toole case demonstrates how legal advocacy, shaped by the lived experiences of those most directly affected, can drive systemic change and reinforce the protections of disability rights law. But litigation alone cannot dismantle the structures that perpetuate institutionalization. Across the country, communities are advancing that mission in a variety of ways, including through peer-led advocacy and services.
“Peer support isn’t solely a profession. It happens at the grassroots level — in your everyday life, at the community center, the barber shop, the hair salon, or at your kitchen table,” says Vesper Moore. “We train people to be changing agents, to advocate for transformation, to center humanity — and that’s what makes peer support so powerful.”
“But sustaining that work is tough, especially as federal agencies pull back funding or change requirements,” they continue. In response, many groups are turning toward flexible, sometimes private funding — but as Moore warns, “Once we switch to private funding, what happens next? Who will hold you accountable?”
Organizations like the Kiva Centers, which emerged from the consumer-survivor-ex-patient movement in the 1980s, have long pushed for services that center lived experience and community healing, including peer support. Moore, who serves as the Kiva Center’s Chief Operating Officer, notes, “We build alternatives to acute units — peer-run respites where people can stay in a house for 5–7 days, manage their own medications, come and go freely, and heal at their own pace.
“We call them guests,” they add. “They have their own room, no locked doors, and they’re supported by certified peer specialists — people who’ve been there. When people access what we offer at Kiva Centers, they’re often completely diverted from going to a unit or emergency room that could disrupt their lives.”
The Alliance for Rights and Recovery, formerly known as the New York Association of Psychiatric Rehabilitation Services (NYAPRS), is a national leader in advancing non-coercive, community-based, and peer-led mental health care. Its Peer Bridger Program, which has been replicated throughout the country, pairs individuals entering or leaving psychiatric hospitals with trained peer advocates who offer practical support and mentorship.
“The unique thing about our Bridger model is that it begins at admission,” says Harvey Rosenthal, CEO of ARR. “We want to be there for the trauma of hospitalization, saying, ‘It’s going to be all right. I’ll be with you through this.’ We build relationships that can last 9 to 12 months. We’re there on the unit, we run peer support groups, and we’re there when people return to the community.
“We created the Peer Bridger model in 1994 with savings from hospital closures in New York,” he adds. “When we first brought the program into state hospitals, we were working with people who’d been institutionalized for 15 or 20 years. Just having someone come in and believe in them — that alone sparked hope.”
Now, the Alliance is helping other states — Washington, Mississippi, Kentucky — adapt Peer Bridger services to their systems. “When states face Olmstead lawsuits, they call us. Because this model works,” says Rosenthal. “It helps people transition from institutions into real lives in their communities.”
Services like Peer Bridgers show what it means to honor Olmstead in practice: supporting people as they leave institutions and rebuild their lives in the community. Through litigation and advocacy, organizations like the Bazelon Center fight to make those rights enforceable and ensure that states invest in community-based services instead of reverting to segregation and coercion.
As we reflect on 35 years of the ADA, it’s clear that the fight for disability rights is far from over, including for people with mental health disabilities. Unnecessary segregation is a form of discrimination. Yet in far too many jurisdictions, it remains common due to underinvestment in community services. Instead of funding housing, peer support, and voluntary services, many policymakers continue to default to coercion. In doing so, they not only impede civil rights, but waste public resources on costly, ineffective systems that isolate people from their communities.
Bazelon has spent decades challenging this state of affairs by pursuing litigation to enforce Olmstead, defending the right to self-determination, and pushing lawmakers to invest in what works. That includes services like supported housing, mobile crisis teams, peer support, and supported employment — proven strategies that have already helped thousands reclaim their lives.
But to make these solutions the rule, not the exception, we need more than evidence. We need political will. We need to confront the fear-based narratives that drive exclusion, and dismantle the systems that equate disability with incapacity.
The ADA’s mandate is clear. It guarantees the right of all people with disabilities — including those with serious mental health conditions — to live integrated, self-directed lives in their communities. On this anniversary, let’s celebrate the progress we’ve made, but let’s also be clear-eyed about the work ahead. Rights are not realized through rhetoric. They are enforced through law, built through organizing, and sustained by collective resolve.
Join the Bazelon Center in marking the 35th anniversary of the ADA at our Annual Awards Reception, taking place Wednesday, September 17, 2025, from 6:30–9:00 PM ET at the National Press Club in Washington, D.C. Get your tickets and event details here.
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