High court weighs rights of mentally disabled

Does federal law give patients right to live with nondisabled in centers?

April 22, 1999|By Lyle Denniston | Lyle Denniston,SUN NATIONAL STAFF

WASHINGTON -- Faced with a historic demand to release mentally disabled patients from state hospitals, Supreme Court justices expressed worry yesterday that those hospitals could be emptied even of patients who need treatment there.

A major case from Georgia drew pleas from the disability rights movement for the court to end the longtime segregation of mentally disabled people in hospitals. The case tests whether federal law gives the mentally disabled the right to be integrated with nondisabled people in community centers or homes.

The state of Georgia argues that federal law protecting the disabled from discrimination does not dictate that mental hospitals release patients who could benefit from treatment in such institutions.

Justice Stephen G. Breyer asked a lawyer for two disabled Georgia women for assurances that a broad ruling in favor of such release from hospitals would not cast out medically needy patients, too.

`Abandoned on streets'

Voicing concern that other justices indicated they shared, Breyer said: "What worries me is writing [a decision], which, as it works out in the real world, leaves many who need to be in institutions out, abandoned on the streets."

Justice Sandra Day O'Connor said, "We have to worry about other cases," not just the case of the two Georgia women who have fought hospitalization.

"The question is a very pressing one," O'Connor told Michael H. Gottesman, a Georgetown law professor who is the lawyer for the two Georgians.

The two women, Elaine Wilson and Lois Curtis, were in the courtroom as three lawyers argued over their rights under the Americans with Disabilities Act. Both women are mentally retarded. They contend that they were kept at the Georgia Regional Hospital in Atlanta, even though they did not need to be institutionalized.

Wilson now lives in an apartment of her own, with aides visiting her home to help her. Curtis lives in a three-person group home. Lower courts have noted that the two women remain at risk of being sent back to the state hospital, even though they do not need treatment there.

A year ago, a federal appeals court ruled that it is a form of illegal discrimination for a state to fail to treat a mentally disabled person in a community-based setting, when that is appropriate, and instead to place the disabled person in a state psychiatric hospital.

Georgia is challenging that decision in the Supreme Court. Initially, the state appeal had the support of 21 states, including Maryland. But Maryland and 13 other states have dropped their support for the state appeal, indicating that they no longer want to be aligned against the disabled. That has left only seven states on Georgia's side.

Justice Breyer suggested yesterday that the outcome of the Georgia case could affect up to 76,000 patients now in state mental hospitals, some of whom may need to remain there but would be discharged anyway if the court issued a sweeping ruling requiring release.

Population is dwindling

State organizations have told the court that the number of mentally ill people in state hospitals has been declining and is now "less than 73,000," perhaps as low as 64,000. In the 1990s, those organizations have said, states have closed 37 mental hospitals and plan to close eight more within coming weeks.

A Georgia assistant attorney general, Beverly Patricia Downing, told the justices yesterday that her state does not discriminate against the mentally disabled. Downing also said Georgia lacks enough community-based facilities to accommodate all who could be treated in such centers.

She argued that each decision about treatment is made for each patient based on individual disability and treatment needs, not on any intent to discriminate.

But Gottesman, the lawyer for the two retarded Georgia women, contended that "isolation and segregation" of mentally disabled people in hospitals and away from nondisabled people is "pervasive," and that Congress intended to stop it.

He tried to assure Justice Breyer and others that patients would not be allowed to push the states into costly treatment and would not insist on being released if that was not "appropriate" to their needs.

When Justice Antonin Scalia suggested that alternatives to hospitals could be "pretty expensive," Gottesman replied that community-center treatment was cheaper than hospitalization.

A ruling on the case is expected by this summer.

Pub Date: 4/22/99

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