Conflict Over Care

Hospitals for mental patients have been scorned since World War II, and most have been closed. But many states still operate a few large hospitals for the mentally ill. Georgia, for example, has more than 100,000 beds in its state facilities.

But that may be about to change. A federal judge in Atlanta, acting on an appeal from two mentally retarded women who wanted to leave a mental hospital, ruled they had a right to be cared for in a community home. The Americans With Disabilities Act forbids “segregation” of people with mental disabilities if their doctors say they could do as well or better outside, said U.S. District Judge Marvin Shoob. Clinton administration lawyers agree, adding that community care is cheaper for the states than confining people in a hospital.

Georgia’s lawyers, joined by those from 12 other states, will challenge that ruling before the Supreme Court on Wednesday. They say a mandate for community care will lead to “massive deinstitutionalization” nationwide and will create difficulties for state officials. (Olmstead vs. L.C., 98-536)