New York Segregated Mentally Ill People, Federal Judge Rules

The state of New York discriminated against thousands of mentally ill New York City residents by unnecessarily institutionalizing them in "adult homes," cutting them off from participation in the broader community, a federal judge has ruled.

U.S. Judge Nicholas G. Garaufis said the state violated the Americans with Disabilities Act and the Rehabilitation Act.

"In carrying out their administration of New York's mental health service system, defendants have denied thousands of individuals with mental illness in New York City the opportunity to receive services in the most integrated setting appropriate to their needs," Judge Garaufis wrote.

He concluded that the privately owned "adult homes" where the residents are housed are institutions that segregate the residents from those without disabilities. The residents' are isolated from the broader community, their lives are highly regimented and their personal autonomy is eliminated, he said.

The judge ordered the defendants, including Gov. David Paterson, New York's Department of Health and the state's Office of Mental Health, to submit a remedial plan to the court by Oct. 23. The plan must address how to expand the state's supply of community-based housing and move mentally ill New Yorkers into such settings.

Disability Advocates Inc. filed the lawsuit in 2003 in the U.S. District Court for the Eastern District of New York.

DAI, an Albany-based nonprofit organization, provides legal representation and advocacy on behalf of disabled New Yorkers.

Andrew Gordon, one of DAI's attorneys, hailed the decision in a Sept. 8 statement as "a significant victory in protecting the rights of disabled citizens in New York state."

The case involved "adult homes," which are state-licensed, privately owned residential care facilities that provide long-term care and supervision to people with disabilities or mental illnesses. Mentally ill New Yorkers often are placed in such facilities when they are discharged from psychiatric hospitals, according to Judge Garaufis' opinion.

The advocacy group argued that the state's treatment of these citizens violates the U.S. Supreme Court's integration mandate from Olmstead v. L.C., 527 U.S. 581 (1999), a decision holding equating unnecessary segregation and institutionalization with discrimination.

The current decision followed a five-week bench trial in May and June during which Judge Garaufis heard testimony from numerous state officials, adult home residents, advocates for the disabled and mental health experts.

The judge found "overwhelming evidence" that adult home residents are needlessly institutionalized.

Most adult homes house "well over 100 people, all of whom have disabilities, and most of whom have mental illness," he said.

They are designed to "manage and control large numbers of people" through "inflexible routines," he said.

"Residents line up to receive meals, medication and money at inflexibly scheduled times during the day," the judge wrote. "They are assigned seats in the cafeteria, roommates and treatment providers."

"They have next to no privacy or autonomy in their own daily lives, and they are discouraged, and most often prohibited, from managing their own activities of daily living, such as cooking, taking medication, cleaning and budgeting," he added.

In addition, living in such facilities impedes residents' abilities to interact with non-disabled people and eliminates any meaningful access to community amenities, Judge Garaufis concluded.

Further, nearly all of DAI's constituents are capable of living in community-integrated settings with appropriate support from the state. However, the state failed to prove that offering the mentally ill such options, rather than housing them in adult homes, would increase the cost for taxpayers, the judge said.

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DAI is represented by Jennifer E. Mathis and Ira A. Burnim of the Bazelon Center for Mental Health Law in Washington; in-house attorney Cliff Zucker of DAI in Albany; and Andrew G. Gordon, Anne S. Raish, Sandra Sheldon and Jonathan R. Bolton of Paul, Weiss, Rifkind, Wharton & Garrison; Jeanette M. Zelhof of MFY Legal Services; John A. Gresham of Lawyers for the Public Interest; Charlyne M. Brumskine Peay of the Urban Justice Center; Roger A. Bearden of New York Lawyers for the Public Interest; all in New York. Barbara K. Hathaway, Amy Marie Held, Scott J. Spiegelman and Matthew Silverman of the New York attorney general's office represent the state.