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6 Dev. Mental Health L. 1 (1986)

handle is hein.journals/dvmnhlt6 and id is 1 raw text is: A Quarterly Publication of the Institute of Law, Psychiatry & Public Policy at the University of Virginia
Developments in
Mental Health Law
L BOX 100, Blue Ridge Hospital, Charlottesville, VA 22901 (804) 924-5435  Vol. 6, Nos. 1-2 January-June 1986

Ruling could lead to new programs for mentally disabled

Fourth Circuit discovers right to treatment

by Willis J. Spaulding
A mentally disabled client of a
community mental health pro-
gram has a constitutional right
to appropriate services, even if that
means creating new and costly
programs for that client. This
important ruling is now the law in the
states within the jurisdiction of the
Fourth Circuit Court of Appeals.
On January 9, 1986, the Fourth
Circuit Court of Appeals affirmed the
order of a federal District Court in
North Carolina, requiring the state to
transfer its former patient from an in-
appropriate commmunity placement
to a stable suitable supervised com-
munity residential placement such as
(1) a non-institutional specialized
adult foster care situation ... or (2) a
group home with adults of average
intelligence, and provide him with
an array of non-residential services
such as counseling, adult education
and vocational training.
Youngberg v. Romeo
applied to community
In Thomas S. v. Morrow, 1 the Fourth
Circuit relied on the 1982 Supreme
Court ruling in Youngberg v.
Romeo2, a case involving a resident
of Pennsylvania's Pennhurst State
School. In Youngberg the Supreme
Court discovered in the Fourteenth
Amendment's Due Process Clause
substantive rights to food, clothing,
shelter, safety, freedom from undue
restraint, and treatment that was suffi-
cient to protect the resident's rights to

safety and freedom from undue re-
straint. The resident in Youngberg,
Nicholas Romeo, had been placed in
mechanical restraints for long periods
of time, and had been injured by his
own actions and by other residents of
Pennhurst on numerous occasions.
The members of the Court agreed
that the Constitution gave him a right
to enough treatment to prevent the
undue use of mechanical restraints
and to prevent an unreasonable risk
of injury.
In Thomas S. the Fourth Circuit said
that the plaintiff, who neither had
been placed in mechanical restraints
nor had suffered any physical injury,
possessed the same constitutional
right to treatment. The fact that
Thomas S. had been discharged from
the state hospital during the pen-
dency of the litigation and was living
in the community did not diminish the

importance of his liberty interest in
freedom from undue restriction. The
restrictions imposed on Thomas S.
consisted neither of mechanical
restraints, nor even involuntary
hospitalization, but of the appoint-
ment of a guardian with the power to
select the ward's domicile and in the
nature of the treatment provided by
the state. These were the state-
imposed restrictions which gave
Thomas S. a right to sufficient treat-
ment from the state to reduce the
restrictions to a reasonable level in.
light of the circumstances of his case.
Thomas S. became a ward of the
state at birth in 1963. At age eighteen
he was adjudicated incompetent and
a guardian was appointed for him. By
the time of the District Court decision
he had lived in forty different
Continued on page 2

Also in this issue
1986 General Assembly review  .............. 4
Forensic evaluation  revisions  ...............  6
Jail to  hospital transfers  ...................  7
Spring  forensic symposium  .................  8
In the Virginia  Supreme Court  .............. 18

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