The Bazelon Center for Mental Health: Supporting People with Mental Health Conditions

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One out of five people in the US – a total of 51.5 million – live with a mental health condition, including common illnesses such as depression, anxiety, and PTSD. Although the implementation of the Americans with Disabilities Act (ADA) has improved the lives of many disabled people, the mental health community still faces barriers, specifically related to education, employment, and the criminal justice system. The attorneys at the Bazelon Center for mental health law protect the rights of people with mental disabilities. ABILITY Magazine spoke with Eve Hill, Chair of the organization, about her work for the Bazelon Center, recent legal achievements, and their upcoming event to celebrate the ADA’s 30th anniversary.

Advocating for a stigmatized community

The Judge David L. Bazelon Center for Mental Health Law was founded by lawyers and mental health professionals with the mission to support people with a variety of mental health conditions. Since 1972, their advocacy has enforced landmark court decisions that have paved the way for many other advocates to fight for their rights and improved the lives of people with mental disabilities. Using laws and legal steps to create equality, the Bazelon Center pioneered the field of mental health law. “Our main priority is to eradicate the stigma and the misconceptions around people with mental illnesses. We try to break down the prejudices by challenging them legally, and therefore proving that those assumptions were wrong,” Eve Hill, Chair of the Bazelon Center, says.

Becoming a disability rights lawyer

Eve is the new chair of the Bazelon Center. As an attorney, she couldn’t be more passionate about her work. When she talks about disability rights and her involvement at the Bazelon Center, her eyes sparkle, she waves her hands around while talking, and her voice becomes more assertive and forceful. She loves what she is doing.

Eve has been a disability rights lawyer since 1993. Before she started her fight for people with disabilities, she was a natural gas contract lawyer. “Because that’s the career path you choose if you want to become a civil rights lawyer,” Eve laughs. She graduated from law school right as the ADA was being passed and began working on pro bono cases for a law firm, while learning how to enforce the ADA.

“I loved that the ADA is such a balanced law. It says, ‘Look, based on our wrong assumptions about people with disabilities for 400 years, we’ve been treating them this way. We now know that our assumptions are wrong, and we need to unbuild those assumptions from our society. But we recognize that we can’t do it all at once. Yes, we assumed people with wheelchairs wouldn’t be out in the world with us. So we built everything with stairs. Now, we need to unbuild that, but we recognize you can’t tear everything down right now.’ So it really puts this balance in place,” Eve explains.

Today, Eve primarily supports the National Federation of the Blind, one of her largest clients, focusing on assistive technology, for example, accessible websites and apps. In a more recent case, she ensured that blind people were able to vote during the 2020 election, enforcing voting stations to provide accessible ballots.

The Bazelon Center is changing the mental health system

Another area she feels strongly about is the institutionalization of people with mental health conditions. “Not just the institutions we think of like psychiatric hospitals or nursing homes, but also the places that have become institutions but weren’t supposed to be…,” Eve says, “… like jails and prisons. And what we call ‘homes or assisted living,’ which were all designed for some other purpose but our communities keep putting people with disabilities in them, because of a lack of understanding that people with disabilities can live in the world and that services don’t have to be in a place; they can be wherever the person is.”

O’Toole v. Cuomo

The Bazelon Center recently won a case related to, as Eve calls it, people with disabilities that have been “put away because it is assumed they cannot live in the world.” The O’Toole v. Cuomo case was one of the ground-breaking achievements of the center. For almost two decades, the organization fought for every one of the 4000 New Yorkers living in so-called ‘adult homes.’ “Hundreds of people would be living in what looks like an apartment building, but really is an institution and the only place services were available to them. Those really limited their lives. They had strict rules. You couldn’t go out. You can only go to certain places. You have to be home at a specific time. Everything was regulated, even though these people just live with a mental illness. They aren’t supposed to be in a prison. They haven’t done anything wrong,” Eve illustrates.

A case filed in 2003, which criticized that those facilities lack the resources to enable an independent life for people with mental health conditions, was finally won in 2009; the court ruled that the state of New York violates the ADA and Section 504 of the Rehabilitation Act. The state was ordered to allow residents to move to supported housing that offered the services they needed. “The case is settled now, but we’re continuing to monitor its implementation. The state doesn’t always step up to do what it’s supposed to do without us coming in and saying, ‘We are watching you. You don’t get to let this slide!’,” Eve says.

This settlement is much more than only a won case. It is what sets out whether a facility is an institution or a community-based setting. “It became the framework for Medicare and Medicaid services to tell whether something meets its home and community-based services requirements; it’s become the framework the justice department uses to look at whether people are being unnecessarily institutionalized,” Eve explains.

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Equal education

Another important pillar of the Bazelon Center’s advocacy is equal education for children with mental disabilities. The case Doe v. Pasadena Unified School District, a class action complaint on behalf of students with mental health needs, supports students that have been placed in a school for mentally disabled students, unnecessary segregating them from non-disabled students. “We don’t just talk about keeping kids with disabilities in regular classrooms. We talk about benchmarks for making sure that they are actually getting an equal education. It is not simply about just educating these kids; it is about getting them access to the same information that other kids have, but in a way they can incorporate,” Eve says. Despite the challenges children with mental disabilities face, with the right accommodations, they can be as successful as their non-disabled classmates. This case is currently in the settlement stage.

Criminal injustice and incarceration

According to the World Health Organization (WHO), mental health conditions are especially prevalent in prison. The US Department of Justice published a special report in 2006, stating that half of all prison and jail inmates had a mental health problem. Other data suggest at least 20 percent of all inmates live with a serious mental illness. Based on the WHO publication, this high number is mainly due to the ‘misconception that all people with mental disorders are a danger to the public; the general intolerance of many societies to difficult or disturbing behavior; the failure to promote treatment, care and rehabilitation, and, above all, the lack of, or poor access to, mental health services in many countries.’

Eve agrees. “The services outside the doors of the criminal justice system are often not serving people in crises. Part of the problem is that people will not voluntarily choose to go into an institution because of the stigma and the fear they will give up their rights and lives. They will avoid that for as long as they possibly can, which means they have crises on the streets.” On top of this, in most areas, only the police respond to those crises, and oftentimes, they don’t have the necessary expertise to offer the support needed. “One of my mottos is: don’t hire a cop when a social worker or a psychiatrist would do,” Eve says, “…but we have hired cops, and we have not hired social workers and psychiatrists.”

The Bazelon Center works on creating the community-based system that will encourage people to get the help they need when they need it. Additionally, they train police officers to recognize when they might not be the right person to respond to a crisis, connect them with professionals like social workers and psychiatrists, and give them more crisis intervention tools. “The Bazelon Center also works at the exit door. People with mental illnesses tend to be kept in jail and prison longer because it’s assumed that there is nowhere for them to go after. So we help them to get back onto Medicaid, find a provider and a place to live, get their prescription filled,” Eve adds.

Event flyer for the 30th anniversary of the ADA celebration by the Bazelon Center for Mental Health Law — Virtual Annual Award Celebration — Click To Enlarge

Mental health conditions and employment

Another area the Bazelon Center is passionate about is the employment of people with mental health conditions. People with disabilities face exponentially higher unemployment rates, and the stigma around mental health conditions prevents many affected people from even talking about their condition. “It is difficult to decide whether to reveal or not to reveal what is otherwise a hidden disability most of the time,” Eve says. “But when you have an acute mental health episode, when you need help, then things are going to be revealed, and your employer or your coworkers are not prepared for it. And they tend to react badly.”

The Bazelon Center guides people with mental health conditions through this decision-making process and educates employers about the accommodations they should provide. “Employers might think, ‘Oh, you have a mental illness. You can’t go to school. You can’t work. Go away.’ So while they think they’re trying to protect you, what they are doing is denying you education or employment, which feels like punishment. And it’s also illegal and apparently not a reasonable modification to say, ‘Go away,’” Eve says. One of the main points the Bazelon Center is working on related to employment is making employers recognize that people with mental illnesses are already in their workforce and are their students; they just don’t realize it. “Why don’t you know it? Because your employees or students don’t trust you, because you have not made it welcoming. You have not been supportive. And as a result, you’re forcing people, your workers, your students, to deal with things on their own. And that’s probably distracting them from being your best workers. So you could make it a little easier for them. You could have support programs and employee assistance programs,” Eve explains.

Gun violence and mental health

Perhaps the most harmful misconception surrounding people with mental health conditions is the fear of them being dangerous. Frequently, when media reports about gun violence, they make assumptions about the mental state of the shooter, which is harmful to people living with mental health conditions. Evidence-based facts highlight that the majority of mass shootings have nothing to do with mental illness – less than 1 % are related to people with serious mental illnesses. “People with mental illnesses are way more likely to get killed by gun violence than they are to engage in it. So it is not people with mental illnesses that are the problem,” Eve emphasizes with a firm voice.

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In the US, different federal and state laws exist that prevent people with documented mental health conditions from buying a gun. “The Gun Control Act makes it unlawful for certain categories of persons to ship, transport, receive, or possess firearms or ammunition, to include any person: who has been adjudicated as a mental defective or has been committed to any mental institution,” 18 U.S.C. §922(g) states.

“Cracking down on gun ownership by people with mental illnesses is not the answer since people who have a diagnosed mental illness and are getting treatment for it – which are the only ones you’re going to know about – are clearly not the problem. They are getting treatment. They know what their disability is. They recognize when it’s happening. They are not the ones who are going to have a crisis and pull out a gun,” Eve explains. According to Eve, those prohibitions discourage people from seeking treatment. “It is not just not letting them have a gun. That’s not where it ends. Once you’re on some registry of people who are getting treatment for mental illness, you face all the prejudices and stereotypes, so who wants to be on that list?” These laws do not exist for other disabilities or illnesses. “It’s unfair and punitive, and it defeats our goals of getting people the help that they need,” Eve says. The Bazelon Center works hard to debunk these common myths and hosts congressional briefings to dispel the misconception of people with mental illness as ‘the madman.’

Celebrating the 30th anniversary of the ADA

The ADA was passed 30 years ago, and the Bazelon Center was part of it. To celebrate this milestone and all the Bazelon Center has achieved over the last three decades, the organization hosts a virtual event on November 17 at 7 PM EST. Attendance is free. (Register for the event here). “We’re honoring Tony Coelho with a major award because he was the original sponsor of the Americans with Disabilities Act. And he has done a lot of work over the time, too. He didn’t only improve the ADA where it needed to be improved, but also made sure people knew about it, and that there were enforcement and education mechanisms, so that it was more than just a piece of paper in a book,” Eve says. Other guests include former President Bill Clinton, House Speaker Nancy Pelosi, former advisor to President Obama Valerie Jarrett, and many more.

For more than 40 years, the Bazelon Center has fought for the rights of people with mental health conditions, so that they can find employment, get the education they want, and live independently. But most importantly, the Bazelon Center continuously pushes back against the discrimination of people with mental health conditions. Each case won is not only a significant achievement for the organization, but it also paves the way towards a less stigmatized future for every single person with a mental disability walking on this path after.

Stories of people affected by the Bazelon Center’s NY adult homes case: Online PDF