Ruling could alter mental health care in state

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In a decision that could reshape the way New York cares for the mentally ill, a federal judge in Brooklyn Tuesday ruled that the state's practice of warehousing thousands of patients in large, institutionalized "adult homes" is illegal.

Judge Nicholas Garaufis, who presided over a five-week trial over the summer, said in a 210-page opinion that the state should rely more heavily on housing the mentally ill in scattered-site apartments that are better integrated with the community and on providing outpatient support services.

"The adult homes at issue are institutions that segregate residents from the community and impede residents' interactions with people who do not have disabilities," Garaufis wrote. " . . . 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."

The lawsuit challenged the state's use of 28 large adult homes in New York City with more than 120 beds each and that house an estimated 4,300 patients. It said New York was essentially creating a chain of mental health ghettos in violation of the Americans with Disabilities Act and other federal laws that require integration of the mentally ill into the community mainstream to teach them self-sufficiency, instead of treating them as helpless.

The state argued that more independent housing settings were not appropriate for many patients, and that paying for smaller settings and support services would be far more costly. Garaufis rejected those claims, finding that many patients would thrive on their own and that the cost to New York State would be similar.

A spokesman for the state Office of Mental Health had no comment Tuesday on the decision or a possible appeal.

But it was hailed by Cliff Zucker of Disability Advocates, the Albany advocacy group that brought the suit.

He said the ruling could influence courts in other states, and could produce less reliance on group homes on Long Island and other areas outside New York City, if state officials take Garaufis' reasoning to heart.

"Hopefully, at the end of the day, it will mean freedom for thousands of people who are now being unnecessarily warehoused," Zucker said.

The lawsuit is an aftermath of the movement in the 1970s and 1980s to close down huge state mental hospitals. An industry of large for-profit adult homes, licensed by the state, filled the vacuum as patients were released.

That industry remains a major provider of services with a reputation for political clout in Albany, despite the development of alternatives and periodic controversies about exploitation of residents at some homes. In recent years, 385 adult homes statewide housed more than 12,000 patients.

Garaufis did not issue an injunction Tuesday detailing how rapidly he will force the state to develop and fund housing alternatives. He ordered the state to propose a remedial plan by Oct. 23.

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