The Autistic Self Advocacy Network is appalled by Christine Montross’s February 18th op-ed in the New York Times promoting a return to mental institutions. Montross’s op-ed is part of a dangerous agenda to send people with disabilities back to institutions. She cites cases of intense support needs and behavioral difficulties as reasons for institutional placement, but there is overwhelming scientific evidence supporting community inclusion. We achieve the best possible outcomes when people with disabilities receive appropriate supports in community settings. It is ridiculous to use a random collection of anecdotes to ignore overwhelming research literature and decades of experience in favor of community living.
Montross concludes that long-term institutions are the solution to cycles of hospitalizations followed by losses of adaptive skills. We must reject her call for a return to outmoded and ineffective service models. In 2012, the Department of Justice entered a settlement with Virginia over Olmstead violations. The investigation and subsequent settlement addressed not only recurring hospitalization but also the state’s refusal to allow people to return to community settings after hospitalization. It is clear that the issue was not insufficient availability of long-term institutional placements, but inadequate quality and availability of community-based services. This settlement exemplifies the need for improvements in community services.
It is troubling that people with mental disabilities are warehoused in jails and prisons at alarming rates. Through the disturbing experiences of our own constituency in the criminal justice system, we are keenly aware of the many injustices and lack of services for people with mental disabilities while incarcerated. In recent months, we have taken an active role in advocating on behalf of Neli Latson, a young autistic man of color who spent over a year in solitary confinement without access to necessary services after multiple failures of the system to support him. Our advocacy in Neli’s case has always focused on the need to develop a transition plan to a community setting, as we know from both the science and our experience that all people have the capacity to thrive in the community with the right services.
We are deeply disturbed by the suggestion that rather than advocate for a return to the community, we should support the creation of “therapeutic” or “specialized” institutions whether for people with psychiatric disabilities or people with intellectual and developmental disabilities. It is unacceptable to propose “solving” the problem of institutionalization in the prison system with institutionalization in a psychiatric system. The solution is not different types of prisons but better funding for more community-based supports and services as long advocated by the disability community.