New Right to Treatment

Even Alabama mental health officials admit that Tuscaloosa's Bryce Hospital is little more than an almshouse for many of its patients. All but 5% of the hospital's 4,800 patients are confined there involuntarily through civil court orders; almost half are geriatrics cases or mental retardees who receive only custodial care. The rest get scant medical treatment. Bryce is so backward that it does not even qualify for federal Medicare funds. The state spends only $6.80 a day on each patient, the second lowest (after Mississippi) such rate in the nation.

Recently a patient's guardian sued the state mental health board to protest the hospital's deficiencies. In a pioneering decision, last month, U.S. District Court Judge Frank Johnson provided a remedy. Alabama's involuntarily committed patients, he ruled, have a constitutional right to adequate medical treatment. "To deprive any citizen of his or her liberty upon the altruistic theory that the confinement is for humane therapeutic reasons," said Johnson, "and then fail to provide adequate treatment violates the very fundamentals of due process."

Though the District of Columbia Court of Appeals has issued similar rulings, Johnson's decision is the first to insist on adequate treatment for mental patients as a constitutional right. Even Alabama's mental health commissioner, Dr. Stonewall Stickney, another defendant in the suit, agreed with the decision. "I think the order is basically benevolent for the patients," said Stickney. "We feel we can live up to it."

To help Stickney keep his word, Judge Johnson has given the state six months to submit evidence that it has established appropriate treatment programs. If the state fails to take such steps, Johnson says that he will appoint a panel of mental health experts to show Alabama how to improve its dismal performance.

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