The U.S. Supreme Court has issued numerous rulings regarding mental health and how society treats and regards the mentally ill. While some rulings applied very narrowly, perhaps to only one individual, other cases have had great influence over wide areas.
the Court held that not all individuals who suffer some sort of physical difficulty are per se "disabled" under the ADA. Instead, those who believe they suffer from a disability must prove their claim on a case-by-case basis by showing that their alleged disability substantially impacts on a major life activity
When deciding whether to evaluate a criminal defendant's competency, the court must considered any evidence suggestive of mental illness, even one factor alone in some circumstances. Therefore, the threshold for obtaining a competency evaluation is low. When the issue is raised, the motion should be granted. The defendant must not bear all the burden for raising the issue.
CIVIL-an involuntarily committed, legally competent patient who refused medication had a right to professional medical review of the treating psychiatrist's decision. The Court left the decision-making process to medical professionals.
CRIMINAL-Prisoners have only a very limited right to refuse psychotropic medications in prison. The needs of the institution take precedence over the prisoners' rights. However, there must be a formal institutional hearing, the prisoner must be found to be dangerous to himself or others, the prisoner must be diagnosed with a serious mental illness, and the mental health care professional must state that the medication prescribed is in the prisoner's best interest.
CRIMINAL-In a ruling very similar to Harper, the Court found that the State may force administration of psychotropic medications to a pre-trial detainee, if it establishes a medical need for the drug, and a need for the detainee's safety and that of others. To the Harper requirements, they added "less restrictive alternative" language, which requires the State to document that there are no behavioral, environmental, or other measures available that will be equally effective.
due process requires that the nature and duration of commitment bear some reasonable relation to the purpose for which the individual is committed.” Reasoning that if commitment is for treatment and betterment of individuals, it must be accompanied by adequate treatment, several lower courts recognized a due process right
Raised the burden of proof requirement, in order to civilly commit a person, from preponderance, to clear and convincing. Also, permitted the courts to defer judgment regarding a person's need for commitment, to the doctor(s)
Each individual has a due process protected interest in freedom from confinement and personal restraint; an interest in reducing the degree of confinement continues even for those individuals who are properly committed. freedom from undue physical restraint and from unsafe conditions of confinement
In terms of impact, O'Connor v. Donaldson, may be the single most important decision in mental health law. It has been used by opponents of involuntary commitment to argue that civil commitment be limited to only mentally ill and dangerous persons. This interpretation has been important in hampering efforts to implement changes in commitment law (limiting access to treatment).
The Court stated, "A finding of 'mental illness' alone cannot justify a State's locking a person up against his will and keeping him indefinitely in simple custodial confinement… In short, a state cannot constitutionally confine without more a nondangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends."
Reflecting the more conservative ('pro-government') attitude of the times, the Court found that mentally retarded persons are not a 'suspect' class of persons (requiring the same level of protection as racial minorities); thus, governments are free to enact almost any legislation or rule to civilly commit them, and the courts will not intervene, short of illegal or ridiculous actions (called 'rational' scrutiny).