Yesterday, the District of Columbia Court of Appeals (the highest local court, not the D.C. Circuit) issued what to me is a very fascinating opinion
in Padou v. District of Columbia
. The plaintiff, who edits a community newspaper serving the Brookland section of D.C., sued under the local freedom-of-information law to obtain various information about privately-operated group homes serving people with psychiatric and/or developmental disabilities in Ward 5 (which encompasses Brookland) of the District. In particular, she asked the District to provide her with "the number of such facilities, their addresses and contact information, a description of the services provided, and their capacity." The District, citing the privacy exemption from the local FOIA, refused to provide the addresses of the facilities, and the plaintiff sued.
The D.C. Court of Appeals upheld the refusal to provide information about group homes for people with mental illness, but it remanded to the trial court for further proceedings regarding information about group homes for people with developmental disabilities. As to group homes for people with mental illness, the court explained:
The substantial privacy interest of the mentally ill, who reside in Ward 5 MHCRFs [Mental Health-Related Community Residential Facilities], in protecting themselves from the continuing stigma of mental illness in our society outweighs the public interest, championed here by Ms. Padou, to know “what the government is up to” in those MHCRFs. Disclosure of the addresses could result in harassment and ridicule, or “unwanted intrusions” of MHCRF residents by those who are not sensitive to, nor understanding of, mental illness, and hence, disclosure of the addresses “would interfere with the [residents'] reasonable expectations of undisturbed enjoyment in the solitude and seclusion of their own homes” as the non-mentally ill residents attempt to find out what is happening inside and outside the premises. As to group homes for people with developmental disabilities, the court of appeals remanded to the trial court largely on factual grounds. But it did explain:
At the same time, it is not clear to us that the intellectually disabled bear the same stigma as the mentally ill, especially in light of society's increasing understanding that not all intellectual disabilities interfere with the ability to function in the larger society. We think that the better course is to remand the DDS matter to the trial court so that it may consider whether DDS has sustained its statutory burden to defend the withholding of street addresses and contact information in its May 1, 2009, disclosure of residential placements in Ward 5.
The case interests me for lots of reasons. One, obviously, is the distinction the court draws between the stigma attendant to a psychiatric disability (which seems to the court clearly to exist) and that attendant to developmental disabilities (which, according to the court, may not exist, at least to the same extent). Stigma's a concept with a lot of ideas packed into it, and it seems to me those ideas cut in complex ways here. One idea of stigma is that it is a characteristic that leads to aversion. Both psychiatric and developmental disabilities have, historically and now, triggered aversive prejudice. My sense is that people with mental illness, when their disability is not hidden, face more aversive prejudice today than do people with developmental disabilities, but that both groups do continue to experience that sort of prejudice. Goffman, in his classic work on stigma, talks about stigma as a characteristic that defines a person in the eyes of others -- and defines them as "not quite human." Again, I think it's clear that both people with psychiatric disabilities and people with developmental disabilities experience that kind of stigma, though here I think that the problem may be worse for people with developmental disabilities. In my experience, it is easier to get people to think of a person with mental illness as a "normal" person who has a condition from which s/he'll recover, a person who has skills and agency, than it often is to get people to think of a person with a developmental disability as having skills and agency. Again, though, I think this is a problem for both groups; I have heard judges say, as if it were obvious, that any person with mental illness should have a guardian, for example.
There is a different stigma point that interests me, as well. From a disability rights perspective, hiding one's identity as a response to feared stigma is totally understandable and may well be the best course for an individual all things considered, but it is deeply problematic. It is problematic for the individual, who in Goffman's terms is "discreditable," and who will experience a psychological cost in trying to keep an important aspect of his or her life secret. It is also problematic for people with disabilities generally, because it is integration of people with disabilities into society -- with the disability identity known -- that best promises to break down stigma and stereotypes. Here, of course, it was the District of Columbia government, and not the individuals with disabilities themselves, who asserted the privacy claim. While that claim may well be right legally, it raises complicated issues for people with disabilities.
Finally, the case is interesting because it shows why advocates for community integration have moved away from the group home model towards an emphasis on supported living in apartments scattered across developments that mainly house people without disabilities. Group homes provide a target for stigma, and they can thus end up actually segregating their residents from the very communities in which they are placed (segregating them less than confinement in a nursing home or large institution, to be sure, but segregating them nonetheless).
Sorry to go on about a FOIA case. But I think it does highlight a number of interesting points about psychiatric and developmental disabilities and community integration.
Labels: Community Treatment