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Center for Public Representation

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Center for Public Representation

A Public Interest Law Firm Dedicated to Serving Individuals
with Disabilities for More Than 30 Years

Mental Health

Since its first major system reform case on behalf of residents of the Northampton State Hospital, the Center has had a unique interest and expertise in phasing down public psychiatric hospitals and promoting the community integration of their residents.  Its efforts have resulted in the successful closure of several facilities in Massachusetts, Florida, and other States.

Documents and pleadings which may be helpful to attorneys litigating or considering the litigation of disability law related cases are available by following the links below.


April 26, 2012:  Advocates Object to Use of Restraint Chair in MA

CPR and other legal advocacy agencies have joined together to object to Massachusetts DMH's plans to use a restraint chair at a soon to be opened state mental hospital. The advocates have written to the DMH Commissioner asking her to reconsider and have branded the restraint device as dangerous and demeaning.  Read the letter and bibliography supporting the advocates' arguments.


February 9, 2012:  Lynn E. v. Lynch

Six individuals filed this class action on behalf of themselves and all persons with serious mental illness who are institutionalized in the New Hampshire Hospital (NHH) or the Glencliff Nursing Home (Glencliff), or at serious risk of institutionalization in these state-operated facilities.  New Hampshire has failed to provide the community services that the plaintiffs need to leave NHH and Glencliff and to prevent their unnecessary institutionalization in these facilities.  These services include: mobile crisis intervention, Assertive Community Treatment, supported housing, and supported employment.

The plaintiffs request declaratory and injunctive relief under Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and the Nursing Home Reform Amendments to the Medicaid Act, as well as an order directing the State to provide community services required to avoid class members’ needless institutionalization.

The U.S. Department of Justice also conducted an investigation of NH's mental health system.  Findings issued in April 2011 concluded that New Hampshire is violating the Americans with Disabilities Act and Olmstead v. L.C., 527 U.S. 581(1999) by failing to provide services to individuals with serious mental illness in the most integrated setting appropriate to their needs. The United States found that this failure “has led to the needless and prolonged institutionalization of individuals with disabilities...” and that the “systemic failures in the State’s system place qualified individuals with disabilities at risk of unnecessary institutionalization now and going forward.”

The plaintiffs are jointly represented by the Disability Rights Center, Devine Millimet & Branch, the Bazelon Center for Mental Health Law and the Center for Public Representation.  Documents filed in the Lynn E. v. Lynch case are listed below:
 
Lynn E. v. Lynch Complaint
Lynn E. v. Lynch Press Release
Lynn E. v. Lynch Fact Sheet
Lynn E. v. Lynch Letter to Assistant Attorney General Perez, December 6, 2011
Lynn E. v. Lynch Letter to Attorney General Delaney, December 9, 2011
Lynn E. v. Lynch Plaintiffs' Demand Letter, sent November 2, 2010
Lynn E. v. Lynch DOJ Findings Letter, issued April 7, 2011

Following the tragic death of a mental health residential program staff person apparently at the hands of a program resident, the Massachusetts Department of Mental Health established a Task Force on Staff and Client Safety. In April 2011, the Center for Public Representation submitted two documents to the Task Force for its consideration. The first is an argument against involuntary outpatient commitment in light of Massachusetts law and the second is CPR's recommendations for the Task Force's findings: 
Involuntary Outpatient Commitment Paper
Safety Task Force Testimony

A challenge to Vermont's mental health advance directive law as being in violation of the ADA. This is a 2d Circuit amici brief in support of the plaintiff:  Amici brief in Vermont Advance Directive case 8/1/2002

This annotated listing of cases and articles on the use of written advance health care directives by people with psychiatric disabilities was last updated in March 2002: 
Annotated bibliography of cases and materials on Advance Directives for people with mental illness 3/1/2002

An overview of issues in the administration of psychiatric medications to children and adolescents: 
Psychopharmacology for children and adolescents 3/1/2001

CPR and the MA Department of Mental Health signed a memorandum of understanding regarding improved and increased mental health services to DMH clients who are deaf or hard of hearing: 
Deaf services CPR/DMH memorandum of understanding 4/5/2004

This monograph by CPR staff explains the complex web of rules regarding the restraint and seclusion of children and adolescents in various hospital and residential settings in Massachusetts. Added October 2007:
Restraint of Children in Massachusetts -- A monograph 

 Magrini Case — Right to emergency hearing

CPR represented the respondent in an appeal from the denial of his request for an emergency hearing after he alleged "abuse or misuse" of the Massachusetts temporary involuntary civil commitment process. The respondent had been involuntarily readmitted to the hospital within minutes after a court had ordered him discharged. Massachusetts statutes allow individuals to immediately challenge temporary commitments without having to wait for the civil commitment hearing.

In a 2-1 decision the Appellate Division of the District Court affirmed the trial court's refusal to hold an emergency hearing. The respondent appealled and the Supreme Judicial Court has accepted direct review. A copy of the SJC principal brief (Jan 2008) is available below and followed by a link to the appellant's Reply Brief.

The Massachusetts Supreme Judicial Court on July 10, 2008 reversed the district court appellate division's ruling (appearing elsewhere on this page) and held that Mr. Magrini was entitled to an emergency hearing quickly after his involuntary detention. The SJC opinion appears below. The official citation is Newton-Wellesley Hosp. v. Magrini, 451 Mass. 777, 889 N.E.2d. 929 (2008).
SJC Brief
Appellant's Reply Brief
SJC Opinion

Comm. v. Carrara
The Massachusetts Appeals Court holds that a trial judge in a civil commitment case may not restrict the movements of a committed individual to a building. Decisions about privilege level are for the hospital clinicians, not judges.
Read the Carrara opinion.

Comments on MA DMH Risk Management Report

CPR has submitted comments to the Massachusetts Department of Mental Health's "Final Report of the Task Force on Safety and Risk Management." The comments criticize several recommendations that would curtail important legal rights of some DMH clients. The DMH report is available on its website, www.mass.gov/dmh. Read CPR's March 18, 2008 letter to DMH.

Restraint radio program

Not Alone is a weekly radio program produced and presented by the Kim Foundation in Omaha. In September 2008, CPR staff appeared on the program with staff of the Nebraska P&A to discuss restraint and seclusion of individuals with mental illness. Listen to Not Alone's podcast on restraint and seclusion.


The documents contained on this page and within this web site do not constitute legal advice. Anyone engaged in legal action should consult with an attorney. Attorneys should make their own independent judgments. Local laws vary and the law may have changed since these documents were written. Litigants should fully research any claims or defenses before making them.
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Center for Public Representation
22 Green Street
Northampton, MA 01060
413-586-6024

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