In 1975, O’Connor v. Donaldson finally and firmly established the right of people with mental health disabilities to due process protection under the Fourteenth Amendment. In his ruling, Justice Potter Stewart held that “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.” The decision transformed the status of people with mental health disabilities and of mental hospitals in the United States. According to Bruce Ennis, the singularly idealistic and devoted New York Civil Liberties Union attorney who argued the case before the Supreme Court, in an interview he gave to the New York Times on the day the opinion was issued, the result of the ruling was that “mental hospitals as we have known them can no longer exist in this country as dumping grounds for the old, the poor and the friendless.” To those of us who came of age after the civil rights movement, the facts of the case are boggling, compelling, and enraging in equal measure.
Thirteen years before the hospitalization at issue in the case, the plaintiff, Kenneth Donaldson, voluntarily checked himself into a psychiatric facility, an experience he describes in his book, Insanity Inside Out: The Personal Story Behind the Landmark Supreme Court Decision (1976). During this first hospitalization, Donaldson was by his own account a troublesome patient. He resented being forced to work as a dishwasher and scavenge his dinner from the discards on the staff plates. His grumblings about this and other injustices may well have been part of the motivation for referring him to electroconvulsive therapy (ECT), at the time an agonizing treatment that ward attendants and clinicians sometimes used as a punishment. Donaldson was strapped down and tormented with ECT twice a week. After 23 “treatments,” he was finally released.
Following this initial hospitalization, Donaldson was sluggish, hypersensitive, and, for a short period, impotent. He also became understandably suspicious of mental health professionals. As time passed, he began “writing letters to important people. These letters were suggestions, freely given with no expectation of reward other than the feeling of having done one’s part.” So (possibly) a crank. As a result of these letters, he claims in his book, he was subjected to a campaign of harassment by unknown individuals. “My papers were ransacked in my desk drawer and there was cigarette smoke in the room, though neither the maid nor I smoked.” So (possibly) paranoid. He changed his name and then changed it back. He moved over and over again. He had a brush with the law. But all along, he worked, he went to adult education and job training classes, and he raised and supported his family, though he eventually got divorced. Moreover, he was never violent. In fact, those who knew him reported that he was a gentle man.