Olmstead’s Implementation: Differences in Enforcement Approaches

Andrea Avila, William D. Spaulding, Eric A. Evans

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Olmstead v. L.C. ex rel Zimring (1999) was a landmark U.S. Supreme Court decision holding that unjustified segregation of people with disabilities is impermissible discrimination; specifically, if the clinician and client believe community integration to be appropriate, the state must have reasonable accommodations in place for the client to be in the community. Enforcement of the Olmstead decision for people with serious mental illness (SMI) has taken many shapes, from the U.S. Department of Justice’s (DOJ) settlement agreements requiring substantive development of community mental health services and aggressive community integration protocols, to the Third Circuit approach which requires only lower census numbers in the state psychiatric hospital (SPH). The question of whether Olmstead is being differentially enforced is addressed in an empirical, qualitative analysis of legal documents, including court opinions and settlement agreements. Through legal research spanning all U.S. jurisdictions, five distinct Olmstead enforcement approaches in ten different states were identified. The enforcement approaches are described, and limitations and future directions are discussed.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalPsychological Services
Issue number2
StatePublished - Jun 10 2021


  • Americans with disabilities act
  • Community transition
  • Disability rights
  • Olmstead
  • State psychiatric hospitals

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology


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