The commitment of disabled Americans to publicly funded, state-operated, and privately owned institutions dates to the eighteenth century. Called “custodial” because they attempted to care for people while confining them, these hospitals, asylums, and schools aimed to train disabled individuals and assimilate them back into non-disabled society. The majority of inmates had developmental and psychiatric disabilities. Legal, medical, and professional changes at the turn of the twentieth century shifted the institutions’ purpose from education to lifelong custodial care.
By the 1940s, institutions had become overcrowded, critically short-staffed, and severely underfunded by state legislatures. As a result, they quickly devolved into human warehouses. Lawsuits against state institutions by disabled people in Pennsylvania and New York set in motion the deinstitutionalization movement — a push for the closure of most, but not all, custodial institutions in the United States, and a shift toward individualized HCBS.
By the 1960s, Minnesota custodial institutions like the Cambridge State Hospital had reached their capacity. Reflecting national trends, many were understaffed and underfunded while remaining overcrowded. Families of those committed grew concerned about the use of restraints — chemical and physical — and the lack of individualized attention their relatives received. Employees within the institutions often shared these concerns, but calls for systematic change typically went unheeded by state lawmakers.
After witnessing the deplorable conditions at the Cambridge institution, the parents of inmate Patricia Welsch obtained legal support from the Legal Aid Society of Minneapolis, which helps individuals with disabilities. Noticing similar conditions statewide, their lawyers, aided by the Arc of Minnesota, filed a class-action lawsuit for more substantial change.
In 1972, six inmates from six separate state custodial institutions in Brainerd, Cambridge, Faribault, Fergus Falls, Hastings and Moose Lake filed a lawsuit in the U.S. District Court. The plaintiffs in the case, Welsch v. Likins et al., were individuals with developmental disabilities. They argued that the institutional environment, with its prolonged use of restraints, overcrowding and lack of educational opportunities, violated their constitutional rights. They maintained that the defendants (including Vera J. Likins, the Commissioner of Public Welfare, and individual administrators from each of the six state institutions), failed to provide adequate individualized care, education, and training to the inmates. The state argued that neither state nor federal law required specific forms of treatment.
A two-week trial was held in late 1973. While attention centered on the Cambridge institution, the trial addressed something broader: habilitation, a term for vocational training and rudimentary education designed to assimilate disabled people into nondisabled society. Much witness time was spent establishing the proposition that people deemed “mentally retarded” could develop even though they were believed to be severely handicapped.
On Feb. 15, 1974, U.S. District Court Judge Earl Larson issued his first opinion, ruling in favor of the plaintiffs. The ruling relied heavily on a recent series of lawsuits in Alabama and New York that recognized disabled people’s constitutional right to treatment. The Court disagreed with the State’s stance. It determined that both the U.S. Constitution (specifically the Due Process Clause) and Minnesota state law (the newly amended Minnesota Hospitalization and Commitment Act) mandated that state institutions provide habilitation to their inmates. Judge Larson, however, deferred ruling on the issues relating to cruel and unusual punishment under the Eighth Amendment.
After protracted legal proceedings, the parties reached a settlement in the fall of 1987. The settlement aimed to reduce the use of chemical and physical restraints in custodial institutions, increase the number of direct care workers, and improve the processes for discharging inmates and evaluating them in the community. After these reforms, the case was dismissed in August 1989.
For more information on this topic, check out the original entry on MNopedia.
