Neglect, Ill-treatment and Poor Living Conditions of Patients

This first institutional abuse case of its kind in the US illustrates one of many turning points away from the long-term or life care of patients in state institutions for the mentally ill and developmentally disabled.

In their history, state homes, hospitals and asylums had tended to become underfunded and overcrowded and mostly custodial rather than therapeutic. Alternatives to such homes were suggested as early as the 1920s and 1930s over concerns of neglect, ill-treatment, abuse, poor living conditions and lack of hygiene.

The desire to replace institutions with community-based services for people with mental illnesses and disabilities has been a long process with many contributing factors. President John F. Kennedy’s 1963 Community Mental Health Centers Act helped to accelerate deinstitutionalization of state mental institutions by the establishment of community mental health centers.

Halderman v. Pennhurst State School & Hospital Pennsylvannia

In the 1977 class action case of Halderman v. Pennhurst State & Hospital, Terry Lee Halderman sued on behalf of herself and other residents of Pennhurst alleging conditions were unsanitary, inhumane and dangerous and that Pennhurst used cruel and unusual punishment. At trial, the District Court ruled that patients’ rights had been violated, that Pennhurst was overcrowded and understaffed, that it lacked programs necessary for adequate habilitation, and that residents had suffered injuries from abuse by staff and other residents. Among some of the worst abuses were the use of isolation and the use of physical and chemical restraints whereby residents were sedated and tied to their beds.

The class action settled in 1984 with an agreement that community-based services would be offered to all Pennhurst residents. However, several years of litigation followed the settlement. The school was eventually closed in 1987, but plaintiffs filed motions for years to attempt to enforce the settlement agreement, with the defendants being found noncompliant, even up until 1994, for the lack of individualized services available to all plaintiffs.

The class action also resulted in litigation that went all the way to the US Supreme Court on the matter of federal versus state jurisdiction relating to the eleventh amendment. The principle being that a federal court cannot order state officials to comply with state laws.

The buildings and grounds at Pennhurst have become the subject of several ghost-hunting television programs and websites and part of Pennhurst has been turned into a haunted house.