As a person with lived experience of mental illness, addictions, and trauma, I consider July 26 - the 31st anniversary of the Americans with Disabilities Act (ADA) - to be our nation’s second Independence Day. For the millions of us with disabilities, it is a day to celebrate our freedom. Freedom from discrimination and the barriers that block our inclusion in community life. Freedom from unjustified segregation and institutionalization. Freedom to earn and to learn. Freedom to pursue recovery and receive services and supports – including mental health and addiction services – that help us participate fully in American life.
As an employee with SAMHSA for over 26 years, I am proud of our leadership in protecting the rights of people with mental illness and/or addictions including:
- Advocating for the Rights of People with Mental Illness. SAMHSA administers the Protection and Advocacy for Individuals with Mental Illness (PAIMI) program that supports agencies in all states and territories to investigate abuse and neglect, address civil rights violations, and enforce the U.S. Constitution, Federal laws and regulations, and state statutes. Many PAIMI agencies have helped enforce the ADA.
- Reducing and Ultimately Eliminating Seclusion and Restraint. SAMHSA works to prevent and end the use of seclusion and restraint given it can result in trauma, psychological harm, physical injuries and death to both people subjected to and the staff applying these techniques. In so doing, SAMHSA recognizes the need to develop alternatives to the use of such practices.
- Enforcing Mental Health and Substance Use Disorder Parity. SAMHSA, along with the U.S. Department of Labor and the Centers for Medicare and Medicaid Services (CMS), provides oversight of the Mental Health Parity and Addiction Equity Act of 2008 that requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care. Information on knowing your parity rights is available in SAMHSA’s publications.
- Guarding the Confidentiality of Substance Use Disorder Patient Records. SAMHSA establishes standards for the appropriate and allowable disclosure of addiction treatment records.
- Protecting the Civil Rights Protections for Individuals in Recovery from an Opioid Use Disorder. SAMHSA collaborates with the HHS Office of Civil Rights on civil rights protections for individuals receiving Medication Assisted Treatment.
- Helping People with Mental Illness and/or Addictions Involved in Criminal Justice Systems. SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation expands access to services for people with behavioral health disorders in contact with the adult criminal justice system. This includes improving law enforcement response to people in mental health crises that too often results in tragic outcomes.
- Facilitating Community Living. SAMHSA collaborates with CMS and the Administration for Community Living in promoting Home and Community-Based Services, older adult mental health, and peer and family support. SAMHSA also encourages self-directed care approaches in behavioral health.
- Advancing Behavioral Health Equity. SAMHSA works to reduce disparities in mental health and/or substance use disorders across populations. This includes support of the National Network to Eliminate Disparities in Behavioral Health.
- Involving People with Lived Experience. SAMHSA is dedicated to involving people with mental illness and/or addictions in the planning, delivery, evaluation, and policy formulation of behavioral health services. This includes encouraging shared-decision making and psychiatric advance directives in clinical care.
- Promoting Recovery and Recovery Support. SAMHSA’s Working Definition of Recovery states that “protecting…rights and eliminating discrimination – are crucial in achieving recovery.” SAMHSA focuses on the four major dimensions that support a life in recovery: Health, Home, Purpose, and Community.
Over the past 31 years, America has made significant progress in protecting and enforcing the civil rights of people with disabilities – including those of us with mental illness and/or addictions. Despite this progress, we have much more work to do to realize the full promise of the ADA. Too many of us are still without the freedom that all Americans deserve.
Sitting next to President George H.W. Bush, on July 26, 1990, when he signed the ADA into law, was renowned disability advocate Justin Dart Jr. As we continue our pursuit of justice and freedom, let us remember and heed Dart’s call to action to “Lead On!” Happy 31st Anniversary of the ADA!