'Institutions are not magical': Trump DOJ memo that could erode disability rights prompts concern from advocates

As a patient at Georgia Regional Hospital, a mental health facility in Atlanta, Elaine Wilson felt trapped. “I felt like I was in a little box... You couldn’t do anything there but sleep or eat or smoke. That’s all you could do,” she told a local newspaper reporter in April 1999.

Lois Curtis had been in and out of the same hospital, starting when she was 11, in the facility’s adolescent unit. By the time she was a young adult, prescribed medications that kept her sedated, she was miserable and expressed that she wanted to live a normal life in her community.

Eventually, Curtis and Wilson formed a bond over their circumstances. “I prayed to God. I cried at night so I prayed to God every night in my bed. Elaine asked me to pray for her to get out too, so I did,” Curtis recalled later.

A legal aid attorney helped the women challenge their confinement and sue the state. In 1999, the U.S. Supreme Court ruled that under the Americans with Disabilities Act, people have a right to live in communities and that governments have an obligation to provide disabled people with appropriate support to do so. That decision, known as L.C. v. Olmstead—or simply, Olmstead—was a game changer that provided legal protections against the long-held practice of casting people with disabilities aside and warehousing them in hospitals, including mental health institutions.

Since then, there have been dozens of statewide investigations, negotiated settlement agreements, amicus briefs in private and public lawsuits and consent decrees. As of 2019, the U.S. Department of Justice was involved in enforcing 10 Olmstead settlements and was involved in active litigation in Texas and Mississippi.

Last week, the Trump Administration threw into question the future of these legal protections through the release of a DOJ memo which argues that states are not obligated to provide community- or home-based services to people with disabilities, the crux of Olmstead. The question could become particularly urgent in Mississippi, which ranks second for the share of people with disabilities—behind only West Virginia—with 18.5 percent of all state residents having a disability.

The day the DOJ memo came out, Joy Hogge, the outgoing executive director of Families as Allies, a nonprofit that supports families with children who have mental health challenges, was at a conference in Oxford giving a presentation that stressed Olmstead’s role in advancing civil rights for people with disabilities, but offered a warning.

“We need to be careful—just because a right exists now, that doesn’t mean it’s going to continue to exist. We need to be aware of how it came to be and ways that it could be assaulted,” Hogge told The Mississippi Independent.

The 39-page memo, authored by Lanora Christine Petti, a deputy assistant attorney general at the DOJ, came out days before the June 22, 2026, anniversary of the Olmstead ruling and argues that federal law does not require statutes to treat people with mental disabilities in the most integrated setting possible; that federal agencies lack the authority to impose integration mandates on states; and, contrary to longstanding practice, that Olmstead doesn’t set a firm requirement for states to move people out of institutions into community settings.

Backlash from advocates was swift. Allie Wheelz, an Oklahoma-based activist and social media influencer, wrote on Facebook that the memo, “puts in writing the horrible ableist attitudes of this [Trump] Administration and is incredibly alarming. The positioning in the document threatens decades of shared understanding about how we best include people with disabilities and keep people at home with our families.”

National advocacy organizations, some of which, ironically, had just made posts acknowledging the Olmstead anniversary, criticized the move but also stressed that the memo is not legally binding and does not change the law.

Jane Carroll, the communications director for Disability Rights Mississippi, told The Mississippi Independent, “We certainly don’t want people to ignore it but we don’t want anyone to panic because we do have nearly 30 years of legal precedent on our side.”

In Carroll’s view, “This has been a universally accepted thing to fight for. And because it is very distinctly American values—people being free to choose where they live, and have meaningful opportunity in their communities, and self determination. Focusing on those values and upholding those values is more important now than ever.”

The Trump administration’s DOJ memo represents a stark reversal from the agency’s position under Presidents Joe Biden and Barack Obama. A 2011 DOJ investigation prompted a 2016 lawsuit against the state of Mississippi for violating federal law by “failing to provide adults with mental illness with necessary integrated, community-based mental health services.”

“For far too long, Mississippi has failed people with mental illness, violating their civil rights by confining them in isolating institutions,” then-U.S. Attorney General Loretta Lynch said in a news release at the time. “Our lawsuit seeks to end these injustices, and it sends a clear signal that we will continue to fight for the full rights and liberties of Americans with mental illness.”

In 2019, after a month-long trial, U.S. District Judge Carlton Reeves ruled in favor of the federal government. Mississippi appealed and, in 2023 the U.S. 5th Circuit reversed Reeves decision. Then, under the supervision of the Biden Administration, the Justice Department declined to appeal to the U.S. Supreme Court, which could have imperiled constitutional protections for all people with disabilities.

Observers note striking similarities between the June DOJ memo and Mississippi’s arguments in appealing the 2016 lawsuit at the Fifth Circuit. Both documents center on skepticism about the ADA’s community-integration mandate, a narrow interpretation of Olmstead and concerns about federal oversight of state mental-health policy. Given the state’s position in that case, it is unclear whether the DOJ memo will have an immediate impact on the state’s mental-health services. An email to the Mississippi Department of Mental Health’s communications director was not immediately returned this week.

Hogge and Carroll urged citizens to contact their members of Congress and other policymakers to express concerns about the DOJ’s Olmstead memo.

“There’s really very little evidence, if any, that putting someone in an institution helps them. There’s lots of evidence that it harms them,” Hogge said.

Community-based care is also less expensive than institution-based care with Medicaid spending $17,298 per person for home and community based care compared to $54,462 for individuals in institutional settings, according to 2023 Medicaid data.

Hogge observed: “It’s helpful for people to stop and think about the person you know you would consider the most mentally healthy, and to think: How would they feel if they got picked up, often by a sheriff, taken to some place where they don’t know anybody, where they have food that’s unfamiliar to them, where they have to sleep in this bed that they didn’t pick and all these people around them that they don’t know trying to get them to do stuff they don’t want to do.”

“Institutions are not magical places,” Hogge said. “The model itself creates a lot of stress and makes people’s mental health worse. And we know it is very hard to completely control for things like abuse that can happen in institutions — so they’re not a magic solution and they’re not cheaper than community care.”

---

Image: Lois Curtis with President Barack Obama (via White House archive)