May 27, 2002

UNC Charlotte faculty edit book on landmark case

CHARLOTTE C Three UNC Charlotte faculty members have edited a book on the Thomas S. class action lawsuit, a landmark case about the treatment of people with mental retardation and mental illness.

The book, "Lessons Learned from a Lawsuit: Creating Services for People with Mental Illness and Mental Retardation," is edited by Jim Dudley, professor of social work; Mary Lynne Calhoun, dean of the College of Education and professor of special education; and Lynn Ahlgrim-Delzell, project director/lecturer in the Department of Counseling, Special Education and Child Development.

The volume examines a case on behalf of a 19-year-old patient in a state psychiatric hospital who was known by his first name and last initial, "Thomas S." The case started as a federal lawsuit and then became a class action lawsuit on behalf of persons who experienced both mental retardation and mental illness. Class members had been institutionalized and treated for mental illness only without regard to the mental retardation. The suit found the state negligent for the lack of appropriate habilitation for individuals dually diagnosed with both conditions. Following a series of rulings and appeals, the State of North Carolina began implementing the court order resulting from the suit in 1991.

Dudley, Calhoun and Ahlgrim-Delzell were each named to the Thomas S. Longitudinal Research Project as director, associate director and research coordinator respectively. They were subcontracted by the state to monitor North Carolina=s progress in implementing the court order and to track the more than 1,200 individuals who ultimately were part of the suit.

Over the next eight years, North Carolina became one of the nation=s most progressive states in dealing with people with disabilities or mental retardation. Many of these individuals were moved out of state hospitals and into community services, which provided habilitation in a less restrictive environment such as an apartment or group home as opposed to a hospital ward. They accessed available community services and, in some cases, found employment.

"Moving to person-centered planning for people with a dual diagnosis improved their quality of life and made it easier for them to achieve a degree of social integration," Dudley said. "The Thomas S. ruling also challenged the idea that people with mental retardation lacked the capacity to develop and succeed. That assumption had kept them from receiving proper treatment. Now many of these people who were once overlooked in state hospitals are living successfully in the community."

In "Lessons Learned from a Lawsuit," Dudley, Calhoun, Ahlgrim-Delzell and their collaborators trace the evolution of the Thomas S. case, the progress of the participants in the suit (which in most cases was overwhelmingly positive), and the particular provisions of the treatment program that resulted from the ruling. In 1998, the state was judged to have met the requirements of the lawsuit, and the case was dismissed. The final section of "Lessons Learned from a Lawsuit" is a look ahead to the future for people with a dual diagnosis and a consideration of the fragility of the change that resulted from the Thomas S. case.

"The state must find a way to continue to abide by the Thomas S. ruling," Dudley said. "The gains that have been made in the treatment of people with a dual diagnosis must not be undone."

"Lessons Learned from a Lawsuit" is published by the National Association for the Dually Diagnosed (NADD). To receive a copy of the book, call NADD at 1(800) 331-5362.

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Media contact: Natasha Ashe, (704) 687-6131