Beyond the Walls: How Olmstead Transformed Disability Rights

What does it mean not just to live, but to thrive?

That question lies at the heart of Olmstead v. L.C., a landmark Supreme Court case that challenged the institutionalization of people with mental or cognitive disabilities and affirmed their legal right to live, grow, and participate fully in a community (rather than in institutions).

The case was brought by the Atlanta Legal Aid Society on behalf of Lois Curtis and Elaine Wilson, two people with mental illness and developmental disabilities who were initially voluntarily admitted to a state-run psychiatric unit at the Georgia Regional Hospital. Despite clinical assessments determining that both were better suited for community-based treatment, they remained institutionalized for several years.

Filed in 1995 and reaching the Supreme Court in 1999, the case resulted in a 6–3 ruling affirming that mental illness is a form of disability and is therefore covered under Title II of the Americans with Disabilities Act (ADA). Title II protects any “qualified person with a disability” from being excluded from or denied the “benefits of the services, programs, or activities of a public entity.”

The Olmstead decision fundamentally reshaped disability rights in the United States, validating the notion that people with disabilities have an inherent right to live in settings appropriate to their needs. It spurred sweeping reforms at both the state and federal levels, prompting the development of community-based services and reducing unnecessary institutionalization. States were held legally accountable for expanding access to housing, employment, and in-home support. At the same time, advocacy organizations used Olmstead to push for enforcement and system-wide change.

Before the decision, people with disabilities frequently lived in overcrowded institutions. Stories of poor treatment—through neglect or, at times, outright abuse—were commonplace. American distrust in these facilities had been rising steadily for decades, beginning with the deinstitutionalization movements of the 1950s and ’60s, fueled in part by cultural moments such as Ken Kesey’s One Flew Over the Cuckoo’s Nest and scandals like that of the Willowbrook State School.

Following the decision, it is estimated that nearly 80% of the people who were institutionalized in 1987 were living in community-based care by 2019. This transition has allowed countless people to experience fuller, more independent lives outside the walls of psychiatric hospitals to which they had once been confined.

Perhaps most significantly, the ruling shifted power toward people with disabilities themselves—emphasizing personal choice, autonomy, and the right to define one’s own life beyond institutional walls. Yet even today, the promise of Olmstead remains a work in progress. Long waiting lists, housing shortages, and service gaps continue to pose serious challenges to full community inclusion.

As of April 2025, that legacy is still under threat. In Texas v. Kennedy, for example, plaintiffs are seeking to eliminate Section 504 of the Rehabilitation Act of 1973, a law that prohibits discrimination against people with disabilities in programs receiving federal funding.

Lois Curtis and Elaine Wilson passed away in 2005 and 2022, respectively, but their legacy lives on for people whose needs can be met in community-based settings. State resources and programs inspired by Olmstead have improved the lives of countless people with mental disabilities who might otherwise face institutionalization. In 2011, Lois Curtis was invited to the White House, where she presented President Barack Obama with a portrait of herself as a child.