Georgia is set to construct the state’s first new state psychiatric facility in decades as state officials say it is a critical move toward improving mental health care. This hospital will cost $409 million and will have 300 beds, all for patients who have been found not guilty by reason of insanity or incompetent to stand trial. The number of people stuck in jails and prisons awaiting mental health evaluations or treatment due to a lack of hospital beds is a growing issue.
This situation isn’t unique to Georgia. Across the country, disabled people with a variety of diagnoses face a similar shortage of community-based support services. As a result, thousands remain in places like psychiatric hospitals, state facilities, or nursing homes, not because that’s the best option for them, but because the help they need to live independently in the community isn’t available.
There are many others, however, who spend days or weeks languishing in emergency rooms waiting for a bed to be available. For them, unless support services are available in the community, the idea of community living is unrealistic.
Georgia’s announcement brings up a crucial question: How can the state deal with its urgent mental health crisis while still upholding the progress made over the last few decades in disability rights and community integration? This is especially crucial because of the timing. The Supreme Court decided an important case 27 years ago that began in Georgia. The Court ruled that the unnecessary institutionalization of disabled people constitutes discrimination under the Americans with Disabilities Act (ADA). It also confirmed that people have the right to receive services in the most integrated setting that fits their needs.
Georgia has been trying to expand its community-based mental health services since that time, due in part to an agreement with the U.S. Department of Justice. Supportive housing, crisis services, specialized treatment teams and other community programs have been funded. All of these were rooted in the concept of supporting people with disabilities to live in their communities.
But the reality of people’s access to services is still different from what the law says. There are about 16,000 people nationwide who continue to reside in state-run institutions and far more residing in group or nursing homes, where services are limited.
For too many people, life in the hospital is a painful reality. Alexis Ratcliff, who is quadriplegic, spent six years in a North Carolina hospital. She moved there after her grandfather became ill. Doctors said she could live at home safely, and she wanted to, but the home healthcare nurses she needed couldn’t be found.
Even after she turned 18 and the hospital couldn’t legally keep her without her consent, she stayed because the necessary support wasn’t available. For years, she was waiting for something that was never there.
In Maine, a 13-year-old named Abby Bedard spent 304 days in a hospital emergency room waiting for a placement that could meet her needs. This experience revealed to her that there was a national issue: there is not enough support in the community, so people are spending hours in hospitals and emergency rooms.
Government officials in Georgia emphasize the new hospital will be for forensic patients. However, Kevin Tanner, commissioner of the Department of Behavioral Health and Developmental Disabilities, says that the hospital will be open to treating other patients in the future. “We’ll design the hospital to be able to house either population, but for the foreseeable future, it will be just a forensic population,” Tanner said. “We don’t want to design a hospital that couldn’t be used for adult mental health patients when needed.”
Disability advocates, however, are correct to wonder whether an increase in the number of institutions is being offset by an increase in funding to provide community-based services that can keep people from entering institutions in the first place. Concern has been expressed that protections will be ineffective due to budget cuts to Medicaid, inadequate healthcare staffing and uncertainty over guidance from the ADA.
Those concerns are amplified by a recent memo issued by the U.S. Department of Justice that said the ADA doesn’t mandate states provide community services where they don’t yet exist. The memo clarifies that while forcing people into institutions unnecessarily can still violate their rights, the law doesn’t guarantee a right to home and community-based services. Nor does it force states to expand home and community based services to meet demand.
This narrower interpretation of the Olmstead decision has raised alarms among disability advocates, who worry that it will lead to a decrease in the federal government’s ability to enforce its standards and allow states to provide institutional care while not providing the community-based resources that would allow individuals to live integrated lives. This memo adds yet more pressure for Georgia, as a balanced system will require more of the state’s leadership and dedicated funding for community support, without robust federal directions.
The real measure of success will not necessarily be opening a new hospital. But rather, if disabled people have the support they need to live in the community. That’s what Olmstead and the ADA are all about.
Sources:
Fivas, Ellie. “Georgia Is Building First State Psychiatric Hospital Since Landmark Disability Case.” Georgia Recorder, 20 July 2026, https://georgiarecorder.com/2026/07/20/georgia-is-building-first-state-psychiatric-hospital-since-landmark-disability-case/.
Lawlor, Joe. “After 304 Days in the ER, Bingham Girl Finally Gets a Home.” Portland Press Herald, 6 Oct. 2024, https://www.pressherald.com/2024/10/06/after-304-days-in-the-er-13-year-old-bingham-girl-finally-gets-a-home/.
Roppolo, Michael. “16,000 People with Disabilities Are in State-Operated Institutions. This Is How Experts Say Health Care Should Change.” CBS News, 30 Apr. 2024, http://www.cbsnews.com/amp/news/16000-people-disabilities-institutions-no-place-like-home-cbs-reports/.
Shapiro, Joseph. “The Disabled Teen Stuck in a Hospital for Six Years Finally Gets Her Own Home.” NPR, 1 July 2025, http://www.npr.org/2025/07/01/nx-s1-5413356/the-disabled-north-carolina-teen-stuck-in-a-hospital-for-six-years-finally-goes-to-her-own-home.