Historical Foundations of Mental Disability Law
The foundations of mental disability law consisted of a harmful stigma and negative attitudes toward mental illness, which led to a eugenics movement to curb the spread of what were considered to be stains on society. This era demonstrated how the mentally disabled were considered inferior and therefore not deserving of the same human rights as others. However, towards the 1970s, the eugenics era was coming to an end and court cases reflected more progressive rulings in favor of the neurodiverse. Landmark cases such as Buck v. Bell and O’Connor v. Donaldson shaped mental disability law as we know it, reflecting both progressive and regressive outlooks on neurodiversity.
In 1927, Supreme Court case Buck v. Bell ruled that forced sterilization of the mentally unfit was constitutional and did not violate the Fourteenth Amendment, as it promoted the wellbeing of society by removing unfavorable traits from the gene pool. This logic was commonly used to support the concept of eugenics, which actually began in 1883 with Francis Galton, who claimed that “the ablest people should improve humanity by having children” (Ribet). In Buck v. Bell, the court found that Carrie Buck “is the probable potential parent of socially inadequate offspring, likewise afflicted, that she may be sexually sterilized without detriment to her general health, and that her welfare and that of society will be promoted by her sterilization” (Buck v. Bell 3). The outcome of Buck v. Bell demonstrates how the mentally disabled were not regarded as equal to neurotypicals, and that the due process and equal protection clause of the Fourteenth Amendment essentially did not apply to them. The ruling demonstrates the detrimental stigma associated with mental illness, as it was equated to a contagious disease that needed to be eradicated; the fact that sterilization was thought to bolster the overall health of society supports this notion.
Unfortunately, Virginia was not the only state to experience such a eugenics movement. It swept across the nation, and North Carolina in particular, which had the longest lasting eugenics program of all the states (The State of Eugenics). Buck v. Bell was decided in 1927 and North Carolina’s sterilization program began in 1929, showing how Buck v. Bell was an important case in strengthening the eugenics movement across the United States. Elaine Riddick, a survivor of North Carolina’s forced sterilization program, stated, “They cut me open like I was a hog. I didn’t know what they were doing to me. I didn’t give them permission. I was a child” (The State of Eugenics). Riddick’s emotionally moving story illustrates how the mentally disabled were stripped of their rights, and how the Fourteenth Amendment seemingly did not apply to them. Riddick emphasizes that she did not consent to salpingectomy, which highlights the violation of bodily autonomy that sterilized people faced. The documentary mentions how people of color were disproportionately affected by these sterilization efforts, which shows how racial biases continued to pervade and multiple marginalized groups were singled out by such discriminatory practices.
O’Connor v. Donaldson was a landmark Supreme Court case that reflected a pivotal shift in attitudes toward mental illness and demonstrated the lessening stigma surrounding mental health as time progressed. However, it is important to note that this case was decided in 1975, and North Carolina’s eugenics movement persisted into the early 1980s, showing that there was not a complete reversal in the prejudiced school of thought toward neurodiversity (The State of Eugenics). O’Connor v. Donaldson pertained to involuntary institutionalization, as Donaldson was institutionalized for fifteen years despite requesting for release, and family and friends offering to care for him. The court ruled, “The evidence showed that respondent, whose frequent requests for release had been rejected by petitioner notwithstanding undertakings by responsible persons to care for him if necessary, was dangerous neither to himself nor others, and, if mentally ill, had not received treatment” (O’Connor v. Donaldson 2). This was a turning point in disability law as it affirmed the rights and liberties of disabled individuals as provided by the Fourteenth Amendment. The ruling stated that only individuals posing harm to themselves or others can be involuntarily institutionalized, illustrating how the spectrum of mental disability was now being taken into account; every individual is different, and each case must be treated according to the presentation and severity of symptoms. This idea reflects a shift in attitude since Buck v. Bell, in which all disabled individuals were deemed unworthy of being granted reproductive rights, no matter the severity of their disability. The ruling also considered if the reception of treatment was a sound basis to justify involuntary confinement, but it was not even relevant here as Donaldson did not receive treatment, but rather mere custodial care (O’Connor v. Donaldson). Donaldson was awarded compensatory and punitive damages by O’Connor, but still this case reveals how no amount of money can possibly make up for fifteen years of confinement. Though this case establishes a positive precedent for future instances that bear similarities to this case, Donaldson’s plight was unfortunate and cannot be reversed.
Contrasting the rulings of Buck v. Bell and O’Connor v. Donaldson allows us to see the growth in society’s progressiveness over half of a century, though arguably progress has become stagnant in more recent years. Though the harmful history of mental disability law sharply contrasts the current state of society, the mental health stigma is still very prominent, and there is still much progress to be made in order to create a more equitable, just society.
Works Cited
Ribet, Beth. “Historical Foundations”. Cluster 73CW, Seminar 10: Mental Disability Law. 10 April 2025. Online lecture.
The State of Eugenics. Directed by Dawn Sinclair Shapiro, 2016.
United States, Supreme Court. Buck v. Bell 274 U.S. 200. 2 May 1927.
United States, Supreme Court. O’Connor v. Donaldson 422 U.S. 563. 26 June 1975.
