Legal Aid in Mental Hospitals

This report on the experience of five in-hospital legal aid projects and one community-based project for the deinstitutionalized examines the workloads of the lawyers and paralegals who labor in this setting and the various approaches and predispositions they bring to the job or learn while they are at it. The caseloads as well as interviews and observations reveal enormous differences in approach from project to project. The work of some lawyers and their aides confirms the utility and importance of making legal aid directly available to patients on the hospital grounds. But the experience of a couple of other projects warns that certain styles of lawyering can be counterproductive and damaging. In general, lawyers in the mental hospital setting must avoid the legalistic and overly adversarial approach to the problems that are brought to them—many of which are of uncertain legal content, credibility, or psychological makeup. Lawyers must also be careful not to have their own legal priorities get in the way of the best interests of their patient-clients or even those of the hospital as a total institution. The best approach to lawyering in the institutional setting is one that softens the "traditional" legal and adversarial aspects in favor of a more mediatory stance in which fact finding, counseling, and the resolution of issues by compromise are dominant functions. And significant legal attention should be devoted to each of the major categories of problems faced by patients—commitment-discharge, institutional, and civil—if the institutional lawyer's credibility and effectiveness are to be maintained both with the patients and the staffs in charge of their treatment and custody.