Just how 'sane' do voters need to be?

By Beth Daley, 12/10/2000

In Maine, if a resident has a guardian because he or she is mentally retarded, has Alzheimer's disease, or is severely brain damaged, that person still can vote. But if they have a guardian because they are mentally ill, the right to vote is denied.

Maine is not alone in its restrictions. Forty-three other states - including Massachusetts - also in some way prohibit the mentally ill from voting. Most state constitutions restrict voting rights of people who have guardians or have been declared incompetent, but 12 restrict the rights of people using arcane and ambiguous 19th-century definitions such as ''idiots'' and ''lunatics.'' In New England, only New Hampshire allows every mentally ill person to vote; in Massachusetts, anyone who has a guardian cannot.

Nationally, the exact number of people affected by these restrictions is unknown, but the National Alliance for the Mentally Ill estimates it to be as high as the tens of thousands.

As the election saga in Florida reminds Americans just how much one vote can count, fundamental questions over whether the mentally ill should retain the right to vote are beginning to enter the public arena.

For instance, in New Jersey, Republicans are charging Democrats with distributing absentee ballots in several psychiatric institutions, allegedly to get patients to vote for US Representative Rush Holt last month in his tight race for the 12th District seat. New Jersey prohibits an ''idiot or insane person'' from voting, and Republicans say going into hospitals is improper and essentially counts as voter tampering. Holt campaign workers deny the accusations.

Ironically, it was earlier this year that a New Jersey appeals court ruled that a person involuntarily committed to a mental hospital could be deemed mentally ill but not ''insane'' - the operative legal word - after questions were raised when patients at a mental hospital cast absentee ballots in a 1998 election.

The backdrop for the legal skirmish is a campaign by the National Alliance for the Mentally Ill to register mentally ill voters in states where it is legal - and to challenge the law where it is not.

It's perplexing that the American public remains so uninformed about mental illness - Maine voted on Nov. 7 to continue its ban on mentally ill voters, even though lawmakers overwhelmingly voted to remove it - and so unaware of recent medical advances. For example, the drugs now widely used to treat mental illness allow most sufferers to think and live like other citizens most of the time.

In any given year, 1 in 5 Americans suffers from a diagnosable mental illness, according to the National Institute of Mental Health. Chances are most people know someone struggling with such illness - be it depression, schizophrenia, or manic depression. We are a far cry from the 1800s, when little was known about mental illness and thousands were locked away in institutions with little public interaction.

The 1960s changed forever the treatment and perception of the mentally ill. Attempting to fix horrific conditions and ineffective treatment in mental hospitals, thousands of mentally ill people were reintroduced into society - or deinstitutionalized, as it came to be called - using halfway houses and out-patient services. At the same time, pioneering antipsychotic drugs became available. Voices in heads were quieted and many of the severely mentally ill were able to take a bus, work at a job, and live in society for the first time.

These days, fewer and fewer people are being placed in institutions as pharmacological treatments continue to improve. For the severely mentally ill, guardians - either family members or the state - are given the right to make financial and medical decisions if those needing guardianship are unable to during the worst bouts of illness. But most people who suffer from mental illness suffer the disease episodically. Like cancer that may go into remission, the illness will ebb between flare-ups.

There are reasons the public may still harbor stereotypical views of the mentally ill as ''insane'' and unable to think coherently. The first efforts at deinstitutionalization largely failed, and the image of the homeless mentally ill talking to themselves on city sidewalks became etched in people's minds. And while we have grown to understand and accept a mental illness such as depression, it is a long way from the strange world of schizophrenia with its delusions and odd behavior.

But just like cancer with its ladder of severity, mental illness has many gradations that must be taken into account.

''Just because sometimes people are not capable of balancing a checkbook or taking medication, they are capable of understanding political issues and what it means to cast a ballot,'' says Kristin Aiello, of the Disability Rights Center of Maine.

The center has filed suit against the Maine restriction on behalf of three mentally ill people who have guardians and were denied the right to vote. Aiello and others hope to persuade the courts that the ban, the last vestige of an 1821 law, is unconstitutional - not to mention absurd, given it is targeted at only those mentally ill people who have guardians, while others who may be much more impaired, but without the benefit of guardians, are free to cast ballots.

The legal effort, in Maine and nationally, turns in part on figuring out what constitutes a voter's ''informed decision.'' It is a slippery slope, since non-mentally ill voters don't always display rational thought in making their choices. As Bob Carolla, a spokesman for the National Alliance for the Mentally Ill, notes: During the 1992 campaign, 86 percent of Americans knew that President Bush's dog's name was Millie, but only 15 percent knew that Bush and challenger Bill Clinton both supported the death penalty.

There is the real and legitimate worry that the mentally ill - as is the assertion in New Jersey - can be coerced by outside sources to vote a certain way, and thus their votes will be tainted. While this can happen to anyone, it is an understandable fear.

But there are solutions. A compromise based on a 1982 American Bar Association report suggests states do away with voting restrictions based on any disability, and replace them with a simple test - such as stating one's name, address, and giving proof of citizenship.

It's a method that is not only workable, but fair. Americans pride themselves on civil rights and in a participatory democracy, ensuring that everyone has an equal right to have a say should be sacrosanct. Indeed, it is ironic that medical coverage for the mentally ill was included in the presidential candidates' platforms, yet many of the people who will be affected by their stands could not have a say in which candidate they wanted.