STATEMENT: S.862 raises critical questions about who has the right to make medical decisions for adults with disabilities.

Able South Carolina’s position focuses on protecting autonomy while addressing gaps in crisis support systems.

Able South Carolina on S.862 and Protecting the Civil Rights of Adults with Disabilities

Able South Carolina is a disability-led organization dedicated to advancing the civil rights, independence, and full inclusion of people with disabilities. As a Center for Independent Living, our work is grounded in the belief that people with disabilities have the right to direct their own lives and make decisions about their own health, safety, and future.

We recognize the profound grief, fear, and frustration that families experience when a loved one faces a serious mental health crisis. Families often feel powerless within a fragmented system that does not provide timely support, crisis stabilization services, or accessible community-based care. Preventing tragedy and improving crisis response are goals we share.

However, legislative responses to deeply painful events must be approached with caution. Laws written in the wake of tragedy can unintentionally weaken civil rights protections when solutions expand control over individuals rather than strengthen support systems.

For people with psychiatric disabilities, this concern is not theoretical. Historically, moments of crisis have often resulted in the loss of autonomy through policies that prioritize control and involuntary intervention rather than support and recovery. Expanding decision-making authority over adults with disabilities without strong safeguards risks repeating patterns that the disability rights movement has spent decades working to dismantle.

S.862 proposes allowing parents to make medical decisions for adult children with psychiatric disabilities if the adult qualifies as a dependent and remains covered under a parent’s insurance plan. While dependency status may appear to offer a clear threshold, in practice, it is often shaped by systemic barriers faced by people with disabilities. Many adults with disabilities remain on family insurance not because they lack decision-making capacity, but because barriers in employment, housing, and healthcare access make independent coverage unattainable.

Using insurance dependency as a trigger for decision-making authority risks creating a class of adults with disabilities whose civil rights are diminished simply because they rely on family coverage. Legal adulthood cannot become conditional based on employment status or insurance access.

As individuals with disabilities who are also parents, siblings, relatives, and loved ones, we understand the instinct to intervene when someone you love is in danger. The desire to help is real and deeply human. However, good intentions alone cannot justify policies that bypass the legal rights and capacity of adults with disabilities.

It is also important to recognize that South Carolina law already includes mechanisms that allow intervention when an individual is experiencing a severe mental health crisis and may be at risk of harming themselves or others. Under South Carolina’s mental health commitment statutes, an individual may be involuntarily hospitalized for evaluation and treatment when there is evidence of mental illness and a likelihood of serious harm. This process requires both medical evaluation and judicial oversight, ensuring that emergency intervention can occur while still protecting the legal rights of the individual involved.

Typically, the process begins with a sworn affidavit stating that a person may be mentally ill and likely to cause harm to themselves or others if not hospitalized. A physician must then certify that the person meets the legal criteria for emergency hospitalization. If those standards are met, the individual may be transported to a hospital for evaluation. Following that evaluation, a probate court hearing may determine whether continued involuntary treatment is warranted. These procedures exist specifically to balance safety, medical judgment, and due process protections.

This framework reflects an important principle: when the state restricts an adult’s liberty or decision-making authority, it must do so through clear legal standards, medical assessment, and court review. In other words, South Carolina already allows intervention during mental health crises. The real gap in our system is not the absence of authority; it is the lack of accessible, community-based crisis services that help people stabilize before situations escalate.

South Carolina law also already provides legal tools that allow individuals to plan ahead and designate trusted supporters. Mechanisms such as the Adult Health Care Consent Act, medical powers of attorney, and other advance planning tools allow adults to identify people who can assist with medical decisions during emergencies while still preserving their legal authority. These frameworks were created specifically to balance safety, autonomy, and individual rights.

Creating new authority that overrides these existing protections risks weakening the safeguards designed to ensure that an adult’s voice, preferences, and legal capacity remain central to decision-making. Policies that remove decision-making authority based on diagnosis or disability status reinforce outdated paternalistic models that have historically led to unnecessary institutionalization and the erosion of civil rights for people with disabilities.

If South Carolina is serious about preventing tragedy and improving crisis response, policy solutions must address the real gaps in the system: the lack of accessible, community-based mental health supports that help people stabilize before a crisis escalates.

Able South Carolina urges policymakers to prioritize reforms that strengthen support rather than expand control. These include:

Protecting the legal autonomy of adults with disabilities.
Any legislation addressing mental health crises must clearly affirm that adults retain the right to make their own medical decisions unless a court determines otherwise through established due process protections.

Prioritizing less-restrictive alternatives.
Policies should require consideration of supported decision-making, psychiatric advance directives, and medical powers of attorney before granting authority for others to make medical decisions on behalf of an adult.

Investing in community-based crisis response services.
Expanding access to mobile crisis teams, peer support specialists, and trauma-informed mental health professionals can provide timely support while reducing the need for involuntary interventions.

Strengthening the 988 crisis response system.
South Carolina should ensure that 988 is adequately funded and integrated with local crisis response teams trained in disability-affirming and trauma-informed practices.

Increasing access to advance planning tools.
Public education and legal access to psychiatric advance directives, supported decision-making agreements, and medical powers of attorney can empower individuals to identify trusted supporters before a crisis occurs.

Supporting families navigating mental health crises.
Families need resources, education, and crisis navigation services that help them respond effectively without removing the legal rights of the adult in crisis.

Including the disability community in policymaking.
People with psychiatric disabilities and disability-led organizations must be meaningfully involved in shaping policies that affect their lives and rights.

Research consistently demonstrates that accessible, community-based crisis services, including peer support, trauma-informed care, and mobile crisis teams, are more effective at stabilizing individuals while preserving autonomy and dignity. Expanding decision-making authority for family members does not address the root problem: a lack of accessible crisis services and preventive mental health supports.

Without meaningful investment in these systems, families and individuals will continue to face the same gaps in care.

We recognize and respect the pain that often drives calls for legislative change in the mental health system. Compassion for families must be part of this conversation. But compassion must also extend to the civil rights of adults with disabilities.

For decades, the disability community has fought against laws and policies that presume incapacity based on diagnosis, behavior, or disability status. Those policies often resulted in unnecessary institutionalization and the removal of fundamental rights.

South Carolina has the opportunity to pursue a better path, one that responds to crisis with expanded support rather than expanded control.

A modern mental health crisis system should prioritize community-based care, peer support, early intervention, and the least restrictive options possible while protecting the civil rights and autonomy of adults with disabilities.

True reform is not about choosing between safety and freedom.

It is about building a system that protects both.