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Mental disability and voting access

Tuesday, November 4th, 2008

People with varying degrees of cognitive disability from young adults with schizophrenia to seniors with dementia will be among the voters casting their ballots today. But often this group is under-represented at the polls, and two researchers from the University of Pennsylvania are pushing to give more people their turn in the voting booth.


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Download a PDF guide to the voting rights of people with mental disabilities from the Bazelton Center for Mental Health Law and National Disability Rights Network.


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There’s a fine line between encouraging citizens with cognitive disabilities to vote and leaving them vulnerable to outside influence. Penn psychologist Mark Salzer says often voters get turned away and encounter the biggest barriers before they arrive at the polling place.

Salzer: It’s family members, it’s program staff, it’s other people telling someone that they shouldn’t vote or can’t vote. That seems to be the No. 1 issue.

After the 2004 Philadelphia mayor’s race, researcher Jason Karlawish, who’s also from the University of Pennsylvania, surveyed city nursing homes. Karlawish says he found wide differences in the support provided to residents, and some troubling attitudes among workers.

Karlawish: We also had some staff reporting to us: ‘Well first I find out from them do they know what the election is for. Do they know who’s running? Do they know what the issue are, and if they can answer maybe half of those questions then I think they are good to go, and I’ll let them vote.’

Karlawish says that kind of questioning harkens back to the literacy tests some states required before the Civil Rights Era. He believes the practice is unconstitutional and needs to end.

The Commonwealth has no law barring the mentally ill from the polls. People deemed mentally incompetent by a court also have the right to vote, unless a judge says otherwise. That leaves administrators to craft policies to assist residents with voter registration, absentee ballots and transportation.

Karlawish: In this city each nursing home is on its own to decide how they are going to respect their residents’ rights to vote. One of the people we interviewed said, you know the right to vote is such a fundamental right, and to have the power to decide who can and can’t exercise that right, seems to be a little bit too heavy and some guidelines would really help to be able to carry that out in a way that’s fair and proper.

Fears about coercion and fraud have lead to laws like the ones in New Jersey and Delaware, which curb voting access for people the courts have judged to be mentally incompetent.

Jason Karlawish favors a different tack. If someone with a pervasive mental illness is old enough to vote, and not a felon, he says they should be given access and assistance if they need it. He says competency issues get sorted out in the practicality of Election Day.

Karlawish: If they are able to make a choice, they make a choice and we move on, if they can’t make a choice, it’s a spoiled ballot.

Salzer says any other standard lays down unfair barriers for people with serious mental illness.

Salzer: I would actually think that the general population would assume that someone diagnosed with schizophrenia is incapable of voting. And that would be clearly wrong. A lot of these illnesses are episodic and periodic. You are able to understand most things, for the most part. There might be delusions and hallucinations, there, but you can still understand most of the things that are going on around you.

He says advocates should work for greater voter participation.

Salzer: The argument that I would make is that there are plenty of people out in the community who are voting in every election who don’t understand the voting process.

Doctor Karlawish says mobile polling is one option that has worked in Australia. Sometimes called “early voting on-the-go,” it pushes election officials to step in and help out. Vermont is testing the concept.

Karlawish: Prior to Election Day, election officials, ideally a team, goes out to the homes, and in a common area, but done in a private way, allows residents to cast their ballots, and then even takes the ballots to residents who are unable to leave their rooms, who want to vote.

In the Tri-State area, one care provider has changed its policies in an effort to boost voter turnout. Earlier this year, Carelink Community Support Services tapped one person to oversee voter registration for all of its 37 programs. Quality specialist Hayes Russock says two years ago voter registration among Carelink participants was just under 13 percent. Today more than half of the 305 participants are signed up.

Russock: What I’m really hoping to see is that because the people enrolled in our services have more of a voice that there will be a greater response from our government, that there will be better funding and a better understanding overall of what their needs are.

Russock says the company made no sweeping changes, but he says staffers did talk about the election during house meetings and they simply asked residents if they wanted to vote.

Russock: There’s a lot of passion associated with this particular election. So kind of riding that wave of interest that we’re seeing we have the opportunity to encourage people and provide them the supports they need in order to make sure that their voices are heard.

The Carelink example is small, and Russock says his company doesn’t keep track of the number of residents who actually vote. But historically, expanded voter registration has often driven under-represented groups to the polls.

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