Survey: Lower support for rights of people with behavioral disabilities

Adults in the United States report lower support for the human and civil rights of people with severe mental illness or substance use conditions than for the rights of those with physical disabilities, according to a nationwide survey led by researchers at the Andrew M. and Jane M. Bursky School of Public Health at Washington University in St. Louis. Their study is published in JAMA Health Forum.

“The overall ranking confirms decades of stigma research, which consistently finds physical disabilities are viewed more favorably than mental illness, and mental illness more favorably than addiction,” said senior and corresponding author Morgan Shields, PhD, an assistant professor. “What's new is showing that the same hierarchy carries over to support for rights, though the difference between mental illness and substance use was very small in our study.”

People with disabilities face stigmatization and exclusion from society. They are more likely to be unemployed, homeless or incarcerated; to live in poverty and to be victims of violence than people without disabilities. Mental illness and substance use contribute to some of the thorniest social problems, including child abuse and neglect, homelessness and self-destructive behaviors. Policies meant to address such problems can result in the abuse of and discrimination against people living with those conditions. 

The findings from the new study suggest that the American public may place a relatively low priority on the human and civil rights of the people involved when they weigh the pros and cons of such policies, the researchers said. Examples include anti-loitering, involuntary commitment and drug-testing laws. 

“The best approach to mental health treatment is voluntary,” Shields noted. “There is no evidence that forced intervention benefits people. Moreover, it is important to appreciate the inherent value of rights, regardless of their association with clinical outcomes. We often struggle to appreciate the inherent value of human rights in mental healthcare, particularly in the United States, which these study results reflect.”

The findings come from a nationwide survey of 1,442 U.S. adults regarding their support of the human and civil rights for people who have physical disabilities, mental illness or substance use conditions that substantially limit them in at least one area of life. Participants rated their support for human rights, including adequate standard of living, freedom from torture and abuse, high standards of health, legal capacity, and living independently in the community. They also rated support for civil rights — including being a parent, running for political office, and owning a gun — for these marginalized groups. The researchers examined differences in support for rights across multiple demographic characteristics in their survey, such as age, sex, race, income, educational level, and political affiliation. They conducted their survey online for one month (from January 17 to February 12, 2025).

The survey showed that participants were significantly more likely to view people with severe physical disabilities as being more entitled to human and civil rights than those with severe mental health conditions or severe substance use conditions. For example, about 79% of participants supported the right to live independently for people with severe physical conditions, while 67% supported this right for those with severe mental health conditions and 68% supported this right for those with severe substance use conditions.

Civil rights received lower support across all three groups compared to human rights, the researchers noted. For example, about 63% of survey participants supported people with severe physical disabilities running for political office, but only about 40% did for people with severe mental health conditions or substance use conditions.

Public support for the allocation of rights varied by demographics. The researchers found that political affiliation, lived experience, age, and gender were all associated with support ratings for rights. For example, Democratic party affiliation and lived experience with a behavioral health condition or treatment — having a personal or family experience with behavioral healthcare — were associated with higher support for human rights. Being male and younger age (18-24 years) were associated with greater support for civil rights.

The findings are particularly important today, as these marginalized groups are currently being targeted by new government policies, including a 2025 Executive Order that seeks to limit the rights of people with severe disabilities. 

“This study represents an important step in understanding public support for human and civil rights for these marginalized groups and raises a number of questions about how to appropriately address that support,” Shields said. “In particular, the findings can inform interventions to address public attitudes toward people with behavioral health conditions and provide a more complete picture of the landscape for policy reform.” 

The study has caveats: It used an online survey designed to match the U.S. population on key demographics but was not a true random representative sample of the country, which is much harder to obtain. The population sample tended to cover an older population, and it underrepresented younger adults and Latino respondents. Also, the study provides only a snapshot of time. Future studies may track how public attitudes change over time, the researchers said. 

Co-authors included first author Jessica Willams, MD, an assistant professor of psychiatry at WashU Medicine; Mia Kouveliotes, a former undergraduate at WashU and currently a graduate student at the University of North Carolina at Chapel Hill; and Nev Jones, PhD, of the University of Pittsburgh’s School of Social Work.

Williams J, Kouveliotes M, Jones N, Shields M. “Support for Human and Civil Rights in Physical Disability, Mental Illness, and Substance Use Disorder.” JAMA Health Forum. October 2, 2026. DOI: 10.1001/jamahealthforum.2026.3431 

The National Institute on Drug Abuse funded this study.