## Facts

- Thomas S., a 20-year-old Gaston County resident diagnosed with schizophrenia and borderline intellectual functioning, was unable to live independently or manage his affairs.
- He spent his first 18 years in the custody of the county social services agency and was placed in roughly 40 foster homes and institutions.
- After turning 18, he was adjudicated incompetent, and a state official (also serving within the state mental health agency) was appointed as his guardian.
- Clinical professionals recommended a stable, noninstitutional community placement with functioning adults, including education, job training, and therapy.
- Instead, he was placed in a state psychiatric facility’s mental retardation unit.
- The parties agreed in May 1983 to a community-based placement, and the court deferred ruling while implementation proceeded.
- By February 1984, Thomas was removed from the agreed community placement and transferred to a detoxification facility.
- Thomas, through his next friend, sued multiple state and local officials in their official capacities for declaratory and injunctive relief, alleging unconstitutional failures in treatment and placement.

## Issues

1. Whether a legally incompetent, state-dependent person placed in institutional settings has a substantive due process right to reasonably safe conditions and minimally adequate training, as measured by professional judgment.
2. Whether defendants’ decisions and omissions constituted a substantial departure from accepted professional judgment in failing to provide and maintain the recommended community-based placement.
3. Whether declaratory and injunctive relief could require state and local officials to implement and maintain an appropriate community placement and related services.

## Decision

- The court found that Thomas had substantive due process rights to reasonably safe conditions and minimally adequate training necessary to protect his liberty interests.
- The court held defendants violated those rights by failing to provide and sustain professionally recommended, less restrictive, community-based treatment and training.
- The court concluded defendants’ conduct reflected a substantial departure from accepted professional judgment, particularly given the repeated placement instability and the post-agreement transfer to a detox facility.
- The court granted declaratory and injunctive relief requiring officials to provide and maintain an appropriate community-based placement and services consistent with professional judgment.

## Legal Principles

- Substantive due process protects certain liberty interests of persons in state custody or comparable dependency, including reasonably safe conditions and minimally adequate training necessary to protect those interests.
- Decisions concerning care and placement are evaluated under a professional-judgment standard; liability may be imposed when conduct substantially departs from accepted professional judgment, practice, or standards.
- Constitutional compliance requires more than nominal plans; responsible officials must implement and maintain professionally indicated placements and training when necessary to satisfy minimally adequate care obligations.
- Injunctive relief is appropriate where a demonstrated history of noncompliance and instability shows that declaratory relief alone will not prevent ongoing or recurring constitutional violations.

## Conclusion

The court held that responsible state and local officials violated substantive due process by failing to provide and maintain a professionally recommended community placement and minimally adequate training for a legally incompetent, state-dependent adult, and it ordered declaratory and injunctive relief compelling sustained, professionally appropriate community-based care.


Thomas S. v. Morrow, 601 F. Supp. 1055 (W.D.N.C. 1984)