People with mental health conditions or cognitive impairments generally retain the right to vote.

States may restrict voting rights based on legally established mental incapacity.

Caregivers and mental health professionals can help individuals exercise their voting rights.

Voting is a fundamental right in free and democratic societies (Bazelon Center for Mental Health Law, 2026). The Equal Protection and Due Process Clauses of the Fourteenth Amendment to the U.S. Constitution provide important safeguards against arbitrary and discriminatory restrictions on voting rights. But what happens when individuals have schizophrenia, cognitive impairment, bipolar disorder, uncontrolled addiction, or other mental health disorders that may compromise their decision-making capacity? What does the law say about their right to vote, and who has the authority to determine when that right may be restricted?

Various federal and state laws protect voting rights, including those of people with mental health conditions or cognitive impairments. Under the Voting Rights Act (1965), individuals with disabilities who need assistance voting have the right to receive help from a person of their choice, subject certain exceptions (e.g., not an employer). For instance, someone with an anxiety disorder, cognitive impairment, autism, or other mental health condition that makes voting difficult may ask a friend or family member to assist them (Bazelon Center for Mental Health Law, 2026). The Americans with Disabilities Act (1990) also prohibits discrimination by state and local government officials, including individuals responsible for administering elections (U.S. Department of Justice, 2024). For example, election officials generally cannot prohibit voters with disabilities from bringing trained service animals into polling places. States cannot enact laws that discriminate against people with disabilities (Doe v. Rowe, 2001), for instance, disqualifying people from voting simply because they have a mental illness.

Under the National Voter Registration Act (1993), states may remove individuals from voter registration rolls based on mental incapacity, as provided by state law. However, states differ in whether and how they determine whether someone lacks the mental capacity to vote. For instance, Florida Statute § 97.041 prohibits individuals who have been adjudicated mentally incapacitated with respect to voting from voting unless their voting rights have been restored. New Mexico’s Constitution (Article VII, § 1) permits restrictions based on mental incapacity only when individuals cannot mark their ballots and cannot communicate their voting preferences. In contrast, California Elections Code § 2208 presumes that individuals retain the right to vote even when they have court-appointed conservators. Voting rights may be removed only following a specific court ruling, supported by clear and convincing evidence, that the individual cannot communicate a desire to........

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