Gavin Howe
The treatment of mental illness has been a concern for societies since ancient times. In ancient Greece and Rome, asylums were places of refuge for those who were persecuted, including those with mental illnesses. Today, the treatment of mental illness is governed by various laws and institutions, which have been shaped by campaigns to safeguard the rights of those with mental illnesses. In the US, the National Institute of Mental Health (NIMH) was established in 1946 to transform the understanding and treatment of mental illnesses through research. Over the years, NIMH has played a key role in advancing neuroscience and mental health research, influencing policy and improving public health outcomes. Mental Health America, founded by Clifford Beers, has also been instrumental in advocating for the rights of those with mental illnesses, helping to secure the passage of the Mental Health Parity Act and ending discrimination in mental health insurance coverage for federal workers. Various laws, such as the Mental Health Act, the Equality Act 2010, and civil commitment laws, outline the rights of individuals with mental illnesses and the requirements for hospitalization and treatment. These laws aim to protect the rights, dignity, and safety of those with mental illnesses, while also providing access to the best available mental health care.
| Characteristics | Values |
|---|---|
| Institutions | National Institute of Mental Health (NIMH) |
| National Advisory Mental Health Council | |
| National Committee for Mental Hygiene | |
| National Mental Health Association | |
| Mental Health America | |
| National Institute of Neurological Diseases and Blindness (NINDB) | |
| National Alliance for Research on Schizophrenia and Depression (NARSAD) | |
| Laws | Civil commitment laws |
| Mental Health Act | |
| Equality Act 2010 | |
| Mental Capacity Act 2005 | |
| ADAMHA Reorganization Act | |
| Mental Health Parity Act |
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What You'll Learn
The Mental Health Act and sectioning
The Mental Health Act 1983 is the primary legislation in England and Wales that governs the assessment, treatment, and rights of people with mental health disorders. It outlines the circumstances under which individuals can be detained and treated in a hospital without their consent, commonly known as "sectioning".
Sectioning can occur when there are concerns about an individual's mental health and their ability to make use of the help offered. In such cases, relatives or professionals involved in the person's care can request a formal assessment through the Mental Health Act process. This involves an assessment by health professionals to determine if detention is necessary. If sectioned, individuals are kept in the hospital under a specific section of the Act, each with different rules governing the length of stay and treatment.
During detention, individuals have certain rights, including the right to appeal the decision and seek help from an independent advocate. They can also leave the hospital premises, often referred to as ""section 17 leave", if authorised by the responsible clinician, who is typically a psychiatrist in charge of their care. This leave may have conditions attached, such as the duration and place of stay.
The Mental Health Act also provides for aftercare services following discharge from detention. Under Section 117, health authorities and local social services are legally obligated to provide free aftercare for individuals discharged under specific sections of the Act. This aftercare aims to meet the individual's mental health needs and prevent a deterioration that would require readmission to the hospital.
The Mental Health Act and its associated processes aim to balance the need for treatment and the rights of individuals experiencing mental health issues. It provides a framework for ensuring the safety and well-being of those with mental health disorders while also respecting their autonomy and dignity.
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Equality Act 2010
The Equality Act 2010 is a UK law that protects people with disabilities from discrimination. This includes people with long-term or recurring mental health conditions, who are considered 'disabled' under the Act. The Act specifies that all public services, including acute hospitals, must make 'reasonable adjustments' to ensure that people with disabilities are not 'substantially disadvantaged'. This might include, for example, providing specialist nurses, offering easier-to-read information, or adjusting attendance criteria and placement requirements.
The Act also allows for disabled people to be treated "more favourably" in certain circumstances, and for flexibility in policies and processes. For instance, universities must ensure that policies such as Fitness to Study do not inadvertently discriminate against students with mental health conditions.
The Equality Act replaced previous disability discrimination legislation and extended to all public services. It is important to note that the Act does not require providers to make reasonable adjustments to a provision, criterion, or practice that is defined as a competence standard. However, it is good practice for providers to identify and record competence standards and share this information with students.
The Equality Act 2010 is not the only legislation that impacts the rights and treatment of people with mental illness. There are also international principles outlined by the OHCHR, which state that all persons with mental illness should be treated with humanity and respect for their inherent dignity. These principles also guarantee the right to the best available mental healthcare and protection from exploitation and abuse.
In the United States, the National Institute of Mental Health (NIMH) was established in 1946 with the signing of the National Mental Health Act. NIMH's mission is to advance the understanding and treatment of mental illnesses through research, with the goal of paving the way for prevention, recovery, and cure. Over the years, NIMH has developed various research programs and strategic plans to further this mission. Additionally, in 1955, the Mental Health Study Act called for a nationwide analysis and re-evaluation of the human and economic problems of mental illness.
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National Institute of Mental Health
The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research.
The NIMH was first authorized by the US government in 1946 when President Harry Truman signed the National Mental Health Act into law. However, the institute was not formally established until 1949, with Robert H. Felix as its first director. The NIMH is a $1.5 billion enterprise, supporting research on mental health through grants to investigators at institutions and organizations throughout the United States and through its own internal (intramural) research effort.
The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. To continue fulfilling this vital public health mission, the Institute fosters innovative thinking and supports a wide range of novel scientific perspectives to further discovery in the evolving science of the brain, behavior, and experience. The NIMH Intramural Research Program, the institute's internal research division, comprises more than 650 staff and over 40 research groups conducting basic, clinical, and translational research to advance understanding of the diagnosis, causes, treatment, and prevention of mental disorders.
The NIMH has passed through a series of name changes and organizational arrangements within the United States Public Health Service (PHS) throughout its history. In 1992, when the Alcohol, Drug Abuse, and Mental Health Administration was abolished, NIMH was transferred to NIH, retaining its research functions while its treatment services were transferred to the new Substance Abuse and Mental Health Services Administration.
The NIMH has played a highly influential role in shaping policy, research, and communicating with the public. In 1955, the Mental Health Study Act called for "an objective, thorough, and nationwide analysis and reevaluation of the human and economic problems of mental health." In 1963, Congress passed the Mental Retardation Facilities and Community Mental Health Centers Construction Act, beginning a new era in Federal support for mental health services. NIMH assumed responsibility for monitoring the Nation's community mental health centers (CMHC) programs and launched a campaign on special mental health problems, including schizophrenia, child and family mental health, suicide, crime and delinquency, minority group mental health problems, and urban problems.
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Civil rights and mental health
The deinstitutionalization movement of the mid-20th century saw a shift towards community-based care and outpatient facilities. However, this movement has been criticized for failing to adequately support those with severe mental illness, leaving them vulnerable and without adequate resources.
In more recent times, there has been a growing recognition of the civil rights of those with mental illness and the need for protection and equality. Various laws and institutions have been established to uphold these rights, such as the National Institute of Mental Health (NIMH) in the US, which was established in 1946 to advance the understanding and treatment of mental illnesses. The Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, outlined by the OHCHR, assert the rights of those with mental illness to the best available mental healthcare, humanity and respect, protection from exploitation and abuse, and freedom from discrimination.
Mental Health America, established by Clifford Beers, has been instrumental in advocating for the civil rights of those with mental illness. Their efforts have led to positive changes, including the removal of discriminatory questions from federal government employment forms and the enactment of mental health insurance parity for federal workers.
Additionally, legislation such as the Mental Health Parity Act and the Equality Act 2010 in the UK have been enacted to address discrimination and ensure equal rights in areas such as employment and health insurance coverage. The Mental Health Act and the Mental Capacity Act in the UK also outline the rights of individuals detained or sectioned due to mental illness, ensuring their protection and access to appropriate treatment.
While progress has been made, the struggle for civil rights in the context of mental health remains ongoing, with efforts focused on improving access to quality care, ending discrimination, and ensuring the protection and well-being of those living with mental illness.
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Mental health reform
In the United States, the history of mental health reform can be traced back to individuals like Clifford Beers, who, through his autobiography, "A Mind That Found Itself", shed light on the shameful conditions he endured in mental institutions. Beers' work sparked a movement, leading to the establishment of the Connecticut Society for Mental Hygiene in 1908, which later expanded into the National Committee for Mental Hygiene. This committee was a precursor to the National Mental Health Association, now known as Mental Health America. Mental Health America has played a pivotal role in numerous milestones, including facilitating the creation of child guidance clinics, drafting a mental hygiene program for the Army and Navy, and advocating for the rights of those with mental illnesses.
On a national level, significant steps have been taken to address mental health reform. In 1946, President Harry S. Truman signed the National Mental Health Act, establishing the National Institute of Mental Health (NIMH). The NIMH's mission is to advance the understanding and treatment of mental illnesses through research. In 1955, the Mental Health Study Act called for a nationwide analysis of the human and economic problems associated with mental illness. More recently, Mental Health America played a crucial role in passing the "Mental Health Parity Act," which aimed to bring more equity to health insurance coverage for mental healthcare.
Despite these advancements, challenges remain. The deinstitutionalization of people with mental illnesses has, at times, led to inadequate community services and deplorable living environments. Additionally, there is a need for continued advocacy to ensure the protection of the rights of those with mental illnesses, as outlined in principles by organizations like OHCHR. These principles emphasize the right to the best available mental healthcare, respect, protection from exploitation and abuse, and non-discrimination for all persons with mental illnesses.
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Frequently asked questions
The Mental Health Act is a law that outlines the rights of individuals with mental illness and the circumstances under which they may be detained or hospitalized. It includes sections that detail the role of professionals, courts, and relatives in the process.
The NIMH is a US institution established through the National Mental Health Act, signed by President Harry S. Truman in 1946. Its mission is to advance the understanding and treatment of mental illnesses through research, with the goal of paving the way for prevention, recovery, and cures.
MHA, founded by Clifford Beers, has been instrumental in various initiatives. These include facilitating the creation of child guidance clinics, influencing mental health insurance parity, and securing the release of funds for community mental health centers. MHA also drafted a mental hygiene program adopted by the Army and Navy.
The OHCHR has outlined several principles, including the right to the best available mental healthcare, the right to be treated with dignity and respect, protection from exploitation and abuse, and the right to confidentiality. States are encouraged to implement these principles through legislative, judicial, and administrative measures.
