Almost a Revolution: Mental Health Law and the Limits of Change / Edition 1

by Paul S. Appelbaum

Overview

Doubts about the reality of mental illness and the benefits of psychiatric treatment helped foment a revolution in the law's attitude toward mental disorders over the last 25 years. Legal reformers pushed for laws to make it more difficult to hospitalize and treat people with mental illness, and easier to punish them when they committed criminal acts. Advocates of reform promised vast changes in how our society deals with the mentally ill; opponents warily predicted chaos and mass suffering. Now, with the tide of reform ebbing, Paul Appelbaum examines what these changes have wrought. The message emerging from his careful review is a surprising one: less has changed than almost anyone predicted. When the law gets in the way of commonsense beliefs about the need to treat serious mental illness, it is often put aside. Judges, lawyers, mental health professionals, family members, and the general public collaborate in fashioning an extra-legal process to accomplish what they think is fair for persons with mental illness. Appelbaum demonstrates this thesis in analyses of four of the most important reforms in mental health law over the past two decades: involuntary hospitalization, liability of professionals for violent acts committed by their patients, the right to refuse treatment, and the insanity defense. This timely and important work will inform and enlighten the debate about mental health law and its implications and consequences. The book will be essential for psychiatrists and other mental health professionals, lawyers, and all those concerned with our policies toward people with mental illness.

Product Details

ISBN-13:	9780195068801
Publisher:	Oxford University Press, USA
Publication date:	06/28/1994
Edition description:	New Edition
Pages:	248
Product dimensions:	6.50(w) x 9.50(h) x 0.81(d)

About the Author

Paul S. Appelbaum, M.D., is Arnold Frank Zeleznik Distinguished Professor and Chair of the Department of Psychiatry, and Director of the Law and Psychiatry Program at the University of Massachusetts Medical Center. He has served as chair of the American Psychiatric Association's Council on Psychiatry and Law and Commission on Judicial Action, and is a member of the John D. and Catherine T. MacArthur Foundation's Research Network on Mental Health and the Law. In 1990, Dr. Appelbaum received the Isaac Ray Award of the American Psychiatric Association for "outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence."

Table of Contents

1. Setting the Stage for Reform
2. Involuntary Commitment of the Mentally Ill: Civil Liberties and Common Sense
3. Duty to Protect Potential Victims of Patients' Violence: Public Peril vs. Protective Privilege
4. Right to Refuse Treatment with Medication: Consent, Coercion, and the Courts
5. The Insanity Defense: Moral Blameworthiness and Criminal Punishment
6. The Consequences of Reform in Mental Health Law

Editorial Reviews

Reviewer: Mark C. Mantooth, JD (Rush University Medical Center)
Description: This new book is essentially a compilation of four mental health lectures given by the author within the last four years that have been expanded into chapters, along with introductory and concluding chapters.
Purpose: As he states, the author looks for broad patterns and explores the deeper implications of what he has termed an unsuccessful "revolution" in mental health law. He identifies four reform trends that have occurred during the last 15 or 20 years, and he explains why the anticipated revolutionary changes never took place. Because the areas he explores are continuing to develop, they should be of significant interest to clinicians and mental health attorneys.
Audience: Considering that the author presented most of the chapters originally as lectures to psychotherapists and law students, these people remain his intended audience. Because of the emphasis on psychotherapy studies and statistics, though, the audience is more appropriately the clinicians and practitioners.
Features: The chapters begin in a chatty style, starting with an anecdote or actual clinical case. As the chapters progress, they present the historical background of a case, and continue with a logical analysis of the mental health law topic. Each chapter is well referenced.
Assessment: As an informative guide to four areas of mental health law reform, this book proves to be a success. It presents a general thesis in a well-organized and cohesive manner. As an educational guide to developments in this area of law, though, the text is incomplete and consequently inadequate. The author relies excessively on clinical studies to support his thesis while failing to provide the same detail in discussing the changes in the law and the legislative and judicial responses. The author also overlooks other significant areas of mental health law reform, such as confidentiality of patient information.

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