NCJ Number
68416
Date Published
1979
Length
17 pages
Annotation
THIS ARTICLE EXAMINES THE MAJOR TENSIONS BETWEEN THE MENTAL HEALTH AND LEGAL SYSTEMS EVOKED BY LITIGATION DEFENDING THE RIGHTS OF MENTALLY RETARDED PERSONS.
Abstract
TEST CASES INVOLVING THE RIGHT OF THE MENTALLY HANDICAPPED TOOK PLACE IN THE 1970'S. THESE WERE FACILITATED BY ADVOCACY FROM WITHIN LEGAL SERVICES PROGRAMS AND BY REVELATIONS OF PATIENT NEGLECT AND ABUSE IN MENTAL HEALTH HOSPITALS. THE CRITICAL ISSUE UNDERLYING CLASS ACTION RIGHT-TO-TREATMENT AND RIGHT-TO-EDUCATION CASES OF THE MENTALLY RETARDED WAS JUDICIAL CONTROL OF FINANCING DECISIONS REGARDING STATE ALLOCATIONS TO HOSPITALS FOR THE MENTALLY RETARDED AND TO OTHER PROGRAMS AND AGENCIES. THIS CAUSED TENSION BETWEEN THE COURTS AND THE EXECUTIVE AND LEGISLATIVE BRANCHES OF GOVERNMENT. THE EFFORT OF PATIENT ADVOCATES WAS AIMED AT FORCING LEGISLATURES TO REALLOCATE THEIR FISCAL PRIORITIES. SECONDLY, MENTAL HEALTH ADVOCACY EFFORTS HAVE USED THE STRATEGIES OF BOTH THE CIVIL RIGHTS AND THE CONSUMER MOVEMENTS, CAUSING TENSIONS WITHIN THE ADVOCACY NETWORK. SERVICE-ORIENTED ADVOCATES AND CIVIL LIBERTARIANS TAKE RADICALLY DIFFERENT POSITIONS WITH REGARD TO THE ISSUE OF CIVIL COMMITMENT. THE FIRST GROUP UNDERSTANDS COMMITMENT AS A MEANS OF PROTECTING SOCIETY FROM POTENTIALLY DANGEROUS INDIVIDUALS WHILE AT THE SAME TIME PROVIDING TREATMENT TO WHICH THE PATIENTS ARE ENTITLED. CIVIL LIBERTARIANS, ON THE OTHER HAND, CONTEND THAT, WHATEVER THE ALLEGED BENEFITS OF MENTAL HEALTH INTERVENTIONS THROUGH CIVIL COMMITMENT, UNCONSTITUTIONAL CURTAILMENT OF LIBERTY IS INVOLVED. CIVIL LIBERTARIANS AND SERVICE-ORIENTED ADVOCATES ALSO DISAGREE ON THE RIGHT OF MENTAL PATIENTS TO BE PLACED IN THE LEAST RESTRICTIVE SETTING NECESSARY TO ACHIEVE THE LEGITIMATE STATE GOALS OF PROTECTING SOCIETY. A THIRD AREA OF PROFESSIONAL DISSENT INVOLVES MENTAL HEALTH PROFESSIONALS AND PATIENT ADVOCATES. THE PROFESSIONAL EXPERTISE OF PSYCHIATRISTS HAS BEEN CHALLENGED IN THE MATTER OF PREDICTING POTENTIAL DANGEROUSNESS. MOREOVER, SOME MENTAL HEALTH PROFESSIONALS HAVE SOUGHT TO PROHIBIT INVOLUNTARY PATIENT SUBJECTION TO SUCH TYPES OF THERAPY AS BEHAVIOR MODIFICATION, STERILIZATION, AND ELECTROSHOCK TREATMENTS. PSYCHIATRISTS ORDERING SUCH TREATMENT MAY BE WORKING IN THE INTERESTS OF THE INSTITUTION OR SOCIETY RATHER THAN IN THE INDIVIDUAL INTERESTS OF THE PATIENT. THESE VARIOUS PROFESSIONAL AND IDEALISTIC CONFRONTATIONS CENTER AROUND A BASIC CONFLICT OF VALUES ROOTED IN THE CONSTITUTION, SINCE THE RIGHTS OF THE MENTALLY RETARDED SEEM TO INVOLVE A CHOICE BETWEEN LIBERTY AND THE PURSUIT OF HAPPINESS. FOOTNOTES ARE PROVIDED. (MRK)