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.
Mark C. Mantooth 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. "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. "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. "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. "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 judicialresponses. The author also overlooks other significant areas of mental health law reform, such as confidentiality of patient information.

Paul S. Appelbaum

Oxford Institute for Energy Studies

German Historical Institute London

New York: Oxford University Press

United Kingdom and Ireland, United Kingdom

New York ; Oxford, 1994

1, FR, 1994

Includes bibliographical references and index.

This is an overview of the major mental health law reforms of the last generation and their consequences. Appelbaum analyses legal reforms related to involuntary hospitalisation, liability of professionals for violent acts committed by their patients, the right to refuse treatment and the insanity defence.

x, 233 p. ; 25 cm
Includes bibliographical references and index

2023-06-28