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Law Paper
11 August 2016.
Health Law in Regards to Mental Illness and Behavioral Health
Contents
Health Law and Mental Illness. 2
Law, Mental Illness, Behavioral Health, and Public Health. 3
Recent Developments in Health Laws. 4
Significance of Law in Combating Mental and Behavioral Illnesses. 5
Equal Coverage Laws or Mental Health “Parity”?. 7
Minimum Mandated Mental Health Benefits Laws. 8
Introduction
Mental disorders are a very common phenomenon and they have a direct impact on public health. Over the years, there have been steady efforts in most countries, with the United States taking the leading role, to make prevention and treatment of mental illness part of the overall public health. This initiative has led to the establishment of laws that govern the treatment and care for mental illness and behavioral health. As explained by Bartlett and Sandland, mental illnesses and behavioral disorders are typical neurobiological pathologies that are linked to certain social-environmental and heritable risk factors (34). The greatest concern regarding mental illness is that it has the highest possibility of increasing the risks of communicable as well as non-communicable diseases. In addition, mental illness and behavioral disorders greatly contribute to the intentional as well as unintentional injury. According to Appelbaum, the overall cost of mental illness goes beyond the treatment of the disease and is directly associated with poverty, social disadvantage, stigmatization, discrimination, and marginalization (33).
Health Law and ARE Mental Illness
Recent government statistics indicate that more than half of Americans with mental health conditions are not receiving the essential supports; most of them go without minimal care (Warren, Morse, and Zusman 87). Over the years, there has been a steady attempt to set up and improve laws that govern medical care for mental illness and behavioral health conditions. Currently, the U.S. Congress is working on agreed-upon mental health reforms which will set in place new laws in an attempt to improve the approach being adopted in addressing mental illness and behavioral health. These unprecedented agreements have resulted in the introduction of several mental health bills that have positive provisions designed to facilitate of the move towards mental health reforms.
Because mental health contributes significantly to the burden of diseases worldwide, there is a need for health laws to govern the care provision. Besides contributing significantly to the burden of diseases, there are a number of reasons that support the need for health laws. For instance, the longstanding stigma associated with mental illness, violent mentally ill people, public fear of victims of this health problem, poor treatment systems as well as an inadequate investment are some of the major reasons that provide justification for health laws governing care for mental disorders (Callard 45).
Meanwhile, health law provisions have played a significant role in shaping the approach adopted in mental health policies and practices across the nation. Since the early 1960s, state and federal legislatures in the United States of America have attempted to provide laws for physical as well as mental illness through parity in insurance coverage. In addition, they attempted to reduce the impact of both physical and mental illnesses through access to public accommodations and employment. On the contrary, as explained by Frost and Bonnie, over the years, both the state and federal health laws have greatly enhanced the act of coercion, an approach which has directly denied people with mental illnesses access to several types of healthcare products available to other citizens (31). However, in each effort, health laws have been used positively to enhance positive health outcomes across the country. Furthermore, health laws have been positively used to reduce the public risk that is likely to emerge from failure to offer treatment for mental illnesses and behavioral disorders (Brown 109).
Like most other developed countries across the world, America has enacted mental health laws that are frequently used as the basic receptacle for dealing with various aspects, including administrative decisions that affect people living with mental disorders or behavioral illnesses. After conducting a comprehensive literature review, Sales and Shuman concluded that in most countries, people consider mental health law as a separate entity that forms part of public health laws (121). This perception exists majorly because mental health laws have always been treated as an afterthought in every discussion on public health (Sales and Shuman 121).
Law, Mental Illness, Behavioral Health, and Public Health
As defined by Wexler, the public health law is actually the state’s legal duties and powers that are developed to ensure a healthy condition of people such as the identification, prevention, as well as amelioration of risk factors that contribute to health and safety of the population (99). Public health laws can also be considered as the limitations of the state powers that could restrain the privacy, autonomy, as well as the liberty of other people for the general purpose of protection of community health. This power is given by the express authority of the government also nicely frames all issues that form the core of the overall application of health laws to people with mental illnesses and behavioral disorders. With respect to these problems, the arising issues maybe include the duty of states to provide healthcare to all, the power of the state to coerce people to take healthcare, and the use of law to protect the public from dangerous health conditions (Myers 87). The government also has a duty to ensure that people have voluntary access to mental health care.
According to the proposal by Sales and Daniel, the framework for public health law should consist of three domains including infrastructural law, interventional law, and incidental law. In this respect, the infrastructural law should constitute the establishment of duties, powers, and institutions of public health in the country (121). On the other hand, the interventional law should constitute legal practices that are designed with the primary purpose of directly influencing mental health outcomes in the country. Lastly, the incidental law should constitute legal practices that are directly related to the overall health of the population. As explained by Wexler, three major aspects are greatly considered in contemporary mental health laws (79).
According to Brown, one of the two longstanding issues in mental health law is the limit and reach of a state’s coercive power (79). The second one is the obligation of the national government to provide mental health care to the citizens. Over the years, these two issues have assumed great prominence simply because states had an important role to play, that of being the primary care provider especially to people with mental illnesses and behavioral health problems. Although courts initially used to constrain the state‘s coercive power, this has been changed with the latest developments in mental health reform. As explained by Frost and Bonnie, with the latest developments, courts are revitalizing the states’ coercive powers in identifying and ameliorating mental health risks in the country (131).
Recent Developments in Health Laws
Since the 1960s, there has been a steady improvement in the conditions of mental health laws. These attempts have been made in order to improve the general condition of the public health sector. In America, most progress has been recorded within the last 2-3 decades. Some of the recent developments include two bills based by Congress within the last two years. First, in 2015, house representative Tim Murphy proposed introduced a bill entitled “Helping Families in Mental Health Crisis Act of 2015” which was finally passed on July 6, 2016.
In another development, a similar bill was introduced in Senate house by senators Patty Murray and Lamar Alexander earlier this year. The bill, entitled “Mental Health Reform Act of 2016”, is still being debated and has a strong chance of getting majority votes from the senators. It contains provisions that outline mental health reform strategies that would lead to an improvement in mental healthcare. In addition, it seeks to introduce potential criminal justice reforms such as mental health diversion and reentry including various changes in Medicare financing by the government.
Both bills are within the provisions and frameworks of mental health laws which have been developed in such a way as to bring benefits to the public health. For instance, the two bills will certainly improve the integration as well as program coordination across all government agencies that are meant to serve people with mental illnesses and behavioral disorders. In addition, these mental health laws are designed to improve how mental health care is provided to the public.
Significance of Law in Combating Mental and Behavioral Illnesses
One of the greatest benefits of health law especially with regards to mental illness and behavioral health is the ability to strengthen the overall community response system. With this provision in place, people who are undergoing a psychiatric crisis can be helped before their conditions become worse. Mental health laws provide a framework for specialized training to law enforcement agencies thereby allowing them to deal effectively with people with mental or behavioral sickness. They also facilitate specialized training for correcting officers and first responders thus, eventually strengthening the community’s response system to the mental crisis. Mental laws such as the two new ones in United States, the Mental Health Reform Act of 2016, and Helping Families in Mental Health Crisis Act of 2015, will provide grants and funds for enhancing crisis response services and development of psychiatric inpatient as well as their residential bed tracking to strengthen the community’s response to the crisis.
To a greater extent, mental health laws offer tremendous support to the country’s mental health workforce. By rendering this kind of support, the mental health laws ensure the availability to enough training professionals to provide help to the community’s mental crisis at any given time. It may include support to pediatric mental health professionals in both national and private health centers. Besides, it provides funds for training the professionals thus, enhancing their welfare.
According to Callard, another great sign of mental health law is that it is a sure way of combating suicide in schools, communities, and other places (95). By combating suicide caused by mental health problems and behavioral health disorders, mental health laws ensure that more lives are saved. In the United States of America, the Garrett Lee Smith Memorial Act was developed and enforced to prevent suicide at all ages as well as provide support for early prevention and intervention strategies. This suicide prevention service has been extended by the two aforementioned new acts: the Mental Health Reform Act of 2016 and Helping Families in Mental Health Crisis Act of 2015. Apart from supporting early intervention and prevention strategies for combating youth suicide, the two laws are designed to promote awareness of mental health as well as disorders caused by substance use. As a result, these mental laws have a great potential of combating youth suicide and substance abuse in colleges, campuses, and other institutions of higher learning.
If properly designed and implemented, mental health laws promote early intervention of mental and behavioral disorders. With this ability, the affected people get to access mental health care at the right time thereby promoting their wellbeing. In most developed countries such as the United States, the mental health laws provide funds for the intervention, promotion, and treatment of infants as well as early childhood mental health.
Another significance of mental health law is that it supports the integration of mental health care in the country consequently allowing the affected people to get wholesome care and treatment as opposed to focusing on one condition. In this respect, mental health laws can play a critical role of permitting Medicaid billing of health services. These statutes are also significant in dealing with mental and behavioral disorders because they support an evidence-based and promising mental care practice, which allows people to get effective support and care for their health conditions. Lastly, as explained by Warren, Morse, and Zusman, mental health laws actually clarify health privacy laws thus allowing mental health families, individuals as well as professionals to know their rights and work within that limit (88).
Equal Coverage Laws or Mental Health “Parity”?
One of the greatest significance of mental health laws is the provision of parity in mental healthcare services. In relation to the mental health and behavioral disorders, parity has everything to do with the prohibition of insurers and health care plans against discrimination of any kind in the type of coverage offered to people with mental illnesses or behavioral disorders. Because of their mental condition, there is a general attempt by some practitioners to discriminate against mentally ill people based on their mental illness, substance abuse, serious mental illness as well as other forms of physical disorders. With the provision of parity by the mental health laws, mental health insurers and health care service plan providers are required to provide the same level of benefits to the mental illnesses, substance abuse, as well as any form of physical disorder without any form of discrimination. The parity in the mental health laws actually provides a wide range of benefits such as co-payments, deductibles, visit limits, and life as well as annual limits among others. When it comes to mental health and behavioural disorders, the parity laws present a wide range of variables that directly affect the level of coverage that is required by the health laws. The parity laws directly affect insurance coverage. The state parity laws are meant to provide equal benefits, albeit to varying degrees, to the people with mental and behavioral illnesses.
Minimum Mandated Mental Health Benefit Laws
In the United States and other developed countries, many mental health laws put a mandate on some level of coverage to be provided to people with mental and behavioral illnesses as well as substance abuse problems. As explained by Appelbaum, the coverage are not considered to offer full parity simply because they admit some levels of discrepancies in terms of co-payments, deductibles, visit limits, as well as annual and lifetime limits (93). In some quotas, advocates of mental health argue that the minimum mandated mental laws are a source of compromise to the full parity provided by some levels of health care. Meanwhile, there is a general feeling from other quotas that anything apart from full parity is a source of discrimination against the mentally and physically ill people. Some of the state laws that mandate minimum mental health benefits specify deductibles and co-payments to be of equal value for physically as well as mentally ill persons.
Housing and Employment
Due to the general perception about the violence associated with this group, housing and employment constitute a critical concern for people living with mental and behavioral disorders. In most cases, they lack stable housing and employment making their life difficult for them. However, in most countries, health laws give authorities the responsibility of providing stable housing and employment to people living with mental illness and behavioral disorders. As explained by Bartlett and Sandland, when drafting the mental health laws, the stable housing and meaningful employment is seen as central components in the treatment and recovery process for the people living with mental and behavioral illnesses (84). According to various research findings investment in supportive housing and meaningful employment not only saves the state’s money in care provision but also enhances recovery while saving lives (Appelbaum 33; Callard 45; Brown 109; and Wexler 99). In the United States alone, thousands of mentally ill people are trapped in a cycle of poverty and homelessness, an indication of the dire need for the government’s provision of housing and meaningful employment.
Conclusion
Over the years, mental health services have formed a significant part of medical care in the United States; however, it has not been seen as part of public health policy. Instead, mental health services have largely been considered as an entity that is separate from the public health policymaking realm. In America and other developed countries, the object of policy discussions in state legislation concerning mental health has been centered on the costs, coverage, as well as availability of the required services. Despite the tremendous efforts being made by state legislatures, there is no consensus concerning the extent to which the government should provide medical coverage for mental illness and behavioral disorders.
Mental health laws are of great significance to a country for many reasons. First, they contribute significantly to the reduction of the burden of diseases caused by mental illnesses and behavioral disorders. In addition, they exist to govern the medical care provided to mentally ill people. These problems contribute significantly to the burden of diseases, and this is one of the reasons for the widespread enactment and enforcement of health laws that are designed to address this healthcare challenge. For instance, they address the longstanding stigma associated with mental illness, violent mentally ill, public fear of the mentally ill people, treatment system as well as inadequate investment. Indeed, these are some of the major reasons that provide a compelling justification for the enactment of health laws governing the care of mental disorders. Essentially, Mental health is an integral part of public health and therefore, it should be given due attention. The mental health laws applied to the population is largely derived from the same legal principles but focusing on the people with mental illnesses and behavioral disorders, points to the same end as health laws.
Works Cited
Appelbaum, Paul S. Law and the Disordered: The Consequences of Reform in Mental Health Law. New York: Oxford University Press, 1994. Print.
Bartlett, Peter and Sandland, Ralph. Mental Health Law: Policy and Practice. Oxford: Oxford University Press, 2013. Print.
Brown, Robert. The Approved Mental Health Professional’s Guide to Mental Health Law. London: Sage, 2016. Print.
Callard, Felicity. Mental Illness, Discrimination and the Law: Fighting for Social Justice. Chichester, West Sussex: John Wiley & Sons, 2012. Print.
Frost, Lynda E, and Bonnie, Richard J.. The Evolution of Mental Health Law. Washington, DC: American Psychological Association, 2001. Print.
Myers, John. Mental Health Law in a Nutshell. West Academic, 2015. Print.
Sales, Bruce D, and Shuman, Daniel W. Law, Mental Health, and Mental Disorder. Pacific Grove, CA: Brooks/Cole Pub, 1996. Print.
Warren, Carol A. B, Morse, Stephen J. and Zusman, Jack. The Court of Last Resort: Mental Illness and the Law. Chicago: University of Chicago Press, 1984. Print.
Wexler, David B. Mental Health Law: Major Issues. New York: Plenum Press, 1981. Print.
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